Fluids and Electrolytes

CHLORIDE

Cl – extracellular anion,

Nornal serum levels = 96-106 mEq/L

binds with Na, H (also K, Ca, etc)

Most abundant anion in ECF

exchanges with HCO3 in the kidneys & in RBC

Cl- is roduces in the stomach as HCl acid

-
FUNCTIONS

helps regulate BP, serum osmolarity

Helps balance Na

Acid/base balance (exchanges with HCO3)

Major component of gastric secretions

Na & Cl assist in determining osmotic pressure

Works with Na+ to maintain serum osmolality.

Maintains the balance of anions in the ICF and ECF

Sources

salt, canned food, cheese, milk, eggs, crab, olives

IMBALANCES IN CHLORIDE

1. HYPOCHLOREMIA

CAUSES:

Excessive losses through the GI system- vomiting, diarrhea

nasogastric suctioning & irrigation

Diuresis

Metabolic alkalosis

Hyponatremia, prolonged D5W IV

Excessive water within the body

over infusion of hypotonic solution

excessive water intake

SIGNS & SYMPTOMS:


hypoNa, hypoK, metabolic alkalosis

Hyperactivity of muscles,tetany,weakness,dysrhythmias

Far Eastern University

Institute of Nursing

This study source was downloaded by 100000856977705 from CourseHero.com on 11-13-2022 02:34:26 GMT -06:00

https://www.coursehero.com/file/68793154/31-HYPOCHLOREMIA-HYPERCHLOREMIAdoc/
 Fluids and Electrolytes
NURSING DIAGNOSIS
Fluid volume excess /
deficit High risk for injury
Impaired physical mobility

MANAGEMENT:
1. replace fluids as ordered
2. replace electrolytes
3. monitor serum electrolytes
4. increase patient's cl- intake
5. Assess for SZ
6. MIO
7. VS
8. ABG
9. Meds ( KCl or NaCl )

DIET: high chloride food

2. HYPERCHLOREMIA

CAUSES:

Metabolic acidosis (terminal cancer, starvation)

Usually noted in hyperNa, hyperK and loss of bicarbonate

Dehydration

SIGNS & SYMPTOMS:


Deep, rapid respirations, weakness, lethargy

hyperK, hyperNa

Diminished cognitive ability, hypertension

NURSING DIAGNOSIS
Fluid volume excess /
deficit High risk for injury
Impaired physical mobility
Self care deficit

NURSING MANAGEMENT:

Identify patient at risk

Treat acidosis

Diuretics monitor V/S, M

Measure I/O

Far Eastern University

This study source was downloaded by 100000856977705 from CourseHero.com on 11-13-2022 02:34:26 GMT -06:00
Institute of Nursing
https://www.coursehero.com/file/68793154/31-HYPOCHLOREMIA-HYPERCHLOREMIAdoc/
 Fluids and Electrolytes

Hypotonic solutions, D5W to restore balance

Monitor serum electrolytes

Monitor ingestion of Cl- from sources

MIO, VS, ABG

Advise to avoid salt

Meds : NaHCO3

Correct DHN

Diet: low Cl (& usually Na)

Far Eastern University

Institute of Nursing

This study source was downloaded by 100000856977705 from CourseHero.com on 11-13-2022 02:34:26 GMT -06:00

https://www.coursehero.com/file/68793154/31-HYPOCHLOREMIA-HYPERCHLOREMIAdoc/
Powered by TCPDF (www.tcpdf.org)