1.005-1.030
Hemoglobin
Male: 13-18Female: 12-16
Hematocrit
Male: 37-49Female: 36-46
BUN
10-20
Sodium
135-145
Potassium range
3-5
Calcium
8.4-10.5
Magnesium
1.5-2.5
Creatinine
0.6-1.2
Fluid volume deficit
hypovolemia
hypovolemia caused by
diuretics, dehydration, abnormal fluid losses (burns, bleeding, N/V/D)
hypovolemia S/SX
decreased urine output, increased HR, low BP, weak pulse, poor turgorHigh hgb, hct, urine gravity & BUN
Fluid volume excess
Hypervolemia
Hypervolemia caused by
renal or cardiac failure, too much fluids, over irrigation of wounds
hypervolemia S/SX
high BP, bounding pulse, crackles, weight gain, distended neck veins, edemaLow hgb, hct, BUN, urine gravity & creatinine
Sodium imbalance
THINK NEURO*major cation of extra cellular fluid*maintains osmotic pressure*needed for nerve impulses (depolarization)
Hypernatremia
high sodiumwater deficit
Hypernatremia caused by
diabetes insipidus, insensible perspiration, water deprivation, hypertonic fluids
Hypernatremia S/SX
decreased LOC, thirst, seizures
hypernatremia Tx
oral water, hypotonic fluids
Hyponatremia
Low sodiumwater excess
hyponatremia caused by
SIADH, water intoxication, tap water enemas, hypotonic fluids
hyponatremia S/SX
decreased LOC, seizures
hyponatremia Tx
fluid restriction
Potassium imbalance
THINK CARDIAC*major cation in extracellular fluid*needed for nerve conduction (repolarization)*needed for smooth muscle, skeletal and cardiac muscle function
Potassium foods
avocados bananaspotatoesspinachbeans citrus juice fish
Hyperkalemia
high potassium Most dangerous
hyperkalemia caused by
potassium sparing diuretics, renal failure, intestinal obstruction, excessive K+ intake, acidosis
Hyperkalemia S/SX
apathy, muscle weakness, diarrhea, dysrhythmias, peaked T waves, cardiac arrest
hyperkalemia nursing interventions
monitor vitals, heart monitor, decrease K+ intake
hyperkalemia Tx
diuretics, dialysis, R insulin & kayexalate (laxative that can be given PO or by enema- it swaps sodium for potassium so the patient will excrete more potassium from the stool)
Hypokalemia
Low potassium *K+ is excreted through stool & urine
hypokalemia caused by
diuretics, D/V, inadequate intake, alkalosis
hypokalemia S/SX
respiratory muscle weakness, shallow breathing, thready pulse, confusion, decreased reflexes, constipation, flat T waves
hypokalemia nursing interventions
monitor vitals, heart monitor, increase intake, PO supplements, IV potassium chloride (no more than 20 mEq/hr, check renal function first, must be diluted and do not push)
calcium imbalance
THINK SKELETAL*needed for bone formation*excitation of cardiac & skeletal muscle
Calcium foods
milkyogurtkalecheesesardinesbroccoliokraalmondsbok choywatercress
hypercalcemia cased by
high calciumexcessive Ca or vit D intake, bone tumors & fractures, hyperparathyroidism
hypercalcemia S/SX
pathological fx, high HR & BP, bounding pulse, late bradycardia, confusion, lethargy
hypercalcemia Tx
monitor vitals & heart, restrict intake, increase mobility, loop diuretic, isotonic fluids
hypocalcemia caused by
(low calcium) **3 T's (tetany, tingling, twitching)inadequate intake, diarrhea, hypoparathyroidism, renal disease
hypocalcemia S/SX
High HR, low BP, pos Chvostek's (tap facial nerve and cheek and eye twitch) & Trousseau's sign (BP cuff inflated and hand contracts)
hypocalcemia TX
monitor vitals, initiate seizure precautions, increase intake and supplements
Magnesium
THINK MUSCLE*required for ATP*needed for muscle contraction*regulates neuromuscular activity & clotting
Magnesium foods
wheat branalmondsspinachcashewsblack eyed peasoatmealpeanutsbrown rice
hypermagnesemia caused by
(high magnesium)overuse of antacids or laxatives, renal failure, too much IV magnesium
hypermagnesemia S/SX
low HR, BP & RR, loss of tendon reflexes
Hypermagnesemia TX
monitor vitals, muscles, respiratory & LOC, IV calcium gluconate & furosemide
hypomagnesemia caused by
(low magnesium) **ETOH increases magnesium excretion-malnutrition, malabsorption, alcoholism, diarrhea, diuretics
hypomagnesemia S/SX
High HR, low BP, pos Chvostek's (tap facial nerve and cheek and eye twitch) & Trousseau's sign (BP cuff inflated and hand contracts)
hypomagnesemia TX
monitor vitals, initiate seizure precautions, increase intake and supplements
breeze through