Question

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1. Describe the effects of aging on fluid and electrolyte regulation.

2. Electrolytes to investigate: (Sodium, Potassium, Calcium, Magnesium). Include causation, clinical manifestations, and nursing interventions.

Answer 1

1) Kidneys plays an important role to regulate fluid and electrolyte balance. The aging process may brings lots of changes in renal, hormonal and thirst regulatory systems which includes sodium and water balance regulation. The sodium imbalance can lead to hypernatraemia or hyponatraemia with impaired function of central nervous system.The decreased thirst mechanism results in less intake of fluid leads to increase in osmolarity and serum sodium level. The impact of elderly age associated disease and usage of medication can also a reason for fluid and electrolyte imbalance.

2) The main cause includes fluid retention,overload,loss of body fluids, medications, imbalanced intake of electrolyte,trauma and uncontrolled loss of sodium.

Clinical manifestation :

* Hyponatraemia : naussea,vomiting, headache,lethargy,tiredness,confusion,dry skin, weakness.

* Hypernatraemia: pulmonary edema, tiredness,hallucination. increased bp, pulse and body temperature.

* Hypokalemia: muscle weakness, abdominal distension,polyuria,fatigue, anorexia.

* Hyperkalemia: muscle weakness, tachycardia,intestinal colic, cramps,anxiety, abdominal distention.

* Hypocalcemia: numbness and tingling of toes and fingers,seizures, deep tendon reflexes.

* Hypercalcemia: muscle weakness,constipation,anorexia,nausea,vomiting,dehydration,calcium stones,fractures.

* Hypomagnesemia: insomnia, anorexia,vomiting,neuromuscular irritability.

* Hypermagnesemia: muscle weakness, drowsiness,hypotensions.

Nursing interventions:

* Administer oral or parenteral fluids to correct deficit.

* Assess for lethargy,seizures,confusion and muscle disorders.

* Monitor skin and tongue turgor to check bluish discoloration.

* Assess urine concentration by obtaining urine samples.

* encourage diet that can balance the electrolyte.