hi guys it's me Professor D and welcome back to my YouTube channel on this video we're going to be going over fluid and electrolytes this is another cahoot before we get started as always I'm going to ask you to please support me and support this channel by liking this video you're going to love it so go ahead and press that Thumbs Up Button now so you don't forget subscribe to my channel if you haven't done so already and don't forget I'm now offering Next Generation and clex review sessions you can reserve your spot by going to my website Nexus nursing institute.com while you're there be sure to check out the audio lessons I have available those audio lessons are made specifically for students who are currently in the nursing program if you have an exam coming up and you have to do really really well check to see what audio lessons I have available if excuse me if I'm covering um a subject that's going to be on your test I suggest you go ahead and grab yourself an audio lesson almost daily can find me covering a variety of nursing topics across my other social media platforms such as Tik Tok Instagram and Facebook Facebook and of course here YouTube so thank you for watching icage you I encourage you to uh check me out on my other social media platforms the name my handle is the same everywhere Nexus nursing all right guys without any further Ado let's get started fluid and electrolytes first question which electrolyte is important for keeping the resting membrane potential of skeletal smooth and cardiac muscles is it sodium pottassium calcium or magnesium we're talking about the electrolyte that's important for the resting membrane potential of skeletal smooth and cardiac muscles very good the correct answer is pottassium so that's important for you guys to know you need to know that potassium has a very narrow therapeutic range it's 3.5 to5 if the potassium is outside of that therapeutic range if the potassium is too low it's less than 3.5 it's too high it's higher than five it can cause muscle weakness it can cause cardiac dis rhythmia even death okay so potassium is a very important electrolyte to know which electrolyte influences excitability of nerve and muscle cells it's also needed for muscle contraction is it sodium calcium magnesium or phosphate what do you guys think you guys are doing pretty good on the live calcium your range for calcium the normal range therapeutic range is about 8.5 to 10.5 you know most people when they think of calcium they think of Bones and calcium is very important for the bones it keeps the bones nice and strong um keeps the Bones from being porous but calcium is also um needed it it influences the excitability of again like you saw saw nerve and muscle cells the patient if they have hypocalcemia that means the calcium is low but where guys where would it be low in the blood so if you see hypocalcemia that means the calcium is low in the blood if you see hyper calcemia that means it's high in the blood this is very important because for some reason when you guys are think about calcium you always want to think about bones so you see hypocalcemia and you're thinking the calcium is low in the bone no it's low in the bloodstream emia that ending e m a that's for bloodstream hypo low calcium emia hypocalcemia guess what remember I told you the range is 8.5 to about 10.5 when the patient calcium is low so it's lower than 8.5 patient has hypocalcemia you want to know what you may see muscle and nerve irritation patient may experience tetany right start doing this right you see the spasms of the hands if you take their blood pressure and you start seeing this that's the positive true Soul sign or you touch your cheek and you see the S going like this right that's the positive CHC sign um those are two signs that are positive for hypocalcemia make sure you guys know that all right type in your answer which serum electrolyte will decrease if the sodium calcium's elevated and it will increase if the sodium calcium is lowered so which electrolyte if the calcium's high it'll be low and if the calcium's low it will be high which electrolyte are we talking about type in your answers guys you guys are doing great on the live okay the correct answer is phosphorus phosphate um the normal range for this guys is 2.8 to 4.5 and um phosphate has a um inverse inverse relationship with calcium so when the calcium level in the blood emia right if the patient has hypercalcemia the phosphorus level below and vice versa they have an inverse relationship correct same all right type in your answer which electrolyte influences the function of neuromuscular Junction and is found in whole grains and dark green leafy veggies what electrolyte are we talking about type in your answer only three people people got this magnesium guys magnesium this is important first of all the therapeutic range for magnesium is 1.7 to 2.2 let's talk about this look at the question which electrolyte influences the function of neuromuscular Junction let's stop there neuromuscular Junction guys this is a site where the transmission for action potential this is where takes place okay so if there's something wrong with this area the transmission of that signal it's not going to go through so that was your first hint and then the rest of the question says you can find it in whole grains and dark green leafy veggies it is magnesium make sure you know that level 1.7 to 2.2 select all the applies what are the signs and symptoms of hyponatremia and hypovolemia so your patient's hyponic and hypovolemic the sodium in the blood is low and the fluid volume in the vessel is low okay what are the signs and symptoms here's our choices hypotension Tachi cardia thready pulse dry mucous membranes dark yellow urine poor skin turer this is a select all that applies there's more than one answer very good Rosie okay you guys did pretty good all of them not too many people chose dark yellow yellow urine or thre pulse okay let's talk about this let's go through all of them so I can explain why all of them are the correct answer first of all we're talking about hyponatremia and hypovolemia we know that the normal well you should know the normal sodium range is 135 to 145 if the sodium drops lower than 135 the patient's hyponic now fluid follows sodium so when the sodium is low when the sodium is low guess what else is going to be low the fluid so sodium's low fluid's low patients at risk for dehydration so let's think about what this patient's going to look like with low sodium low fluid volume first of all hypotension why I want you to think about this guys what is the blood pressure all blood pressure is is the tension that's being exerted against against the vessel so if your blood pressure is high that means there's a lot of pressure there's a lot of tension being exerted against the vessel well guess what in order for there to be a lot of tension exerted against the vessel there has to be a lot of what fluid pushing against the vessels right either that or there's a lot of vasil constriction happening that that'll also cause um the the blood pressure to go up so if the patient's hyponic gone is a sodium they're hypo volic gone is a fluid what's going to be pressing up against the vessels absolutely nothing blood pressure is going to be low so that's why hypotension makes sense let's look at takic cardia why would that heart rate increase I want you to think about this your blood pressure is low we know that the body needs oxygenated blood to survive blood carries oxygen vitamins minerals nutrients everything your tissue need to survive right okay we know that if the patient's hypovolemic fluid is low the tissues aren't getting the fluid that it needs do do you know your body's going to do no matter it's going to do anything that it can to survive it's going to try to compensate so one of the things you're going to see is heart rate go up the reason you see Tachi cardia by the way your normal heart rate is supposed to be 60 to 100 so that heart rate is going to go up higher than 100 why the rate is going to increase because it's trying to push out what oxygenated blood blood it's trying to push out fluid it's trying to push out those important nutrients that your tissue needs your body's not going to let you just plop over and die it's going to try to do whatever it can to survive it's going to try to compensate and tacky card is one of those compensatory mechanisms your heart says oh boy I don't know what's wrong but the tissues are dying let me do what I can do to help I can only do two things I can speed up or slow down it's going to speed up all right let's talk about the thread pulse Professor D you just told me that the heart rate speeds up wouldn't the pulse be strong how's the pulse GNA be strong when you ain't got no fluid just because the heart rate speeds up doesn't mean the pulse is going to be strong think about it sodium's out the window fluid's out the window so yes that heart rate went up but when you check the pulse it's going to be weak and threat nothing there how's it supposed to be strong are you guys following me on the live okay let's keep going make sure you picking up what I'm putting down dry mucous membranes we know why there's dry mucous membranes because the fluid has gone out the window you're GNA see dry mucous membranes you're going to see oliguria decrease your in output you're GNA see flat jugular veins signs and symptoms dehydration patients going to you try to check their skin turg it's going to be tented uh more than three seconds mm let's keep going dark yellow urine why would the urine be dark yellow instead of light yellow or Amber well because it's concentrated patient's dehydrated when the patient dehydrated that urine is going to be concentrated duh and of course last is poor skin turer patients got poor skin turer because they have no fluid they are dehydrated that's a sign and symptom of dehydration you guys got it I'm going to keep going all right select all that applies which foods are high in sodium select all the applies and I'm telling you right now it's more than one here are your choices we got canned foods frozen foods soups packaged Foods deli meats fresh fruits and vegetables remember your normal um range for sodiums 135 to 145 that is the therapeutic range let's say you have a patient that has hypertension or they have CHF they have a medical condition where they should not be eating foods high in sodium what are the foods you're going to tell them to stay away from you need to be able to recognize them because that's what you're going to be teaching to your patient what foods are high in sodium again your choices are canned foods frozen foods soups packaged Foods deli meats and fresh fruits and veggies I'm proud of you guys nobody chose fresh fruits and veggies very good but only 19 of you chose Frozen Foods let me tell you something if it's caned it's frozen it's any type of soup it's packaged it's wrapped in any type of plastic or or um what's that thing called um carb no not carbon I'm saying the wrong thing if it's package just know if it's packaged or any type of deli meat matter of fact how let's put it this way guys the foods that are going to be lowest in sodium are going to be the foods that are in the periphery of the store like where the fresh fruits are right where the fresh vegetables are everything in the middle that comes in a jar or that's boxed or you have those frozen foods in the middle of the store those are going to be high in sodium that's important for you to know that's right nadle no frozen blueberries the frozen blueberries even though the blueberries are fruits they're frozen so it's going to be high in sodium very good type in your answer which electrolyte can be found in canned fish with bones broccoli oranges dairy products and here's your next clue it's needed for vit um vitamin D is needed for its absorption in order to absorb this type of electrolyte you need Vitamin D it's also found in canned food uh excuse me canned fish with bones broccoli oranges and dairy products you need Vitamin D for its absorption which electrolyte am I talking about very good calcium calcium so remember guys again your therapeutic range for C calcium is 8.5 to 10.5 we know that it influences muscle and nerve contraction we know that's important for keeping the um bone strong but you need to know the sources where you can find calcium and you can find it in canned fish with bones broccoli oranges of course dairy products and something important to know is that you could take as much calcium as you want if you don't have vitamin D you're not going to be absorbing that calcium you need Vitamin D for the absorption of calcium and one of uh the biggest sources of vitamin D is what sunlight the Rays that gives you vitamin D which is the correct therapeutic range for pH balance is it 80 to 100 7.35 to 7.45 95 to 95% to 100% or 22 to 26 very good 7.35 to 7.45 that is your normal uh therapeutic range for pH now all the wrong choices you guys all got this right great job 80 to 100 that's the therapeutic range for what partial pressure of oxygen 95 to 100 that's your normal range for um O2 sat oxygen in saturation 22 to 26 M equivalents per liter that is your normal range for um for what oh my gosh give me a second guys what's the Met H3 bicarb right so um your kidneys responsible for bicarb H3 and 22 to 26 that's your normal range um I didn't have enough choices otherwise I would have put 30 to 45 that is your normal range for CO2 which organ um is responsible for CO2 your lungs okay so the lungs responsible for CO2 CO2 is 35 to 45 your kidneys is responsible for bicarb bicarb is 22 to 26 one more thing I want to mention before I go on to the next next screen when we're talking about the lungs and we know the lung's responsible for CO2 there's only two things your lungs can do two things that's it your lungs can either increase its rate or decrease its rate that's it so I want you to think about it if um the patient their respirations increase they start hyperventilating they're do this they're doing what they're blowing off CO2 but if they're breathing slows down and they're holding on what are they holding on to CO2 because again the lung's responsible for what CO2 it's either getting getting rid of it or it's holding on to it where your kidneys on the other end responsible for your byar H3 so your kidneys can shoot out a whole bunch of B carb and bring up that H3 higher than 26 or hold on to it um uh what am I saying it can shoot it out and make it higher than um 26 or the patient can lose it patient can have diarrhea remember base comes out the bud right they can have diarrhea um they can lose um some through the urine there's other ways a patient can lose um that uh bicarb where the bicarb will be lower than 22 so when it comes to the kidneys I want you to think of bicarb I want you to think of H3 and then when it comes to the lungs I want you to think of CO2 which is acidic H3 is basic all right don't say I didn't warn you you guys following me all right type in your answer which organ primarily controls the increase or decrease of CO2 oh I got ahead of myself I shouldn't have done all that teaching everybody better get this right after all that talking I just did that's what I get for being so excited um very good the lungs are responsible very good for the increase or decrease of CO2 all right type in your answer which organ primarily controls the increase or decrease of B carb that's what I get next time I'm just sticking to the questions I get excited and start teaching someone said not the lungs so they can't remember the organ but they know it's not the lungs I know some of you did not still put lungs very good kidneys some people wrote typed in renal yes when we talk about Rena we're talking about the kidneys very good correct which acidbase balance would you find in a patient with pneumonia or Airway obstruction or COPD which imbalance would they have would it be metabolic alkalosis would would it be metabolic acidosis would it be respiratory acidosis or would it be respiratory alkalosis what do you think I spelled imbalanced wrong sorry about that patient has a respiratory condition such as pneumonia Airway obstruction COPD what do you think is going on with them very good respiratory acidosis to the four people that chose respiratory alkalosis I just told you when we're talking about the lungs we're talking about CO2 which is acidic so if the patient has pneumonia they have Airway obstruction they have empyema they have bronchitis COPD they have a condition where they're holding on to C2 that means they're holding on to what acid and it's the lungs that's making them hold on to it so it's going to be respiratory acidosis guys read very carefully when you're reading these test questions because it's very easy it no it's very easy it's very easy for you to get confused and I don't want you to get confused okay which acid base imbalance would you find in a patient with severe anxiety distress acute pain uncontrollable crying what do you think would be going on with them would you suspect metabolic acidosis metabolic alkalosis respiratory acidosis or respiratory alkalosis they have severe anxiety they're in acute distress they're in acute pain they're crying uncontrollably what would you suspect that's right respiratory ossis because they're doing all that crying they're in pain they're do and they're blowing off all that CO2 and we know CO2 within itself is acidic so if they're getting rid of the acid that's going to throw them into an alkalin State and the lung's responsible for that so it's respiratory alkalosis all right oh last question thank goodness Which acid base imbalance would you find in a patient with diarrhea or keto acidosis would it be metabolic acidosis would it be metabolic alkalosis would it be respiratory alkalosis or oh wow I meant to put respiratory acidosis oh gosh all right those who chose red and green you are correct it's metabolic acidosis why base comes out the butt right so patients got diarrhea they're losing all of their base so that leaves you with what acid and we know it's not the lungs doing it right so it's metabolic we talk about the kidneys kidneys acidosis okay guys you did a great job let's see how you guys um fared