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Promoting Fluid and Electrolyte Balance

  • Consume 6-8 glasses water daily

  • Avoid foods with excess salt, sugar, caffeine

  • Eat well-balanced diet

  • Increase fluid intake before, during, and after active exercise

  • Replace lost electrolytes

    • Correcting Imbalances

    Types of Intravenous Solution

    Isotonic

    • Same salt concentration as cells and blood.

    • Has normal osmolarity (275 to 295 m0sm/kg)

    Hypotonic

    • Fewer dissolved particles (like salt and other electrolytes) than is found in body cells and blood.

    • Has lower osmolarity (<270)

    Hypertonic

    • Higher salt concentration than body cells and blood.

    • Has higher osmolarity (>300)

    • IV solutions with very high (>500 mEq/L) should only be

    • given via central lines.

     

    Hypertonic

    Isotonic

    Hypotonic

    Type

    Solution

    Use

    Hypertonic

    Dextrose 5% in 0.45% normal saline

    Later in DKA treatment

    Hypertonic

    Dextrose 5% in normal saline

    Temporary treatment for shock if plasma expanders aren’t available<br>Addison’s crisis

    Hypertonic

    Dextrose 10% in water

    Water replacement<br>Condition where some nutrition with glucose is required

    Isotonic

    Dextrose 5% in water (D5W)

    Fluid loss<br>Dehydration<br>Hypernatremia

    Isotonic

    0.9% sodium chloride (Normal Saline) (NaCl)

    Shock<br>Hyponatremia<br>Blood transfusions<br>Resuscitation<br>Fluid challenge<br>DKA

    Isotonic

    Lactated Ringer’s (LR)

    Dehydration<br>Burns<br>Lower GI fluid loss<br>Acute blood loss<br>Hypovolemia due to third-space shifting

    Hypotonic

    0.45% sodium chloride (1/2 normal saline)

    Water replacement<br>DKA<br>Gastric fluid loss from NG or vomiting

Questions on Promoting Fluid and Electrolyte Balance

Correct Answer is C

Explanation

<p>Metabolic acidosis. This is incorrect because dextrose 5% in water (D5W) does not cause metabolic acidosis in a dehydrated client. Metabolic acidosis is a condition of low pH and low bicarbonate level in the blood, which can be caused by diabetic ketoacidosis, lactic acidosis, renal failure, diarrhea, or ingestion of toxic substances. D5W does not affect the pH or bicarbonate level in the blood.</p>

Correct Answer is ["A","B"]

Explanation

<p>Check the solution for cracks or leaks. This is incorrect because checking the solution for cracks or leaks is not specific to lactated Ringer&#39;s solution. The nurse should check any IV fluid for cracks or leaks before administration to prevent contamination or infection. The nurse should also check the expiration date, color, clarity, and label of the solution before use.</p>

Correct Answer is A

Explanation

<p>To replace lost electrolytes and prevent acidosis. This is not a correct reason because increasing fluid intake does not replenish electrolytes or prevent acidosis in clients who have diabetes mellitus. Clients who have diabetes mellitus are at risk of developing diabetic ketoacidosis (DKA), which is a life-threatening condition caused by insufficient insulin production or utilization, resulting in high blood glucose and ketone levels. DKA causes metabolic acidosis, which lowers the pH of the blood and body fluids. DKA also causes electrolyte imbalances, such as low potassium, sodium, chloride, and bicarbonate levels. Therefore, increasing fluid intake does not correct the metabolic acidosis or electrolyte imbalances caused by DKA.</p>

<p>This is partially correct because dextrose 5% in normal saline will increase the blood volume, but this is not the only solution that can do that. Other isotonic or hypertonic solutions can also expand the intravascular space. Dextrose 5% in normal saline is preferred in Addison&#39;s crisis beca

<p>Increased serum potassium level. This is incorrect because serum potassium level is affected by several factors in DKA, such as insulin deficiency, acidosis, osmotic diuresis, and fluid therapy. In DKA, serum potassium level may be normal or high initially due to the shift of potassium from the i
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