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Fluid and Electolyte Imbalances

by Joanna Jackson
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    00:00 Hi, I'm Joanna Jackson and we're going to review Fluid and Electrolyte Imbalances.

    00:05 Many students find fluid and electrolyte imbalances some of the most difficult content you have to learn. Here are some tips to help you conquer this material.

    00:13 Review lab values, immediately before the test begins. Write them down on a blank piece of paper or the dry erase board that you're given as soon as the test starts.

    00:23 Make up funny or quirky acronyms about medications or processes that will help you remember them. For example, the nursing process can be remembered as ADPIE. Assess, diagnose, plan, implement and evaluate. Here are some key terms.

    00:42 Listen for these terms throughout this lesson, write the definition, and practice using these words in sentences, and visualize using them as a nurse.

    00:50 Hypovolemia. This is a fluid imbalance. Hypovolemia is a fluid volume deficit, meaning not enough fluid. It is a serum concentration of less than 135 mEq/L. It occurs when there's an excess of extracellular water relative to sodium. Some signs and symptoms are fatigue, confusion, a headache, abdominal cramps and nausea.

    01:20 If left untreated, it can lead to seizures, coma, or even death.

    01:25 This is most easily remembered as being caused by gastrointestinal losses, sweating, hemorrhages, diuretics, or third spacing. The exact opposite of hypovolemia is hypervolemia. This occurs when there's a deficit of extracellular water relative to sodium. The serum concentration for hypervolemia is greater than 160 mEq/L. Some signs and symptoms of hypervolemia include tachycardia, hypertension, tachypnea, dyspnea, crackles in the lungs, edema and weight gain. Causes include excessive sodium intake, burns, abnormal renal function, and heart failure.

    02:12 Now let's compare and contrast. Hypervolemia means too much. Hypovolemia means too little. Both are related to the serum concentration of sodium within the body, and both are related to the total body water volume. Normal laboratory findings.

    02:32 It is really crucial and important for you review and learn normal volumes of each fluid and electrolyte imbalance. Again, if you write these as soon as the test begins, it will help you in referencing when you get a question about them.

    02:46 There are many different types of electrolyte imbalances. The most common occur, in relation to sodium, potassium, calcium, magnesium, phosphorous and chloride. All of these have hypo and hyper states. Let's review the most common. Sodium is one common electrolyte that can be imbalanced in the body.

    03:10 This is referred to as hyponatremia or hypernatremia. Hyponatremia refers to low sodium in a fluid excess. Signs and symptoms include fatigue, headache, mental status changes and tachycardia. This can be caused by GI losses, diuretics, kidney disease, sweating or heart failure.

    03:32 Hypernatremia refers to increase sodium intake or sodium retention. This can be as a result from kidney failure, Cushing's syndrome, burns or diarrhea. High sodium equals low fluid. Signs and symptoms include thirst, flushed skin, tachycardia, and abdominal cramping. Hyponatremia is not strictly due to fluid excess. It can mean increased, decreased, or normal extracellular fluid. I know that can be confusing, so try and remember this by simply knowing that it is a gain of water or a loss of sodium rich fluids.

    04:13 Potassium is another major electrolyte. This imbalance occurs in the intracellular fluid. You have hypokalemia and hyperkalemia. Hypokalemia refers to low potassium.

    04:25 Signs and symptoms include bradycardia, nausea, vomiting or diarrhea. This can be caused by GI losses, the use of diuretics, kidney disease or even sweating.

    04:36 Hyperkalemia refers to high potassium. The signs and symptoms of this include restlessness, irritability, and weakness. This can be caused by increased sodium intake or sodium retention, including kidney failure, burns and diarrhea. What to expect on the exam? Expect questions that give you lab values and symptoms, and ask you which imbalance you're suspecting.

    05:01 Expect questions that ask you which condition or disease is associated with a particular imbalance. If you learn the signs, symptoms and causes, it becomes very easy to pick the correct treatment. Tips for success: Always assess, diagnose, plan and then implement. Always assess before taking any action. If two answers feel correct, always choose the best answer. And opposites attract, if two answers are complete opposites, one is usually the correct answer.


    About the Lecture

    The lecture Fluid and Electolyte Imbalances by Joanna Jackson is from the course Physiological Integrity. It contains the following chapters:

    • Fluid and Electrolyte Imbalances
    • Electrolyte Imbalances

    Author of lecture Fluid and Electolyte Imbalances

     Joanna Jackson

    Joanna Jackson


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