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Instructions for Side by Side Printing
  1. Print the notecards
  2. Fold each page in half along the solid vertical line
  3. Cut out the notecards by cutting along each horizontal dotted line
  4. Optional: Glue, tape or staple the ends of each notecard together
  1. Verify Front of pages is selected for Viewing and print the front of the notecards
  2. Select Back of pages for Viewing and print the back of the notecards
    NOTE: Since the back of the pages are printed in reverse order (last page is printed first), keep the pages in the same order as they were after Step 1. Also, be sure to feed the pages in the same direction as you did in Step 1.
  3. Cut out the notecards by cutting along each horizontal and vertical dotted line
To print: Ctrl+PPrint as a list

7 notecards = 2 pages (4 cards per page)

Viewing:

Fluid & Electrolyte Imbalances

front 1

Sodium (Na+)

back 1

135-145 mEq/L

Essential for acid-base, fluid balance, active & passive transport mechanism, irritability & CONDUCTION of nerve-muscle tissue

front 2

Hypernatremia:

>145 mEq/L

Signs & Symptoms

back 2

FRIED SALT (Big & Bloated)

Flushed skin

Restless, anxious, confused, irritable

Increased BP & fluid retention

Edema (Pitting)

Decreased urine output

Skin flushed & dry

Agitation

Low-Grade fever

Thirst (dry mucous membranes)

front 3

Hypernatremia Risk Factors:

back 3

Increased sodium intake

- excess oral sodium ingestion

- excess administration of IV fluids w/ sodium

- hypertonic IV fluids

Loss of fluids

- fever

- watery diarrhea

- diabetes insipidus

- excessive diaphoresis

- infection

Decreased sodium excretion

- kidney problems

HEMOCONCENTRATION = INCREASED SODIUM

front 4

Hypernatremia Interventions:

back 4

If due to loss:

- administer IV infusion

If the cause is inadequate renal excretion of sodium

- give diuretics that promote sodium loss

Restrict sodium & fluid intake as prescribed

front 5

Hyponatremia:

<135 mEq/L

Signs & Symptoms:

back 5

HYPOVOLEMIC / HYPONATREMIA: DECREASE OF FLUID & SODIUM

HYPERVOLEMIC / HYPONATREMIA: INCREASE BODY WATER THAT IS GREATER THAN SODIUM

SALT LOSS

Stupor/coma

Anorexia ( nausea/ vomiting)

Lethargy (weakness/ fatigue)

Tachycardia (thready pulse)

Limp muscles

Orthostatic hypotension

seizures/ headache

stomach cramping (hyperactive bowels)

front 6

Hyponatremia Risk Factors:

back 6

Increased sodium excretion

4 D's

-diaphoresis (high fever)

-diarrhea & vomiting

-drains (NGT suction)

-diuretics (thiazide & loop diuretics)

SIADH

Adrenal insufficiency (adrenal crisis)

Inadequate sodium intake

-fasting, NPO, low-salt diet

-kidney disease

heart failure

front 7

Hyponatremia Interventions:

back 7

ADD SALT

Administer IV sodium chloride infusions (only if due to hypovolemia)

Diuretics (if due to hypervolemia) Hyponatremia-high fluids & low salt = hemodilution

Daily weights: where sodium goes, water flows

Safety (orthostatic hypotension AKA risk for falls)

Airway protection (NPO) Do not give food to a lethargic, confused client can lead to an increased risk for aspiration

Limit water intake: hypervolemic hyponatremia (high fluid & low salt)

Teach about foods high in sodium (canned food, packaged/ processed meats