Describe Osmolality and Tonicity Discuss the iso-osmolality range for serum and isotonicity of intravenous solutions. Describe the four classifications of intravenous fluids. Differentiate between cations and anions of electrolytes.

Explain the major function of cations. Discuss examples of potassium, calcium, and magnesium supplements. Explain the methods used to correct potassium, calcium, and magnesium excess. Describe several signs and symptoms of hypokalemia, hyperkalemia, hyponatremia, hypernatremia, hypocalcemia, hypercalcemia, hypochloremia, hyperchloremia, hypophosphatemia, hyperphosphatemia.

Describe the assessments. and client teaching for fluid.Explain the pharmacokinetics and pharmacodynamics of oral and intravenous potassium chloride and calcium salts. calcium. Interventions. nsg. . and magnesium imbalances. sodium. potassium.



y Intravascular fluid or plasma y Interstitial fluid y Others compartments of ECF: y Lymph y Transcellular fluid .DISTRIBUTON OF BODY FLUIDS INTRACELLULAR FLUID found within the cells of the body EXTRACELLULAR FLUID found outside the cells and counts about 1/3 of total body fluids.

.  Is expressed as osmoles or milliosmoles per kilogram (mOsm/kg) of water.

 Has more particles than water. .  Has fewer particles than water. glucose.:  Has the same proportion of weight of particles (Na. urea. protein) and water.

2 .: 1.

Hyper-osmolar  Serum Osmolality is greater than 295 mOsm/kg  It pulls the fluid right out the cell and dehydrates the patient .Normal Serum Osmolality  275-295 mOsm/kg Hypo-osmolar  Serum Osmolality is less than 275 mOsm/kg  May be the result of excess water intake or fluid over load (edema).


 D5W NSS or NaCl LR sol n Ringers sol n mOsm/kg 250 310 275 310 .

hestarch. and lactated ringers sol n. saline. amino acids. Regulating body fluids=I & O water . and plasmanate.y Includes dextrose. y This group of sol n is used for replacement and maintenance of fluid therapy y Are the volume expanders that include dextrant sol n.

Sodium Potassium Calcium Magnesium Chloride Phosphorus .

Maintaining fluid balance Contributing to acid-base regulation Facilitating enzyme reactions Transmitting neuromuscular reactions .

Sodium and Potassium Normal level of Na ECF = 135-145 mEq/L ICF = 3.5-5 mEq/L Normal level of K ICF = 135-145 mEq/L ECF = 3.5-5 mEq/L Na ± K pump .


(Na 135 mEq/L) .

(Na 145 mEq/L) .


Periodic table .

5mEq/L) y Ectopic beads y Nausea and vomiting y Abdominal distention -droped peristalsis y Skeletal muscles weakness .(K  Metabolic Alkalosis  UO  Tissue trauma. injury  Vomiting (loos H ion)  insulin 3.

VEGETABLES y B aked potato y A sparagus y R aw carrot y R aw tomato y S pinach FRUITS B anana A pricot C antaloupe O range D ried fruits B EVERAGES A pricot nectar M ilk O range juice .

(K Causes: S/S: 5.3 mEq/L) Tx: Tx: Drugs:Kayexalate Drugs: .

(8.5 mEq/L) .5 10.

(Ca Intake of Ca and vitamin D y Lactose intolerance y Kidney failure y CRF? y Diuretics y 8 mg/dL) y (+) Trosseau s sign y (+) Chvostek s sign y Irregular pulses y Weakness .

5mg/dL) .(Ca 10.


5 mEq/L) .5-2.(1.

 IV magnesium sulfate  Calcium gluconate .

(95-108 mEq/L) Buffer in O2 and Co2 in RBC Regulating ECF balance Regulating acid-base balance HCL production .


7-2.(1.6 mEq/L) .

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