Fluid and electrolyte balance is a dynamic process that is crucial for life and homeostasis. Show
HomeostasisHomeostasis is the dynamic process in which the body maintains balance by constantly adjusting to internal and external stimuli. Negative and Positive Feedback
Systems Involved in Feedback The major systems involved in feedback are the nervous and endocrine systems.
Body FluidsFluids make up a large portion of the body, which is approximately 50%-60% of the total body weight. Location of Fluids
Fluid Regulation Mechanisms
Normal Intake and Output
Overhydration and Edema
Dehydration
ElectrolytesAn electrolyte is a substance that will disassociate into ions when dissolved in water.
Fluid and Electrolyte TransportTotal electrolyte concentration affects the body’s fluid balance.
Permeability of Membranes
Passive Transport
Active Transport
Fluid and Electrolyte BalanceFluid and electrolyte balance is vital for proper functioning of all body systems.
Acid-Base BalanceAcid-base balance is another important aspect of homeostasis. Acid, Bases, and Salts
Potential of Hydrogen
Buffers
ClassificationThere are different fluid volume disturbances that may affect an individual.
Disturbances in electrolyte balances are common in clinical practice and must be corrected.
PathophysiologyNurses need an understanding of the pathophysiology of fluid and electrolyte balance to anticipate, identify, and respond to possible imbalances.
CausesCauses of fluid and electrolyte imbalances are discussed below in general.
Clinical ManifestationsSigns and symptoms that occur in fluid and electrolyte imbalances are discussed below.
ComplicationsFluid and electrolyte imbalances could result in complications if not treated promptly.
Assessment and Diagnostic FindingsThe following are laboratory studies useful in diagnosing fluid and electrolyte imbalances:
Medical ManagementTreatment of fluid and volume imbalances needs accuracy to avoid consequences that can result in complications.
Pharmacologic therapy
Nursing ManagementNurses may use effective teaching and communication skills to help prevent and treat various fluid and electrolyte disturbances. Nursing AssessmentClose monitoring should be done for patients with fluid and electrolyte imbalances.
DiagnosisThe following diagnoses are found in patients with fluid and electrolyte imbalances.
Nursing Care Planning & GoalsMain Article: 10 Fluid And Electrolyte Imbalances Nursing Care Plans Planning and goals for fluid and electrolyte imbalances include:
Nursing InterventionsThere are specific nursing interventions for fluid and electrolyte imbalances that can aid in alleviating the patient’s condition.
EvaluationEvaluation of the care plan can check the effectiveness of the treatments. The interventions are deemed effective if the client has:
Discharge and Home Care GuidelinesAfter hospitalization, treatment and maintenance of the condition must continue at home.
Documentation GuidelinesData should be documented for future medical and legal references. The nurse must document:
Practice Quiz: Fluids and ElectrolytesHere’s a 10-item quiz about the study guide. Please visit our nursing test bank page for more NCLEX practice questions. 1. ECF is primarily composed of: A. Aqueous fluid and lymphatic fluid. 2. A chemical set up to resist changes, particularly in the level of pH, is: A. A base. 3. Water moves across a semipermeable membrane via which process? A. Active transport. 4. To balance water output, an average adult must have daily fluid intake of approximately: A. 500-900 ml. 5. The primary organs involved in pH regulation are: A. Kidneys and lungs. 6. A clinical manifestation not found in hypokalemia is: A. Muscle weakness 7. The nurse should expect that a patient with mild fluid volume excess would be prescribed a diuretic that blocks sodium reabsorption in the distal tubule, such as: A. Bumex 8. Nursing intervention for a patient with a diagnosis of hyponatremia includes all of the following except: A. Assessing for symptoms of nausea and malaise. 9. To supplement a diet with foods rich in potassium, the nurse should recommend the addition of: A. Fruits such as bananas and apricots 10. The most characteristic manifestation of hypocalcemia and hypomagnesemia is: A. Anorexia and nausea. Answers and Rationale 1. Answer: C. Interstitial and intravascular fluids.
2. Answer: B. A buffer.
3. Answer: D. Osmosis.
4. Answer: C. 2,000-3,000 ml.
5. Answer: A. Kidneys and lungs.
6. Answer: B. Oliguria
7. Answer: D. Lasix
8. Answer: B. Encouraging the intake of low-sodium liquids such as coffee or tea.
9. Answer: A. Fruits such as bananas and apricots
10. Answer: D. Tetany
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[sc name=”Affiliate_MedicalSurgical”] Which clinical manifestations would the nurse identify when assessing a client with hypercalcemia?Hypercalcemia. The signs and symptoms include muscle weakness, constipation, anorexia, nausea and vomiting, dehydration, hypoactive deep tendon reflexes lethargy, calcium stones, flank pain, pathologic fractures, and deep bone pain.
Which clinical manifestations does the nurse expect to find in a patient who has a febrile Nonhemolytic reaction after receiving a blood transfusion?Patients present with an unexpected temperature rise (≥38°C or ≥1°C above baseline, if baseline ≥37°C) during or shortly after transfusion. This is usually an isolated finding. The symptoms of an FNHTR may also include chills, rigors, increased respiratory rate, change in blood pressure, anxiety and a headache.
Which clinical manifestations does the nurse find in a patient with hypomagnesemia?Symptoms and Signs of Hypomagnesemia
Some patients are asymptomatic. Clinical manifestations include anorexia, nausea, vomiting, lethargy, weakness, personality change, tetany (eg, positive Trousseau or Chvostek sign or spontaneous carpopedal spasm, hyperreflexia), and tremor and muscle fasciculations.
Which signs is an indicator of fluid volume imbalance in a patient?An elevated blood pressure and bounding pulses are often seen with fluid volume excess. Decreased blood pressure with an elevated heart rate and a weak or thready pulse are hallmark signs of fluid volume deficit.
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