Fluid and Electrolytes in Nursing

Introduction

• Importance of fluid and electrolyte balance in the body.
• 70% of the body is water; crucial roles in the brain, muscles, bones, and blood.
• Main electrolytes discussed: potassium, sodium, chloride, calcium, phosphate, and magnesium.

Functions of Electrolytes

• Muscle contraction
• Nerve impulses
• Bone formation
• Fluid balance via osmosis
• Acid-base balance in blood

Maintenance of Electrolyte Balance

• Obtained through food and drink; absorbed in the gut.
• Kidneys play a crucial role in filtering blood and maintaining electrolyte levels.
• Renal issues can cause electrolyte imbalances; dialysis may be required.
• Diuretics can impact electrolyte levels.

Causes of Electrolyte Imbalance

• Trauma, blood loss, burns, vomiting, diarrhea, NG suction.
• Hormonal imbalances e.g., aldosterone, ADH.

Sodium

• Normal levels: 135-145 mEq/L
• Hyponatremia: < 135 mEq/L
  • Causes: Low sodium intake, diuretics, GI losses, Addison’s disease, SIADH.
  • Symptoms: Seizures, lethargy, confusion, cramps, orthostatic hypotension.
• Hypernatremia: > 145 mEq/L
  • Causes: Cushing's syndrome, Conn's syndrome, dehydration, diabetes insipidus.
  • Symptoms: Fatigue, restlessness, extreme thirst, decreased urine output.

Chloride

• Normal levels: 95-105 mEq/L
• Maintains acid-base balance, aids digestion, fluid balance.
• Hypochloremia: Low chloride levels often coincide with hyponatremia.
• Hyperchloremia: Often associated with hypernatremia.

Potassium

• Normal levels: 3.5-5 mEq/L
• Involved in muscle contraction and nerve impulses.
• Hypokalemia: < 3.5 mEq/L
  • Causes: Diuretics, corticosteroids, insulin overdose, GI losses.
  • Symptoms: Lethargy, muscle weakness, abnormal heart rhythms.
• Hyperkalemia: > 5 mEq/L
  • Causes: Burns, tissue damage, Addison’s disease, renal failure.
  • Symptoms: Muscle weakness, respiratory failure, cardiac issues.

Calcium

• Normal levels: 8.5-10.5 mg/dL
• Crucial for bone health, nerve conduction, muscle contractions, blood clotting.
• Regulated by vitamin D, parathyroid hormone, calcitonin.
• Hypocalcemia:
  • Causes: Parathyroid surgery, low vitamin D, bisphosphonates, renal disease.
  • Symptoms: Cramps, convulsions, muscle spasms, positive Trousseau and Chvostek's signs.
• Hypercalcemia:
  • Causes: Overactive parathyroid, high vitamin D, bone cancer.
  • Symptoms: Muscle weakness, EKG changes, kidney stones.

Magnesium

• Normal levels: 1.5-2.5 mg/dL
• Works with sodium-potassium pump, muscle relaxation, blood pressure regulation.
• Hypomagnesemia:
  • Causes: Poor intake, malabsorption, alcoholism, proton pump inhibitors.
  • Symptoms: Muscle twitching, hyperactive reflexes, cardiac issues.
• Hypermagnesemia:
  • Causes: Excess magnesium supplementation, renal failure.
  • Symptoms: Lethargy, prolonged EKG intervals, respiratory issues.

Phosphate

• Normal levels: 2.5-4.5 mg/dL
• Important for bone health, energy production.
• Hypophosphatemia:
  • Causes: Antacid overuse, starvation, hyperparathyroidism.
  • Symptoms: Bone pain, neuro changes, red blood cell destruction.
• Hyperphosphatemia:
  • Causes: Renal failure, excessive vitamin D.
  • Symptoms: Similar to hypocalcemia, itching (common in renal failure).

Conclusion

• Understanding fluid and electrolyte balance is essential for nursing care.
• Access further resources and quizzes for more detailed study.