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Fluids & Electrolytes

Nio Cruzada Noveno, RN, MAN, MSN
FLUIDS and ELECTROLYTES

BODY FLUIDS
Functions of Fluids

o Body fluids:
o Facilitate in the transport
[nutrients, hormones proteins, & others…]
o Aid in removal of cellular metabolic wastes
o Provide medium for cellular metabolism
o Regulate body temperature
o Provide lubrication of musculoskeletal
joints
o Component in all body cavities
[parietal, pleural fluids]

Water is the principal body fluid & essential for life.
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FLUIDS and ELECTROLYTES

BODY FLUIDS

Distribution of Body Fluids: 50-70% of total body weight;
infant [70-80%], elderly [45-50%]

ICF ECF
60-kg man
TBW = 0.6 x 60 kg = 3.6 L

ECF
P IS ICF = 0.4 x 60 kg = 24 L
=12 L

3L 9L

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40% TBW 20% TBW
FLUIDS and ELECTROLYTES

BODY FLUIDS

Factors that Dictate Body Water Requirement

1) Amount needed to give the proper osmotic
concentration
2) Amount needed to replace water lost excretion
Normal Routes of water gain and loss
INTAKE ml/day OUTPUT ml/day

Fluid intake 1,500 Insensible loss 400
Food 800 Sweat 600
Metabolic water 300 Feces 100
Urine 1,500
4
TOTAL
nionoveno@yahoo.com 2,600 TOTAL 2,600
Renal Disorders
FLUIDS and ELECTROLYTES

FLUID EXCHANGE BETWEEN BODY FLUID
COMPARTMENTS

ICF ECF

Osmotic Pressure Gradient

Oncotic P (Colloid osmotic P)

Capillary P (Hydrostatic P)

P ISF
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FLUIDS and ELECTROLYTES

Control of Osmotic Pressure, Volume & Electrolyte
Concentration

OBLIGATORY Reabsorption
o occurs in the proximal tubules
o 178 L/day of glomerular filtrate (80%
reabsorbed)
o 2° to solute reabsorption
o independent of the water requirement

FACULTATIVE Reabsorption
o occurs in the distal & collecting tubules
o independent of the active solute transport
o dependent of body’s need of water
6 o under the control of ADH
nionoveno@yahoo.com Renal Disorders
FLUIDS and ELECTROLYTES

DISTURBANCES IN FLUID BALANCE

EDEMA (Dropsy)

ο ↑ in the interstitial fluid volume of about 2 L or
more due to increase transudation of fluid from
capillaries 2° to:

o Increased HP [pregnancy, CHF]

o Decreased OP
[malnutrition, end-stage liver disease,
nephrotic syndrome]

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FLUIDS and ELECTROLYTES

DISTURBANCES IN FLUID BALANCE

CELL OVERHYDRATION

o excess of water in the ECC w/ a normal amount of
solute or a deficient amount of solute

o occurs in prolonged and excessive diuresis, forcing
hypotonic fluids to produce diuresis in the
presence of renal impairment

o fluid overload from ↑ production of adrenal
corticoid hormones [Cushing’s syndrome]

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FLUIDS and ELECTROLYTES

DISTURBANCES IN FLUID BALANCE

CELL OVERHYDRATION

o Symptoms
o Weight gain & edema
o Cough, moist rales, dyspnea
[fluid congestion in lungs]
o CVP, bounding pulse, neck vein engorgement
[fluid excess in the vascular system]
o Bulging fontanelles
ο ↓ Hg and Hct
o Nausea & vomiting

9 nionoveno@yahoo.com Renal Disorders
FLUIDS and ELECTROLYTES

DISTURBANCES IN FLUID BALANCE

CELL OVERHYDRATION

o Management
o Restrict fluids to lower fluid volume
o Diuretics or hypertonic saline
o Continuous assessments to prevent skin
breakdown
o Record daily weight to assess progress of
treatment

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FLUIDS and ELECTROLYTES

DISTURBANCES IN FLUID BALANCE

CELL DEHYDRATION (DHN)

o loss of body fluids, particularly from the extracellular
fluid compartment
o water loss > water intake

o Causes
o Fever
o Insufficient water intake
o Diarrhea, vomiting
o Excess urine output [Diabetes insipidus, diuretics]
o Excessive perspiration, burns
o Hemorrhage, shock, metabolic acidosis
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FLUIDS and ELECTROLYTES

DISTURBANCES IN FLUID BALANCE

CELL DEHYDRATION (DHN)

o Symptoms
o Thirst, dry mucus membranes, sunken
eyeballs
o “Doughy“ abdomen, dry skin w/ poor turgor
ο ↑ temp, weight loss
ο ↑ HR, ↑ RR, ↓ BP
o Restlessness,irritability, disorientation,
convulsion, coma [22-30% body H20 loss]
o Management
o Fluid replacement therapy & continued fluid
12 maintenance
nionoveno@yahoo.com Renal Disorders
FLUIDS and ELECTROLYTES

Volume Disorders 2° Alteration in Sodium Balance
Volume ECF ICF Water Conditions
Disorder Vol. Vol. Shift

Expansion
Isotonic Inc N No net change Isotonic fluid
ingestion
Hypertonic Inc Dec ICF → ECF Sea water
ingestion
Hypotonic Inc Inc ECF → ICF Hypotonic IVF

Contraction
Isotonic Dec N No net change Diarrhea
Hypertonic Dec Dec ICF → ECF Diabetes insipidus
Hypotonic Dec Inc ECF → ICF Addison’s dse

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FLUIDS and ELECTROLYTES

ELECTROLYTES

o salts or minerals in extracellular or intracellular
body fluids

o Sodium – major cation of ECF

o Potassium – major cation of ICF

o Chloride - major anion of ICF

o Protein – in ICF > ISF

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FLUIDS and ELECTROLYTES

ELECTROLYTE Composition

Electrolyte Conc Plasma (mEq/L) ISF ICF

Sodium, Na+ 142 141 10
Potassium, K+ 5 4.1 150
Calcium, Ca++ 5 4.1 -
Magnesium, Mg++ 3 3 40
(155)
Chloride, Cl- 103 115 15
Bicarbonate, HCO3- 27 29 10
Biphosphate, HPO4- 2 2 100
Sulfate, SO4- 1 1 20
Protein 16 1 60
Organic foods 6 3.4 -
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(155)
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FLUIDS and ELECTROLYTES

ELECTROLYTES

Functions of Electrolytes

o Contribute most of the osmotically active
particles in body fluids

o Provide buffer systems for pH regulation

o Provide the proper ionic environment for
normal neuromuscular irritability & tissue
function

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FLUIDS and ELECTROLYTES

ELECTROLYTES
Hyponatremia [Na+ < 135 mEq/L; Normal = 135-145 mEq/L]

o Causes
ο ↓ Na+ intake
ο ↑ Na+ excretion [diaphoresis, GI suctioning]
o Adrenal insufficiency

o Assessment
o N & V, abdominal cramps, weight loss
o Cold, clammy skin, ↓ skin turgor
o Apprehension, HA, convulsions, focal
neurologic deficit, coma [cerebral edema]
o Fatigue, postural hypotension
17 o Rapid thready pulse
nionoveno@yahoo.com Renal Disorders
Hyponatremia
Drugs that cause decreased sodium
Antineoplastics:
Anti-convulsant: Cyclophosphamide
Carbamazepine Vincristine

Antidiabetics: Diuretics:
Chlorpropramide Bumetanide
Tolbutamide Ethacrynic acid
Furosemide
Antipsychotics: Thiazides
Fluphenazine
Thiozoridazine Sedatives:
Thiothixene Barbiturates
Morphine

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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hyponatremia [Na+ < 135 mEq/L; Normal = 135-145 mEq/L]

Management
o Provide foods high in sodium
o Administer NSS IV
o Assess blood pressure frequently
[measure lying down, sitting & standing]
o High sodium foods
o Celery
o Cheeses
o Condiments
o Processed foods
o Smoked meats
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o Snack foods
Treatment
Interventions
Mild
Water restriction if water retention
problem
 Increase Na in foods if loss of Na
Moderate
IV 0.9% NS, 0.45% NS, LR
Severe
3% NS – short-term therapy in ICU
setting
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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hypernatremia [Na+ >145 mEq/L; Normal = 135-145 mEq/L]

o Causes
o Excessive, rapid IV adm’n of NSS
o Inadequate water intake
o Kidney disease

o Assessment
o Dry, sticky mucus membranes
o Flushed skin
o Rough dry tongue, firm skin turgor
o Intense thirst
o Edema, oliguria to anuria
21 o Restlessness, irritability [cerebral DHN]
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Hypernatremia

Skin flushed
Agitation
Low-grade fever
Thirst
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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hypernatremia [Na+ >145 mEq/L; Normal = 135-145 mEq/L]

o Nursing Intervention
o Weigh daily
o Assess degree of edema frequently
o Measure I & O
o Assess skin frequently & institute nursing
measures to prevent breakdown
o Encourage sodium-restricted diet

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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hyperkalemia [K+ > 5.5 mEq/L; Normal = 3.5-5.5 mEq/L]

o Causes
o Renal insufficiency
o Adrenocortical insufficiency
o Cellulose damage [burns]
o Infection
o Acidotic states
o Rapid infusion of IV sol’n w/ potassium-
conserving diuretics

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Hyperkalemia
Drugs that increase potassium

ACE inhibitors NSAIDs

Antibiotics Spironolactone

Beta blockers Chemotherapeutics

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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hyperkalemia [K+ > 5.5 mEq/L; Normal = 3.5-5.5 mEq/L]

o Assessment
o Thready, slow pulse
o Shallow breathing
o N & V, diarrhea, intestinal colic
o Irritability
o Muscle weakness, flaccid paralysis
o Numbness, tingling
o Difficulty w/ phonation, respiration

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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hyperkalemia [K+ > 5.5 mEq/L; Normal = 3.5-5.5 mEq/L]

o Nursing Interventions
o Administer kayexalate as ordered
o Administer/monitor IV infusion of glucose &
insulin
o Control infection
o Provide adequate calories & carbohydrates
o Discontinue IV or oral sources of K+

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FLUIDS and ELECTROLYTES
ELECTROLYTES

Hypokalemia [K+ < 3.5 mEq/L; Normal = 3.5-5.5 mEq/L]

o Causes
o Renal tubule defects
o Prolonged diuretic therapy
o Prolonged vomiting, diarrhea, laxative use,
NG suctioning, severe diaphoresis
o Anorexia
o Acute alcoholism
o Hyperaldosteronism, excessive steroids
o Metabolic alkalosis
o Administration of potassium-deficient
hyperalimentation sol’n, hypertonic glucose
o Excessive amounts of insulin
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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hypokalemia [K+ < 3.5 mEq/L; Normal = 3.5-5.5 mEq/L]

o Assessment
o Thready, rapid, weak pulse
o Faint heart sounds
ο ↓ BP
o Skeletal muscle weakness
ο ↓ or absent reflexes
o Shallow respirations
o Malaise, apathy, lethargy
o Loss of orientation
o Anorexia, vomiting, weight loss
o Gaseous intestinal distention
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Hypokalemia
Skeletal muscle weakness
U-wave
Constipation; ileus
Toxic effects of digoxin
Irregular, weak pulse
Orthostatic hypotension
Numbness [paresthesia]
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Hypokalemia
Drugs that decrease potassium

Adrenergics:
Albuterol Cisplatin
Epinephrine Costicosteroids
Antibiotics: Diuretics:
Amphotericin B Furosemide
Carbenicillin Thiazides
Gentamicin Laxatives [excess use]
Insulin

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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hypokalemia [K+ < 3.5 mEq/L; Normal = 3.5-5.5 mEq/L]

o Nursing Interventions
o Administer K+ supplements to replace losses
o Be cautious in administering drugs that are not
potassium-sparing
o Monitor acid-base balance
o Monitor pulse, BP and ECG
o High potassium foods
o Avocados
o Bananas
o Dates
o Oranges
o Potatoes
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o Raisins
FLUIDS and ELECTROLYTES

ELECTROLYTES

Hypercalcemia [Ca > 5.8 mEq/L; Normal = 4.5-5.8 mEq/L]

o Causes
o Hyperparathyroidism
o Immobility
o Increased vitamin D intake
o Osteoporosis & osteomalacia [early stages]

o Assessment
o N & V, anorexia, constipation
o Headache, confusion
o Lethargy, stupor
o Decreased muscle tone
33 o Deep bone/flank pain
nionoveno@yahoo.com Renal Disorders
Hypercalcemia
Drugs that increase calcium

Calcium-containing antacids
Calcium preparations
Lithium
Thiazide diuretics
Vitamin A
Vitamin D

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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hypercalcemia [Ca > 5.8 mEq/L; Normal = 4.5-5.8 mEq/L]

o Nursing Interventions
o Encourage mobilization
o Limit vitamin D intake
o Limit calcium intake
o Normal saline
o Administer diuretics
o Calcitonin

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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hypocalcemia [Ca < 4.5 mEq/L; Normal = 4.5-5.8 mEq/L]

o Causes
o Acute pancreatitis
o Diarrhea
o Hypoparathyroidism
o Lack of vitamin D in the diet
o Long-term steroid therapy

o Assessment
o Painful tonic muscle & facial spasms
o Fatigue, dyspnea
o Laryngospasm, convulsions
36 o (+) Trousseau’s and Chvostek’s signs
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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hypocalcemia [Ca < 4.5 mEq/L; Normal = 4.5-5.8 mEq/L]

o Nursing Interventions
o Administer oral Ca lactate or IV CaCl2 or
gluconate
o Providing safety by padding side rails
o Administer dietary sources of calcium
o Vitamin D
o Provide quiet environment
o High calcium foods
o Milk
o Dairy products

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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hyermagnesemia [Mg > 3.0 mEq/L; Normal = 1.5-3.0 mEq/L]

o Causes
o Renal insufficiency, dehydration
o Excessive use of Mg-containing antacids or
laxatives
o Assessment
o Lethargy, somnolence, confusion
o N&V
o Muscle weakness, depressed reflexes
ο ↓ pulse and respirations
o Nursing Intervention
o Withhold Mg-cont’g drugs/foods; Ca adm’n
38 ο ↑ fluid intake, unless CI
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FLUIDS and ELECTROLYTES

ELECTROLYTES

Hypomagnesemia [Mg < 1.50 mEq/L; Normal = 1.5-3.0 mEq/L]

o Causes
o Low intake of Mg in the diet
o Prolonged diarrhea
o Massive diuresis
o Hypoparathyroidism
o Assessment
o Paresthesias, muscle spasm
o Confusion, hallucination, convulsions
o Ataxia, tremors, hyperactive deep reflexes
o Flushing of the face, diaphoresis
o Nursing Intervention
39 o Provide good dietary sources of Mg
nionoveno@yahoo.com Renal Disorders
Hypomagnesemia
Drugs that decrease magnesium
Aminoglycoside: Insulin
Amikacin, gentamicin,
streptomycin,
tobramycin Laxative

Amphotericin B Loop diuretics

Cisplatin
Pentamidine
isethionate
Cyclosporine

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Hypomagnesemia
Seizures
Tetany
Anorexia & arrhythmias
Rapid heart rate
Vomiting
Emotional lability
Deep tendon reflexes increased
[tremors, twitching, tetany]
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Dietary sources
Chocolates
Dry beans and peas
Green, leafy vegetables
Meats
Nuts
Seafood
Whole grains

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FLUIDS and ELECTROLYTES

IV FLUID REPLACEMENT THERAPY

Indications

o Replacement of abnormal fluid & electrolyte
losses [surgery, trauma, burns, GI bleeding]

o Maintenance of daily fluid & electrolyte
needs

o Correction of fluid disorders

o Correction of electrolyte disorders
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FLUIDS and ELECTROLYTES

IV FLUID REPLACEMENT THERAPY

Types of Solutions

o Isotonic
o 0.9% sodium chloride (NSS)
o Lactated Ringer’s sol’n
o Hypotonic
o 5% dextrose and water (D5W)
o 0.45% sodium chloride
o 0.33% sodium chloride
o Hypertonic
o 3% NaCl
o Protein sol’ns
o Colloids
44 o Salt poor albumin Plasmanate, DextranRenal Disorders
nionoveno@yahoo.com
BURNS

BURNS

 wounds caused by excessive exposure to the
following agents or causes:

Causes of Burns:

o Thermal [moist or dry heat]
o Electrical
o Chemical [strong acids and strong alkali]
o Radiation [UV, x-rays, radium, sunburns]

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BURNS

CLASSIFICATION OF BURNS

o Superficial Partial thickness (1st degree)
o Outer layer of dermis
o Erythema, pain up to 48 hrs
o Healing 1-2 wks [sunburn]
o Deep Partial thickness (2nd degree)
o Epidermis & dermis
o Blisters & edema, frequently quite painful
o Healing 14-21 days
o Full thickness (3rd degree)
o Epidermis, dermis, subcutaneous fat
o Dry, pearly white or charred in appearance
o Not painful
o Eschar must be removed; may need grafting
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46 Renal Disorders
BURNS

STAGES OF BURNS

1st : Shock/Fluid Accumulation Phase

o 1st 48 hrs
o IVC → ISC
o Generalized DHN [fluid shifting]
o Hypovolemia [plasma loss], ↓ BP, ↓ C.O.
o Hemoconcentration, ↑ Hct [liquid blood
component → ISC]
o Oliguria [↓ renal perfusion], ADH release &
aldosterone
o HyperK, hypoNa
o Metabolic acidosis
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BURNS

STAGES OF BURNS

2nd : Diuretic/Fluid Remobilization Phase

o After 48 hrs
o ISC → IVC
o Hypervolemia,
o Hemodilution, ↓ Hct
o Diuresis [↑ renal perfusion], ↓ ADH & aldosterone
secretion
o HypoK, hypoNa [K moves back into the cells, Na+
still trapped in the edema fluids
o Metabolic acidosis

48 nionoveno@yahoo.com Renal Disorders
BURNS

STAGES OF BURNS

3rd : Recovery Phase

o 5th day onwards
o Hypocalcemia
o Ca is lost on the exudates
o Ca is utilized in the granulation tissue
formation
o Negative nitrogen balance
o Due to stress response
ο ↑ protein catabolism
o Protein intake is lesser than the demand
o HypoK
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BURNS

ASSESSMENT

1. Assess extent of body surface burned
o Greater morbidity & mortality for burns affecting
face, hands & perineum
o Assess for dyspnea, stridor, hoarseness

1. Assess extent of burn injury
o Rule of nine – immediate appraisal
o Lund-Browder chart – more accurate
o Berkow’s method – based on client’s age &
changes that occur in proportion of head & legs
to the rest of the body as one grows

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BURNS

ASSESSMENT
9%

Front=18%
9% Back=18% 9%

1%
Burn Evaluation Chart
18% 18%

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BURNS

ASSESSMENT

3. Assess depth of burn
o Major burns – 2nd degree over 30% of body
o Hospitalization - eyes, face, neck, hands,
perineum, genitalia

4. Assess unique contributing factors
o Age of client
o Health history
o Diabetes, preexisting ulcers
o Tetanus immunization

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BURNS

EMERGENCY MANAGEMENT

Stop the burning process
o Remove patient from source of injury
o Advise client to roll on the ground if clothing is in
flame [STOP-DROP-ROLL]
o Throw a blanket over the client to smother the
flame
o Remove clothing only if hot or for scald burn
o Immerse affected part in cold water [10 min]
o Irrigate copiuosly w/ large amount of running
water w/ chemical burns [except w/ phosphorus]
o Interrupt power source w/ electrical burn

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BURNS

MANAGEMENT

o Maintenance of adequate airway

o Promoting comfort: relieve pain

o Promoting fluid-electrolyte, acid-base balance

o Preventing infection

o Maintaining adequate nutrition

o Wound care

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BURNS

METHODS OF TREATING BURNS

o Open method or Exposure method
o Face, neck, perineum, trunk
o Allowing exudate to dry in 3 days

o Occlusive
o Less pain, absorption of secretion, comfort,
transportability, accelerated debridement
o Aesthetic considerations

o Semi-open method
o Covering of wound w/ topical antimicrobials:
o Silver sulfadiazine 1% (Flamazine)
o Silver nitrate 0.5% sol’n
o Mafenide acetate (sulfamylon acetate)
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BURNS

BIOLOGIC DRESSING (Skin Graft)

o Allograft
o Skin taken from other person [cadaver]

o Autograft
o Same person

o Heterograft
o Different species
o Xenograft
[segment of skin from animal such as pig or dog]

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BURNS

FLUID REPLACEMENT

Types of fluids:

o Colloids
o Blood
o Plasma & plasma expanders

o Electrolytes
o Lactated Ringers

o Non-electrolyte
o D5W

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BURNS

FLUID REPLACEMENT

EVAN’S Formula:
o C – 1ml x % burns x kg BW
o E - 1ml x % burns x kg BW
o Glucose 5% for insensible loss – 2,000ml D5W

 Administer sol’n 1st 24 hrs – ½ [1st 8hrs], ½ [16hrs]

BROOKE Formula: [Administer as in Evan’s]
o C – 0.5ml x % burn x kg BW
o E - 1.5ml x % burn x kg BW
o Water – 1000ml D5W

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BURNS

FLUID REPLACEMENT

MOORES BURN BUDGET:

o 75 ml of plasma, 75 ml of electrolyte-cont’g fluid
for q 1% TBSA plus 2000 D5W

HYPERTONIC RESUSCITATION Formula:

o Hypertonic salt containing 300 mEq of Na+, 100
mEq of Cl-, 200mEq lactate
o Administered to maintain urinary output of 30-40
ml/hr

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ACID-BASE DISORDERS
Disorder Clinical Compensation
manifestation

Respiratory acidosis ↑Paco2, ↑ or normal Kidneys eliminate H+
HCO3-, ↓ pH and retain HCO3-

Respiratory alkalosis ↓ Paco2, ↓ or normal Kidneys conserve H+
HCO3-, ↑ pH and eliminate HCO3-

Metabolic acidosis ↓ or normal Paco2, Lungs eliminate CO2
↓HCO3-, ↓ pH and conserve HCO3-

Metabolic alkalosis ↑ or normal Paco2, Lungs hypoventilate to
↑HCO3-, ↑ pH ↑ Paco2, kidneys
conserve H+ excrete
HCO3-

nal Disorders60 nionoveno@yahoo.com
Causes of Acid-Base
Disorders
Nursing management:
Metabolic acidosis  Administer sodium bicarbonate
Causes:  Monitor for signs of
 DKA, uremia, hyperkalemia
starvation, diarrhea,  Provide alkaline mouthwash
severe infections  Lubricate lips to prevent
dryness
Manifestations: I & O
 Headache, nausea  Institute seizure precaution
and vomiting  Monitor ABG & electrolyte
 Signs of losses
hyperkalemia
 Seizures, coma,
hyperventilation
nal Disorders61 nionoveno@yahoo.com
Causes of Acid-Base
Disorders
Metabolic alkalosis
Causes: Nursing
 Severe vomiting, NGT management:
suctioning, diuretic  Decreased
therapy, excessive respirations
ingestion of NaHCO3,  Replace fluids nad
biliary drainage electrolytes losses
I & O
Manifestations:  Assess for signs of
 Nausea and vomiting hypokalemia
 Signs and symptoms  Monitor ABG &
of hypokalemia electrolytes
nal Disorders62 nionoveno@yahoo.com
Causes of Acid-Base
Disorders
Respiratory acidosis
Causes:
 Hypoventilation: COPD, Nursing
barbiturate or sedative
overdose, acute airway management:
obstruction, neuromuscular Semi-Fowler’s
disorders
Patent airway
Manifestations: Turn, cough, deep-
 Headache, weakness, visual breath
disturbances, rapid Administer fluids
respirations, confusion,
drowsiness, tachycardia, O2 therapy
coma
Monitor ABG
nal Disorders63 nionoveno@yahoo.com
Causes of Acid-Base
Disorders
Respiratory alkalosis
Causes: Nursing
 Hyperventilation,
management:
mechanical
overventilation,  Offer reassurance
encephalitis  Encourage breathing
Manifestations: into a paper bag
 Numbness and tingling of  Provide sedation as
mouth and extremities
ordered
 Inability to concentrate
 Monitor mechanical
 Rapid respirations, dry
mouth, coma ventilation and ABG

nal Disorders64 nionoveno@yahoo.com
Interpretation
UC PC FC

pH ↓ or ↑ ↓ or ↑ normal

HCO3- ↓ or ↑ ↓ or ↑ ↓ or ↑
normal
Paco2 ↓ or ↑ ↓ or ↑ ↓ or ↑
normal
nal Disorders65 nionoveno@yahoo.com
Fluids & Electrolytes

Nio Cruzada Noveno, RN, MAN, MSN