Question

Module 08 Written Assignment - Fluid Imbalances

Your written assignment for this module should be a 1-2 page paper (not including title page and reference page) that describes the following:

Describe what a fluid and electrolyte imbalance is and how this is important to the function of the body?

Pick a fluid or electrolyte imbalance and describe how the patient would present, in addition to the treatment (nursing and expected medical)?

You should include a minimum of 3 scholarly references. Include a title page, in-text citations, and a reference page in APA format.

Answer 1

Fluid and electrolyte balances within the body are necessary to maintain the health and body functions. These balances are maintained by intake and output of water and electrolytes and regulation of the renal and pulmonary system. Sometimes the factors such as illness, altered fluid intake, diarrhea, and vomiting lead to electrolyte imbalances.

Distribution of Body fluids:

Body fluids generally distributed as intracellular fluids and extracellular fluids. ICF comprises about 40% of body weights and includes the fluid within the body cells. Extracellular fluid found outside the cells which consist of interstitial fluid (lymph), intravascular fluid (blood plasma), and transcellular fluids( cerebrospinal, pleural, peritoneal, and synovial fluids).

Composition of Body fluids:

An electrolyte is a component which dissolved in water or solvent and separates into ions and it has cations which are positively charged such as the sodium, potassium, and calcium and the anions are negatively charged which has chloride, bicarbonate, and sulfate. In addition minerals present in the body fluids are essential for the physiological processes and act as catalysts in muscle contraction, nerve response, and metabolism of nutrients.

Fluid imbalances:

Fluid imbalances occur through isotonic or osmolar. Isotonic excess or deficit is due to water and electrolyte gain or loss. Osmolar imbalances are due to only water gain or loss. This affects the serum concentration.

Electrolyte imbalances:

Sodium imbalances:

Hyponatremia is lower than the normal serum sodium level. This occurs due to loss of sodium without loss of fluid, that results in the decrease of osmolality of ECF. If hyponatremia continues, the body preserves the blood and interstitial volume which results in dilution of sodium ECF.

Hypernatremia is greater than the normal sodium level. In this, the sodium in ECF become excess or the excess of overall sodium. If it continues, sodium is retained and potassium is excreted through increased renal reabsorption.

Potassium imbalances:

Hypokalemia is the inadequate amount of potassium present in the ECF. This commonly occurs in use of diuretics. In severe cases, it affects the cardiac conduction and function.

Hyperkalemia is greater than the normal serum potassium level. The main cause is the renal failure which decreases potassium excretion from the kidney. Severe hyperkalemia affects the cardiac conduction and function.

Calcium imbalances:

Hypocalcemia is lower than the normal serum calcium levels which result from severe illnesses and affects of thyroid and parathyroid gland. The inability of the kidney to excrete phosphorous and leads to decrease of calcium levels and a rise of phosphorous. It affects the function of neuromuscular, cardiac and renal functions.

Hypercalcemia is greater than the normal calcium level. The causes are malignancies and hyperparathyroidism. The excess release of calcium from the bones, and increased renal and intestinal reabsorption also results in hypercalcemia.

Magnesium imbalances:

Hypomagnesemia is the result of inadequate intake of malnutrition and alcoholism and inadequate absorption due to diarrhea, vomiting. Excessive loss due to thiazide diuretics and aldosterone excess and polyuria. This shows signs and symptoms of the neuromuscular system.

Hypermagnesemia is the rise of serum magnesium levels. It affects the skeletal muscle and nerve function. This lead to bradycardia, Cardiac Arrhythmias.

Chloride imbalances:

Hypochloremia is due to excessive vomiting or prolonged nasogastric drainage. The use of diuretics also leads to chloride loss. Hypochloremia leads to metabolic alkalosis as a result of increased bicarbonate reabsorption.

Hyperchloremia occurs when the serum bicarbonate levels fall or sodium level excess.

Hyperkalemia:

Medical management:

ECG should be taken immediately which shows shortened repolarization, peaked T waves. Blood Serum potassium levels to be repeated. Dietary potassium should be restricted. Monitor blood pressure to detect hypotension when calcium gluconate is administered. IV administration of sodium bicarbonate is also necessary.

Nursing Management:

• Observe the patient closely for signs and symptoms.
• Assess for muscle weakness and dysrhythmias.
• Avoid potassium-rich foods.
• If potassium is corrected by IV fluids careful monitoring of the patient.
• Potassium conserving diuretics should not be administered to the patient with renal dysfunction.