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While thirst and dry membranes are early signs, hypotension and tachycardia indicate severe fluid volume deficit and potential progression toward hypovolemic shock, requiring immediate intervention.
Using the ABC priority framework, crackles indicate pulmonary edema (Airway/Breathing), which is a life-threatening complication of hypervolemia.
Older adults have a decreased thirst sensation, making them less likely to consume adequate fluids independently, increasing the risk for hypovolemia.
LR is an isotonic crystalloid commonly used for acute blood loss and trauma rehydration.
Frequent oral hygiene keeps the mouth moist, and ice chips (calculated as half their volume in liquid) are effective at quenching thirst during restrictions.
Hypokalemia (<3.5 mEq/L) can cause life-threatening cardiac arrhythmias. Monitoring heart rhythm is the priority safety action.
Intravenous potassium must never be given by IV push, as it can cause immediate cardiac arrest and death.
Symptomatic hyponatremia (<136 mEq/L) with neurological changes (cerebral edema) is treated with hypertonic 3% saline.
Chvostek’s sign is a twitching of the facial muscles in response to tapping the facial nerve, indicating hypocalcemia.
The kidneys excrete 90% of the body’s potassium. Renal failure prevents this excretion, leading to dangerous accumulation.
Hypomagnesemia (<1.3 mEq/L) causes neuromuscular irritability, resulting in spasms and tetany.
IV magnesium is a high-alert medication that can cause life-threatening respiratory depression.
Hypotonic solutions (0.45% NS) move water into the cells to rehydrate them in cases of hypernatremia.
Calcitonin is a hormone that helps lower blood calcium levels in clients with hypercalcemia (>10.5 mg/dL).
Peaked T waves are a hallmark sign of hyperkalemia, whereas U waves are seen in hypokalemia.
Leafy greens, seeds, and nuts are excellent sources of dietary magnesium.
The pH is low (<7.35) and the PaCO2 is high (>45 mmHg) with a normal bicarbonate, which defines respiratory acidosis.
In diabetic ketoacidosis (DKA), acidic ketones build up in the body, leading to metabolic acidosis.
The lungs attempt to compensate for metabolic acidosis by blowing off CO2 (acid) through deep, rapid breathing.
Prolonged vomiting removes large amounts of stomach acid (H+ ions), leading to an increase in bicarbonate and metabolic alkalosis.
Narcotics like morphine suppress breathing (hypoventilation), which will worsen the retention of CO2 and exacerbate respiratory acidosis.
Hyperventilation rids the body of too much CO2, leading to an alkaline state.
These results show respiratory alkalosis. Rebreathing exhaled CO2 (via a paper bag or rebreather mask) helps increase CO2 levels.
COPD causes an inability of the lungs to remove enough CO2, leading to chronic respiratory acidosis.
Blood transfusions can lead to hyperkalemia (from cell lysis) and hypocalcemia (from the preservative citrate).
Hypermagnesemia (>2.1 mEq/L) has a "sedating" effect on the body, leading to decreased DTRs, lethargy, and hypotension.
Success in treating hypervolemia is evidenced by weight loss. Total weight gain should not exceed 3 lbs per week; therefore, loss/stabilization indicates fluid removal.
While several labs are used, Hematocrit increases specifically with dehydration (hemoconcentration), making it a key indicator of fluid status.
Vasopressin stimulates the kidneys to conserve water (excrete less urine), which in turn raises blood pressure.
Gastric suctioning removes large amounts of hydrochloric acid (HCl) from the stomach, leading to a loss of hydrogen ions, resulting in an alkaline state in the body
Test your knowledge about the 5 seeing habits discussed in the text 'UPS 5 seeing habits'.