Chloride, often seen as "four-eyed chloride" for being nerdy and behind the scenes, is crucial in the body.
Hyperchloremia: Chloride levels
Elevated chloride levels in blood (> 107).
Function: Assists sodium in maintaining blood volume, blood pressure, and pH balance of body fluids.
Causes of Hyperchloremia
Hypernatremia: High sodium levels (chloride follows sodium).
Dehydration: Causes hemoconcentration (e.g., severe diarrhea leading to metabolic acidosis).
Trauma or Head Injury
Metabolic Acidosis
Hyperparathyroidism
Respiratory Alkalosis: Hyperventilating, blowing off too much CO2, resulting in alkalosis.
Signs and Symptoms
Cardiovascular System
Hypertension: High blood pressure
EKG abnormalities: Dysrhythmias
Respiratory System
Tachypnea: Rapid, deep respirations
Respiratory Alkalosis: Due to hyperventilation (blowing off too much CO2)
Neurological System
Increased intracranial pressure (ICP)
Cognitive changes: Altered level of consciousness (LOC)
Gastrointestinal and Urinary Systems
Diarrhea
Diuresis: Increased urination
Musculoskeletal System
Lethargy, fatigue, and weakness
Severe cases can lead to inability to move due to extreme muscle bloat
Nursing Interventions for Hyperchloremia
Treat the Underlying Causes
Restore Fluid Balance
IV fluids: Lactated Ringer’s or Normal Saline
Administer Sodium Bicarbonate
Helps to even out chloride levels
Summary
Understanding hyperchloremia involves recognizing its close relationship with sodium, identifying its causes, noting the signs and symptoms, and knowing the right nursing interventions to restore balance.