Guide to Fluid, Electrolyte, and Acid-Base Balance

by Heitz, Ursula Eaterday; Horne, Mima M.; Webber, Karen S.

• ISBN13: 9780323013239
• ISBN10: 0323013236
• Edition: 4 POC SUB
• Format: Paperback
• Copyright: 2000-12-01
• Publisher: Elsevier Science Health Science div

Summary

The fourth edition of this handy pocket guide provides the latest information on fluid and electrolyte balance, related disorders, and specific imbalance conditions in adult, pediatric, and geriatric patients. It presents pathophysiology, assessment, diagnostic tests, collaborative management, and nursing diagnoses/interventions in a quick reference format that is logical, consistent, and easy-to-read. A Volume in the Nursing Pocket Guide Series Spanish version of 2nd edition also available, ISBN: 84-8086-084-7

Table of Contents

Unit 1 Basic Principles	1	(47)
Overview of Fluid and Electrolyte Balance	3	(11)
Composition of body fluids	3	(3)
Water	3	(1)
Solutes	4	(2)
Fluid compartments	6	(2)
Intracellular fluid	6	(1)
Extracellular fluid	6	(2)
Factors that affect movement of water and solutes	8	(6)
Membranes	8	(1)
Transport processes	8	(4)
Concentration of body fluids	12	(2)
Regulation of Vascular Volume and Extracellular Fluid Osmolality	14	(10)
Regulation of vascular volume	15	(5)
Sympathetic nervous system	18	(1)
Renin-angiotensin	19	(1)
Aldosterone	19	(1)
Atrial natriuretic factor	20	(1)
Antidiuretic hormone and thirst	20	(1)
Regulation of extracellular fluid osmolality	20	(4)
Antidiuretic hormone	21	(1)
Thirst	22	(1)
Defense of brain cell volume	23	(1)
Fluid Gains and Losses	24	(4)
Fluid gains	24	(1)
Oxidative metabolism	24	(1)
Oral fluids	24	(1)
Solid food	24	(1)
Fluid therapy	25	(1)
Fluid losses	25	(3)
Kidneys	25	(1)
Skin	26	(1)
Lungs	26	(1)
Gastrointestinal tract	27	(1)
Additional losses	27	(1)
Third-space losses	27	(1)
Nursing Assessment of the Patient at Risk	28	(8)
Nursing history	28	(1)
Physiologic	28	(1)
Developmental	28	(1)
Psychologic	29	(1)
Spiritual	29	(1)
Sociocultural	29	(1)
Clinical assessment	29	(2)
Daily weights	29	(1)
Intake and output	30	(1)
Hemodynamic monitoring	30	(1)
Vital signs	31	(2)
Body temperature	31	(1)
Respiratory rate and depth	32	(1)
Heart rate/pulses	32	(1)
Blood pressure	32	(1)
Physical assessment	33	(3)
Integumentary system	33	(1)
Cardiovascular system	33	(1)
Neurologic system	34	(1)
Gastrointestinal system	35	(1)
Laboratory Assessment of Fluid, Electrolyte, and Acid-Base Balance	36	(11)
Tests to evaluate fluid status	36	(5)
Serum osmolality	36	(1)
Hematocrit	37	(1)
Urea nitrogen	37	(1)
Urine osmolality	38	(1)
Urine specific gravity	39	(1)
Urine sodium	40	(1)
Tests to evaluate electrolyte balance	41	(1)
Tests to evaluate acid-base balance	41	(4)
Arterial blood gases	41	(1)
Carbon dioxide content or total carbon dioxide	42	(1)
Anion gap	42	(1)
Urine pH	43	(2)
Lactic acid	45	(1)
Related tests	45	(2)
Creatinine	45	(1)
Serum albumin	46	(1)
Unit II Disorders of Fluid, Electrolyte, and Acid-Base Balance	47	(150)
Disorders of Fluid Balance	49	(41)
Hypovolemia	49	(21)
Assessment	49	(3)
Diagnostic tests	52	(2)
Collaborative management	54	(13)
Nursing diagnoses and interventions	67	(2)
Patient-family teaching guidelines	69	(1)
Hypervolemia	70	(5)
Assessment	70	(1)
Diagnostic tests	70	(1)
Collaborative management	71	(1)
Nursing diagnoses and interventions	72	(3)
Patient-family teaching guidelines	75	(1)
Edema formation	75	(7)
Assessment	77	(1)
Collaborative management	77	(1)
Diuretic therapy	78	(1)
Complications of diuretic therapy	78	(4)
Intravenous fluid therapy	82	(8)
Commonly prescribed intravenous fluids	83	(7)
Disorders of Sodium Balance	90	(10)
Sodium changes	90	(1)
Hyponatremia	91	(5)
Assessment	91	(2)
Diagnostic tests	93	(1)
Collaborative management	93	(1)
Hyponatremia with reduced extracellular fluid volume	94	(1)
Hyponatremia with expanded extracellular fluid volume	94	(1)
Nursing diagnoses and interventions	94	(2)
Patient-family teaching guidelines	96	(1)
Hypernatremia	96	(4)
Assessment	96	(1)
Diagnostic tests	97	(1)
Collaborative management	98	(1)
Nursing diagnoses and interventions	98	(1)
Patient-family teaching guidelines	99	(1)
Disorders of Potassium Balance	100	(13)
Hypokalemia	101	(7)
Assessment	101	(1)
Diagnostic tests	102	(2)
Collaborative management	104	(1)
Nursing diagnoses and interventions	105	(2)
Patient-family teaching guidelines	107	(1)
Hyperkalemia	108	(5)
Assessment	108	(1)
Diagnostic tests	109	(1)
Collaborative management	109	(1)
Subacute	109	(1)
Acute	109	(1)
Nursing diagnoses and interventions	110	(2)
Patient-family teaching guidelines	112	(1)
Disorders of Calcium Balance	113	(12)
Hypocalcemia	114	(6)
Assessment	114	(2)
Diagnostic tests	116	(1)
Collaborative management	116	(1)
Nursing diagnoses and interventions	117	(2)
Patient-family teaching guidelines	119	(1)
Hypercalcemia	120	(5)
Assessment	120	(1)
Diagnostic tests	121	(1)
Collaborative management	121	(1)
Nursing diagnoses and interventions	122	(2)
Patient-family teaching guidelines	124	(1)
Disorders of Phosphorus Balance	125	(12)
Hypophosphatemia	126	(6)
Assessment	126	(2)
Diagnostic tests	128	(1)
Collaborative management	128	(1)
Nursing diagnoses and interventions	129	(2)
Patient-family teaching guidelines	131	(1)
Hyperphosphatemia	132	(5)
Assessment	132	(1)
Diagnostic tests	133	(1)
Collaborative management	133	(2)
Nursing diagnoses and interventions	135	(1)
Patient-family teaching guidelines	136	(1)
Disorders of Magnesium Balance	137	(11)
Hypomagnesemia	138	(6)
Assessment	138	(1)
Diagnostic tests	139	(1)
Collaborative management	140	(1)
Nursing diagnoses and interventions	140	(3)
Patient-family teaching guidelines	143	(1)
Hypermagnesemia	144	(4)
Assessment	144	(1)
Diagnostic tests	144	(1)
Collaborative management	145	(1)
Nursing diagnoses and interventions	145	(2)
Patient-family teaching guidelines	147	(1)
Overview of Acid-Base Balance	148	(13)
Buffer system responses	148	(1)
Buffers	148	(1)
Respiratory system	149	(1)
Renal system	149	(1)
Blood gas values	149	(12)
Arterial blood gas values	151	(1)
Step-by-step guide to arterial blood gas analysis	152	(8)
Mixed venous blood gases	160	(1)
Arterial-venous difference	160	(1)
Respiratory Acidosis	161	(13)
Acute respiratory acidosis	161	(7)
Assessment	161	(2)
Diagnostic tests	163	(1)
Collaborative management	164	(1)
Nursing diagnoses and interventions	164	(4)
Chronic respiratory acidosis (compensated)	168	(6)
Assessment	169	(1)
Diagnostic tests	170	(1)
Collaborative management	171	(1)
Nursing diagnoses and interventions	171	(3)
Respiratory Alkalosis	174	(5)
Acute respiratory alkalosis	174	(3)
Assessment	174	(2)
Diagnostic tests	176	(1)
Collaborative management	176	(1)
Nursing diagnoses and interventions	176	(1)
Chronic respiratory alkalosis	177	(2)
Assessment	177	(1)
Diagnostic tests	178	(1)
Collaborative management	178	(1)
Nursing diagnoses and interventions	178	(1)
Metabolic Acidosis	179	(7)
Acute metabolic acidosis	179	(5)
Assessment	179	(2)
Diagnostic tests	181	(1)
Collaborative management	182	(1)
Nursing diagnoses and interventions	183	(1)
Chronic metabolic acidosis	184	(2)
Assessment	184	(1)
Diagnostic tests	184	(1)
Collaborative management	184	(1)
Nursing diagnoses and interventions	185	(1)
Metabolic Alkalosis	186	(7)
Acute metabolic acidosis	186	(4)
Assessment	186	(2)
Diagnostic tests	188	(1)
Collaborative management	188	(1)
Nursing diagnoses and interventions	189	(1)
Chronic metabolic acidosis	190	(3)
Assessment	190	(1)
Diagnostic tests	191	(1)
Collaborative management	191	(1)
Nursing diagnoses and interventions	192	(1)
Mixed Acid-Base Disorders	193	(4)
Case study one	193	(1)
Values	193	(1)
Evaluation	193	(1)
Case study two	194	(1)
Values	194	(1)
Evaluation	194	(1)
Case study three	195	(1)
Values	195	(1)
Evaluation	195	(1)
Case study four	195	(2)
Values	196	(1)
Evaluation	196	(1)
Unit III Clinical Conditions Associated with Fluid, Electrolyte, and Acid-Base Imbalance	197	(82)
Gastrointestinal Disorders	199	(8)
Loss of upper gastrointestinal contents	199	(4)
Saliva	199	(2)
Gastric juices	201	(1)
Gastric suction	201	(1)
Potential fluid, electrolyte, and acid-base disturbances associated with loss of upper gastrointestinal contents	202	(1)
Loss of lower gastrointestinal contents	203	(4)
Pancreatic juice	204	(1)
Bile	204	(1)
Intestinal secretions	204	(1)
Diarrhea	204	(1)
Bowel obstruction	205	(1)
Potential fluid, electrolyte, and acid-base disturbances associated with loss of lower gastrointestinal contents	206	(1)
Surgical Disturbances	207	(3)
Preoperative factors	207	(1)
Perioperative factors	208	(1)
Postoperative factors	208	(1)
Potential fluid, electrolyte, and acid-base disturbances	209	(1)
Endocrinologic Disorders	210	(14)
Diabetic ketoacidosis	210	(2)
Potential fluid, electrolyte, and acid-base disturbances	211	(1)
Hyperosmolar hyperglycemic nonketotic syndrome	212	(5)
Potential fluid, electrolyte, and acid-base disturbances	213	(4)
Diabetes insipidus	217	(4)
Potential fluid, electrolyte, and acid-base disturbances	221	(1)
Syndrome of inappropriate secretion of antidiuretic hormone	221	(1)
Potential fluid, electrolyte, and acid-base disturbances	222	(1)
Acute adrenal insufficiency	222	(2)
Potential fluid, electrolyte, and acid-base disturbances	223	(1)
Cardiac Disorders	224	(3)
Congestive heart failure and pulmonary edema	224	(1)
Potential fluid, electrolyte, and acid-base disturbances	225	(1)
Cardiogenic shock	225	(2)
Potential fluid, electrolyte, and acid-base disturbances	226	(1)
Renal Failure	227	(9)
Potential fluid, electrolyte, and acid-base disturbances	231	(5)
Acute Pancreatitis	236	(3)
Potential fluid, electrolyte, and acid-base disturbances	238	(1)
Hepatic Failure	239	(4)
Potential fluid, electrolyte, and acid-base disturbances	240	(3)
Burns	243	(10)
Potential fluid, electrolyte, and acid-base disturbances	247	(6)
Providing Nutritional Support	253	(26)
Nutritional assessment	253	(5)
Nutritional history	253	(1)
Physical examination	254	(1)
Anthropometric data	254	(1)
Biochemical data	255	(1)
Estimating nutritional requirements	256	(2)
Nutritional support modalities	258	(9)
Enteral nutrition	258	(5)
Parenteral nutrition	263	(4)
Transitional feeding	267	(12)
Potential fluid, electrolyte, and acid-base disturbances in enteral and parenteral nutrition fluid imbalances	267	(3)
Nursing diagnoses and interventions	270	(9)
Selected References	279	(21)
Appendices
A Standard Abbreviations	283	(5)
B Glossary	288	(9)
C Effects of Age on Fluid, Electrolyte, and Acid-Base Balance	297	(3)
D Laboratory Tests Discussed in This Manual (Normal Values)	300