Fluid, Electrolyte, Acid –Base Balance.ppt

A common hypertonic solution used to treat hypovolemia; used to maintain fluid Intake. Supplies 340 cal/L Used for peripheral parenteral nutrition (PPN) Replaces nutrients electrolytes Can temporarily be used to treat hypovolemia if plasma expander is not available Hypertonic Solutions 5% dextrose in 0.45% NaCl 10% dextrose in water (D10W) 5% dextrose in 0.9% NaCl (normal saline) THANKS Nursing Interventions: Monitor vital signs and ABG Assist client to breathe more slowly Help client breathe in a paper bag or apply rebreather mask (to inhale CO2). Metabolic Acidosis Deficit of bicarbonate in ECF. The deficit can occur as the result of an increase in acid components or an excessive loss of bicarbonate. Risk Factors: Conditions that increase nonvolatile acids in the blood ( renal impairment, DM, starvation) Conditions that decrease bicarbonate ( prolonged diarrhea) Excessive infusion of chloride-containing IV fluids (NaCl). Clinical Manifestations: Kussmaul’s respiration (deep, rapid respiration) Lethargy, confusion, headache, nausea, vomiting. Laboratory findings: pH = below 7.35 HCO3 = less than 22mEq/L Nursing Interventions: Monitor ABG values, IO, and LOC Administer IV sodium bicarbonate carefully if ordered Treat underlying problems as ordered. Metabolic Alkalosis Metabolic alkalosis is a primary excess of bicarbonate in ECF. This may be the result of excessive acid losses or increased base ingestion or retention. Risk Factors: Excessive acids losses due to Vomiting Gastric suction Excessive use of potassium- losing diuretics Excessive adrenal corticoid hormones due to Cushing’s syndrome, hyperaldosteroneism. Excessive bicarbonate intake from antacids. Clinical Manifestations: Decreased respiratory rate and depth , dizziness, tingling in extremities Hypertonic muscles, tetany Laboratory findings: pH = above 7.45 HCO3 = greater than 26 mEq/L Nursing Interventions: Monitor IO closely Monit