Fluid & Electrolytes Chapter 29:
• Signs and symptoms of fluid overload pg. 1056 pg. 949 & 956-957
Generalized edema, pulmonary edema (moist rales & crackles), Hepatomegaly, slow bounding pulse, weight gain, lethargy
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Fluid & Electrolytes Chapter 29:
• Signs and symptoms of fluid overload pg. 1056 pg. 949 & 956-957
Generalized edema, pulmonary edema (moist rales & crackles), Hepatomegaly, slow bounding pulse, weight gain, lethargy, elevated venous pressure, seizures, coma. Lab findings: Decreased serum electrolytes, low urine specific gravity, decreased hematocrit, variable urine volume.
• Signs and symptoms of fluid deficit pg. 1056 pg. 949 & 951-955
Top 3: #1 Poor skin turgor #2 abnormal respirations= Tachypnea #3 Prolonged capillary refill >2 secs
Tachycardia, dry skin & mucous membranes, sunken eyes & fontanels, irritability, lethargy, thirst, weight loss, diminished urine output, and altered level of consciousness, disorientation. Lab findings: High urine specific gravity, increased hematocrit, increased BUN, increased serum osmolality
• Hypo and hyperkalemia & Foods that contain potassium Pg. 1359 pg. 1271
Hypokalemia:
o < 3.5 mEq/L
o Abnormal EKG; notched or flattened T waves, decreased ST segment, premature ventricular contractions
o Muscle weakness, cramping, stiffness, paralysis, hyporeflexia, hypotension, cardiac arrhythmias, gallop rhythm, tachycardia or bradycardia, ileus, apathy, drowsiness, irritability, fatigue
Hyperkalemia:
o > 5.5 mEq/L
o Variable urine volume
o Flat P wave on ECG, peaked T waves, widened QRS complex, increased PR interval
o Muscle weakness, flaccid paralysis, twitching, hyperreflexia, bradycardia, ventricular fibrillation and cardiac arrest, oliguria, apnea—respiratory arrest
Foods that contain potassium: Foods with thick skin: Oranges, banana, nuts, squash, carrots, broccoli, kale, tomatoes, beans, avocado, fish, mushrooms
• Signs and symptoms of hypo & hypernatremia pg. 1056 pg. 949-950
Hyponatremia (less than 135 mEq): anorexia, nausea, vomiting, weakness, lethargy, confusion, muscle cramps, twitching, & seizures.
Hypernatremia (more than 145 mEq): Thirst, hyperpyrexia (Extremely high fever), sticky mucous membranes, dry mouth, oliguria (diminished urine output) hallucinations, lethargy, irritability, & seizures.
• Types of dehydration: Isotonic, hypotonic, hypertonic (see Ecollege:DocSharing: Powerpoints: GI dysfunction)
Babies= ECF > ICF (75% water) leads to more rapid loss
Isotonic Dehydration: This is the primary form of dehydration occurring in children (Na remains normal since H2O loss and electrolyte loss are equal. Leads to shock) H2O loss = electrolyte loss hypovolemic shock. The major loss is from the ECF. Symptoms are related to hypovolemic shock
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