HYPERCHLOREMIA

Group 11
SINGH, JOSHUA
SILVERIO, SILVER JOHN
TABARNILLA, MICHIKO
UNICO, PAULA
VILLA , JUSTINA
 01 Etiology

02 Pathophysiology

contents 03 Clinical Manifestation

04 Assessment and Diagnosis

05 Medical Management

06 Nursing Management
Introduction
HYPERCHLOREMIA

• CHLORIDE:
 The major extracellular anion.
 Responsible for maintaining proper hydration,
osmotic pressure, & normal cation-anion.
 Chloride plays a role in helping the body
maintain a normal balance of fluids.
 Chloride is important in the formation of
hydrochloric acid in gastric juice.
 Chloride has an affinity for sodium and an
inverse relationship with bicarbonate.
Introduction

HYPERCHLORIDE

HYPER: HIGH
CHLORE: Chloride
EMIA: BLOOD
SERUM CHLORIDE IS OVER 107
meq/L(107 mmol/L)
ETIOLOGY/ PATHOPHYSIOLOGY
• Severe Diarrhea

• Excess Chloride Exposure

• Metabolic Acidosis
H+ + Cl− + Na+ + HCO3− → Na+ + Cl− + H2CO3 (CO2)

• Renal Tubular Acidosis

ETIOLOGY/ PATHOPHYSIOLOGY
ETIOLOGY/ PATHOPHYSIOLOGY
TYPES:
 Proximal type 2 RTA
ETIOLOGY/ PATHOPHYSIOLOGY
Types:
 Classical distal RTA (type 1) or type 4 RTA
ETIOLOGY/ PATHOPHYSIOLOGY
 Hyperkalemic Type 4 RTA
CLINICAL MANIFESTATIONS

The Signs and Symptoms related to

Who are at risk?
Patients who has diabetes and kidney
• Metabolic Acidosis
diseases
• Hypervolemia
• Hypernatremia
 Weakness Causes
 Lethargy • Severe Diarrhea
• Dehydration
 Deep, rapid respiration
• Traumatic Head Injury
 Diminished Cognitive Ability
 Hypertension
ASSESSMENT & DIAGNOSTICS

• The serum chloride level is 108meq/L or greater, the serum

sodium level is greater than 145 meq/L the serum ph is lesser
than 7.35 the serum bicarbonate is less than 22 meq/L and
there is a normal anion gap of 8-12 meq/L.

• Increased chloride sweat levels are present in cystic fibrosis

diabetes insipidus glucose -6 phosphate deficiency
hypothyroidism malnutrition and acute renal failure.
MEDICAL MANAGEMENT

• Correcting the underlying cause of hyperchloremia and

restoring electrolyte, fluid, and acid–base balance are
essential.
• Hypotonic IV solutions may be administered to restore
balance.
• Lactated Ringer’s solution
• IV sodium bicarbonate may be administered
• Diuretics may be administered
• Sodium, chloride, and fluids are restricted.
NURSING MANAGEMENT

• Monitor vital signs, arterial blood gas values, and intake and output
are important to assess the patient’s status and the effectiveness of
treatment.
• Assessment findings related to respiratory, neurologic, and cardiac
systems are documented, and changes discussed with the
physician.
• Advice the patient while in elevated chloride ion levels to
consumed less quantity of such food like tomatoes and tomato
juice, olives, celery, lettuce, etc. because they food that are high in
chloride.
NURSING MANAGEMENT

• Tell the patient to eat foods rich in magnesium

and potassium.
• Drinking plenty of water is also necessary to avoid
dehydration.
• Caffeinated products are to be avoided as much as
possible.
• Intake of alcohol is to be reduced or to be
completely avoided.
THANK YOU!
KEEPSAFE
EVERYONE!