Fundamentals
Fluid and Electrolyte Balance
Overview
Fluid and electrolyte balance is essential for maintaining physiological functions such as nerve conduction and muscle contraction. Nurses must understand how water and solutes move between compartments to identify imbalances. Monitoring lab values and clinical signs allows for early intervention in potentially life-threatening conditions.
Key nursing concepts
- Homeostasis requires a balance of fluid intake and output.
- Isotonic fluids have the same osmolality as blood.
- Hypotonic fluids cause cells to swell; hypertonic fluids cause cells to shrink.
- Potassium is the major intracellular cation; Sodium is the major extracellular cation.
- Fluid volume deficit (dehydration) presents with tachycardia and dry membranes.
- Fluid volume excess presents with jugular venous distention and hypertension.
Important nursing considerations
- Monitor intake and output (I&O) hourly for critically ill patients.
- Assess for edema in dependent areas like the sacrum and ankles.
- Check skin turgor over the sternum or forehead in older adults.
- Verify the correct IV fluid type and rate against the provider's order.
- Auscultate lung sounds for crackles, indicating fluid volume excess.
- Monitor daily weights at the same time each day with the same scale.
Patient teaching
- Explain the need to limit sodium intake for fluid retention.
- Teach signs of dehydration, such as dark urine and dry mouth.
- Instruct on high-potassium foods if the patient is on certain diuretics.
- Emphasize the importance of reporting sudden weight gain (2 lbs in 24 hours).
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Fluid and Electrolyte Balance flashcards
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Original NursGuru study notes for exam preparation. Pending educator review — always follow your program, current guidelines and institutional policy.