Professional Documents
Culture Documents
– Sodium
– Potassium
• Osmosis
• Diffusion
• Filtration
• Active transport
• Fluid gain
– Dietary intake of fluid and food or enteral feeding
– Parenteral fluids
• Fluid loss
– Kidney: urine output
– Skin loss: sensible and insensible losses
– Lungs
– GI tract
• Laboratory tests of fluid balance
• Homeostatic mechanisms
• Medication use
b. Potassium
Rationale: Potassium is the major intracellular electrolyte.
98% of the body’s potassium is inside the cells.
Potassium influences both skeletal and cardiac muscle
activity.
• Low pH <7.35
• Low bicarbonate <22 mEq/L
• Most commonly caused by renal failure
• Manifestations: headache, confusion, drowsiness, increased
respiratory rate and depth, decreased blood pressure,
decreased cardiac output, dysrhythmias, shock; if decrease
is slow, patient may be asymptomatic until bicarbonate is
15 mEq/L or less
• Correct the underlying problem and correct the imbalance;
bicarbonate may be administered
• High pH >7.45
• High bicarbonate >26 mEq/L
• Most commonly caused by vomiting or gastric suction;
may also be caused by medications, especially long-term
diuretic use
• Hypokalemia will produce alkalosis
• Manifestations: symptoms related to decreased calcium,
respiratory depression, tachycardia, and symptoms of
hypokalemia
• Correct underlying disorder, supply chloride to allow
excretion of excess bicarbonate, and restore fluid volume
with sodium chloride solutions
• Low pH <7.35
• PaCO2 >42 mm Hg
• Always caused by a respiratory problem with inadequate
excretion of CO2
• With chronic respiratory acidosis, the body may
compensate and may be asymptomatic; symptoms may
include a suddenly increased pulse, respiratory rate, and
BP; mental changes; feeling of fullness in the head
• Potential increased intracranial pressure
• Treatment is aimed at improving ventilation
• High pH >7.45
• PaCO2 <35 mm Hg
• pH—7.35 to 7.45
• PaCO2—35 to 45 mm Hg
• HCO3ˉ—22 to 26 mmol/L
• PaO2—80 to 100 mm Hg
• Fluid overload
• Air embolism
• Septicemia and other infections
• Infiltration and extravasation
• Phlebitis
• Thrombophlebitis
• Hematoma
• Clotting and obstruction