Fluid and Electrolytes for Nurses

Introduction

• Importance of fluid and electrolyte balance in the body for life maintenance.
• 70% of the body is water, crucial for nutrient transport, muscle function, blood composition.
• Electrolytes in blood create electrical charges (ions) essential for body signaling.

Key Electrolytes

• Potassium, Sodium, Chloride, Calcium, Phosphate, Magnesium
• Functions: muscle contraction, nerve impulses, bone creation, fluid balance, acid-base balance.

Electrolyte Balance and Maintenance

• Intake: Mostly from food, absorbed in the gut.
• Kidney Function: Filters blood, balances electrolytes.
  • Renal issues can cause imbalances.
• Imbalances: Result from trauma, blood loss, burns, vomiting, diarrhea, diseases (aldosterone, ADH issues).

Sodium (Na)

• Role: Regulates water balance, muscle contraction, nerve impulses.
• Normal levels: 135-145 mEq/L.
• Imbalances:
  • Hyponatremia (<135 mEq/L): Causes include low sodium intake, diuretics, GI loss, Addison's disease, SIADH.
    • Symptoms: Seizures, stupor, lethargy, cramps, orthostatic hypotension, shallow respirations, muscle spasms.
  • Hypernatremia (>145 mEq/L): Causes include Cushing's syndrome, excessive intake, dehydration.
    • Symptoms: Fatigue, restlessness, increased thirst, decreased urine, dry skin.

Chloride (Cl)

• Role: Acid-base balance, fluid balance, digestion.
• Normal levels: 95-105 mEq/L.
• Imbalances:
  • Hypochloremia: Causes include GI loss, diuretics, cystic fibrosis, SIADH.
    • Symptoms: Overlap with hyponatremia, dehydration signs.
  • Hyperchloremia: Causes include high sodium, dehydration, metabolic acidosis.
    • Symptoms: Similar to hypernatremia.

Potassium (K)

• Role: Muscle contraction, nerve impulses.
• Normal levels: 3.5-5 mEq/L.
• Imbalances:
  • Hypokalemia: Causes include diuretics, insulin, GI loss, Cushing's syndrome.
    • Symptoms: Lethargy, low respirations, arrhythmias, leg cramps, low BP.
  • Hyperkalemia: Causes include burns, renal failure, medications.
    • Symptoms: Muscle weakness, low urine, respiratory failure, rhythm changes.

Calcium (Ca)

• Role: Bone health, muscle/nerve function, clotting.
• Normal levels: 8.5-10.5 mg/dL.
• Imbalances:
  • Hypocalcemia: Causes include surgery, low intake, low vitamin D, CKD.
    • Symptoms: Cramps, convulsions, arrhythmias, positive signs (Trousseau's, Chvostek's).
  • Hypercalcemia: Causes include hyperparathyroidism, vitamin D excess, cancer.
    • Symptoms: Weakness, EKG changes, absent reflexes, kidney stones.

Magnesium (Mg)

• Role: Nerve/muscle function, blood pressure regulation.
• Normal levels: 1.5-2.5 mg/dL.
• Imbalances:
  • Hypomagnesemia: Causes include low intake, alcoholism, malabsorption.
    • Symptoms: Twitching, tetany, hypertension.
  • Hypermagnesemia: Causes include renal failure, excessive supplementation.
    • Symptoms: Lethargy, EKG changes, hypotension, confusion.

Phosphate (PO4)

• Role: Bone/teeth health, cell energy.
• Normal levels: 2.5-4.5 mg/dL.
• Imbalances:
  • Hypophosphatemia: Causes include antacids, starvation, hyperparathyroidism.
    • Symptoms: Bone pain, neuro changes, RBC destruction.
  • Hyperphosphatemia: Causes include renal failure, excess vitamin D, rhabdomyolysis.
    • Symptoms: Similar to hypocalcemia, itching.

Conclusion

• Understanding these electrolytes is vital for effective nursing care and intervention.
• Further learning with individual electrolyte videos and quizzes suggested.