PHARMA (ELECTROLYTES)

are substances that separate or dissociate into ions (charged particles) in solution; they are abundant in both ICF and ECF.

cation

Anion

Percentage for Intracellular fluid

Percentage for Extracellular fluid

Percentage for Interstitial fluid

Percentage for Intravascular fluid

Percentage for Total body fluid

Major cations of the INTRACELLULAR FLUID

Major anions of the INTRACELLULAR FLUID

Major cations of the EXTRACELLULAR FLUID

Major anions of the EXTRACELLULAR FLUID

Two principles stand out when considering homeostasis and fluid and electrolyte balance:

The number of solutes in a solution is expressed as a unit of measurement

•number of osmoles per kilogram of water and is expressed as mmol/kg (SI units) or mOsm/kg
(conventional units)
•is the concentration of fluid that affects the movement of water between compartments by osmosis

is the number of osmoles in 1 L of solution and is expressed as mmol/L (SI units) or mOsm/L (conventional units).

Normal serum osmolality ranges from __ to __ mOsm/kg

Three Types Of Fluid Concentration Are Based On The Osmolality Of Body Fluids:

This fluid contains more particles than water.
The plasma serum osmolality (concentration of circulating body fluids) can be calculated if the serum sodium level is known or the sodium, glucose, and BUN levels are known

This fluid contains fewer particles than water

fluid has the same proportion of weight of particles (e.g., sodium, glucose) and water

refers to the concentration of particles in a solution and is used in reference to body fluids.

is used primarily as a measurement of the concentration of IV solutions compared with the osmolality of body fluids.

The recommended water intake for a healthy adult is ___L for a man and ___ L for a woman, or approximately ___ to ___ mL/kg/d.

solutions contain fluids and electrolytes and are able to freely cross capillary walls. They do not contain any proteins, which are necessary to maintain the colloidal oncotic pressure that prevents water from leaving the intravascular space.

•solutions contain protein or other large molecular substances that increase osmolarity without dissolving in the solution.
•are also known as plasma expanders.
•They act by increasing the colloidal oncotic pressure and pulling fluids from the interstitial space into the plasma, increasing blood volume.

Blood products include:

Types of Intravenous Solutions

Crystalloid IFs are classified by their total osmolality when compared with the osmolality of serum. The three major classifications of crystalloid IVF

have the same approximate osmolality as ECF or plasma.

exert less osmotic pressure than ECF, which allows water to move into the cell.

exert greater osmotic pressure than ECF, resulting in a higher solute concentration than the serum.

is the major intracellular cation; 98% of the body’s ___ is found within the cells, and 2% is found in the ECF

Recommended potassium intake is about __ to __ mEq daily, either in potassium-rich foods or as potassium supplements.

potassium deficit, occurs with serum levels ___ mEq/L.

Potassium replacements can be given ___ or ___

potassium deficit, occurs with serum levels <3.5 mEq/L.

is defined as a serum potassium level >5.3 mEq/L

are a major cause of hypokalemia

Diuretics are divided into two categories:

excrete potassium and other electrolytes such
as sodium and chloride in the urine.

retain potassium but excrete sodium and chloride in the urine.

Major drug classifications that can cause hypokalemia:

serum Potassium level: normal level is ___ to ___ MEq/L.

Potassium cannot be given ___. Potassium should never be given as an ___ or ___. Giving IV potassium directly into the vein causes cardiac dysrhythmias and cardiac arrest.

is the major cation in the ECF.

The normal serum or plasma sodium level is __ to __ mEq/L

The dietary requirement for sodium is __ to __ g/d.

plays a major role in fluid volume balance, and is the primary determinant of plasma osmolality.

Sodium combines readily with ___ (Cl− ) or ___ (HCO3 − ) to promote acid-base balance.

is caused by sodium loss, deficient intake, or water gain. Sodium loss can result from vomiting, diarrhea, nasogastric suctioning, burns, wound drainage, trauma,renal failure, heart failure, third-spacing, syndrome of inappropriate antidiuretic hormone secretion, excessive hypertonic or sodium-free IVF, surgery, and thiazide diuretics.

a can be caused by sodium gain, sodium retention, or water loss. Causes include excessive oral sodium intake, deficient water intake, hypertonic tube feedings, hypertonic IVF, hyperaldosteronism, Cushing’s syndrome, corticosteroid use, and acute kidney failure.

When the serum sodium level is elevated ___ mEq/L, sodium restriction is indicated.

is found in approximately equal proportions in ICF and ECF. The serum in this range is 4.5 to 5.5 mEq/L, or 8.5 to 10.5 mg/dL.

Calcium is found in approximately equal proportions in ICF and ECF. The serum calcium range is __ to __ mEq/L, or __ to __ mg/dL.

Vitamin __ is needed for calcium absorption from the GI tract. ___ and ___ can alter vitamin D, affecting calcium absorption.

Inadequate calcium intake causes calcium to leave bone to maintain a normal serum calcium level. Because of calcium loss from bones (bone demineralization), pathological fractures may occur if calcium deficit persists.

Elevated serum calcium may be a result of hyperparathyroidism, malignancy, hypophosphatemia, excessive calcium intake, prolonged immobilization, multiple fractures, and drugs such as thiazide diuretics and steroids.

most plentiful in the ICF. Its deficit often occurs with hypokalemia and hypocalcemia.

Normal serum magnesium level is __ to __ mEq/L or __ to __ mg/ dL.

Magnesium deficit is called

Magnesium excess is called

___ is probably the most undiagnosed electrolyte deficiency. This is most likely because it is asymptomatic until the serum magnesium level approaches 1 mEq/L

For hypermagnesemia, ___ ___may be given to decrease the serum magnesium level.

___ ___ corrects hypomagnesemia and symptoms of digitalis toxicity.

___ is the principal anion of ECF. The chloride ion is a major contributor to acid-base balance, gastric juice acidity, and the osmolality of ECF.

Normal serum chloride level is __ to __ mEq/L.

Hypochloremia

Hyperchloremia

is found in both ICF and ECF but is the primary anion in ICF