Fluid/Electrolyte Imbalance

S/S
Nursing Care
S&S: Weight, turgor, dry skin,
Fluid Deficit
Hypovolemia: Proportional loss
of extracellular fluid (ECF) and
electrolytes
Dehydration: Loss of H2O only with
Na related to N&V, diarrhea, GI
suction, sweating, fluid intake,
diuretics, adrenal insufficiency

Fluid Excess
ECF volume due to heart or renal
failure, cirrhosis, Na, excess IV
fluids, albumin, aldosterone
secretion
Syndrome of inappropriate
antidiuretic hormone (SIADH):
ADH
water retention and Na due to
disorders of CNS and lungs,
infections and malignant tumors

Hypokalemia
Potassium (K_) _3.5mEq/L; due to
vomiting, diarrhea, gastric suction,
diuretics, corticosteroids, diabetic
ketoacidosis (osmotic diuresis),
starvation; hypokalemia risk
of digoxin toxicity

Hyperkalemia

weak and cramping muscles,

thirst, oliguria, postural BP, T,
P, Hct, BUN, specific gravity

Nursing: Monitor S&S, po fluids,

isotonic/hypotonic IV fluids as
ordered, prn antiemetics or
antidiarrheals

S&S: T, P, and BP; edema,

ascites,
crackles, jugular vein distention,
HCT, BUN

Nursing: Monitor S&S; teach Na

diet, fluid restriction, and Na
content of OTC meds; diuretics and
potassium supplements if ordered

S&S: Muscle weakness, fatigue,

N&V, GI motility, reflexes,
abdominal distention,
dysrhythmias, elevated U wave
and flattened T wave on ECG

Nursing: Assess S&S, teach about

foods high in K_ (melon, apricots,
bananas, milk, meat, citrus,
grains). Give ordered po/IV K_
supplements