NUR 155—Exam #2 Study Guide: Fluid & Electrolyte Balance galen college of nursing Questions and Answers | 2026 Update | 100% Correct.

UNIT 4: FLUIDS / ELECTROLYTES  Electrolyte: Ions found in body fluids (Blood, Interstitial fluid, Intracellular fluid) essential for nerve conduction, muscle contraction, hydration, pH balance, and many metabolic processes.  TIP!!! Where Fluids Flow, Electrolytes Go!  TIP!!! Anything that depletes water or fluid (like Vomit, Urination, Diarrhea or Sweating) will all deplete Electrolytes.  Intracellular Fluid (ICF): Fluid that’s inside the cell  Major electrolytes: Potassium (K⁺), Magnesium (Mg²⁺), Phosphate (PO₄³⁻)  Extracellular Fluid (ECF): Fluid that’s outside the cell  Major electrolytes: Sodium (Na⁺), Chloride (Cl⁻), Bicarbonate (HCO₃⁻)  Subdivided into:  Interstitial — Between the cells of an organ or tissue  Intravascular — Plasma in blood vessels  Transcellular — CSF, Cerebrospinal, Synovial, Peritoneal, Pleural DEHYDRATION TYPES OF FLUID LOSS  Sensible Fluid Loss (Measurable)  Vomit  Diarrhea  Urination  Insensible Fluid Loss (Not Measurable)  Sweating (Diaphoresis)  Respiration CAUSES OF FLUID LOSS  Diuretics Loss of fluid due to increased urine output  DKA (Diabetic Ketoacidosis) Loss of fluid due to polyuria Glucose pulls water out  Inadequate Fluid Intake Output fluid is more than Intake fluid  Diabetes Insipidus ADH deficiency Water not absorbed by Kidneys SIGNS & SYMPTOMS  Heart  Vital Signs:  Tachycardia HR First sign of Hypovolemic shock! Tip!!!  Hypotension BP  Tachypnea RR  EKG Changes: Weak thready pulse  Orthostatic Hypotension (Low BP upon standing)  Flat veins Specifically Neck and Hand veins  Lungs  Dyspnea Difficulty breathing  Urinary  Dark thick smelly urine  Increased Urine Specific Gravity  Skin  Dry & flat  Tough & rigid  Slow & sluggish turgor NURSING INTERVENTIONS  Weight daily Monitor patient’s gain or loss of weight  Administer IV fluids Provide Isotonic or Hypotonic fluids as ordered  Teach the patient Causes of dehydration  Evaluate Cause of dehydration  Reposition Slowly change patient’s body position POTASSIUM: 3.5 — 5.0 FUNCTION  Maintain Heart & Muscle contractions  Manages Nerve impulses  Regulated by Kidneys HYPOKALEMIA — LOW POTASSIUM 3.5 SIGNS & SYMPTOMS — LOW & SLOW TIP!!!  Heart  EKG Changes: Weak irregular pulse  Flat T–waves, ST depression, and prominent U wave NCLEX TIP!  Muscular  Decreased DTR (Deep tendon reflexes)  Muscle cramping  Severe sign Flaccid paralysis (paralyzed limbs) NCLEX TIP!  GI tract  Decreased Peristalsis Hypoactive bowel sounds Constipation  Abdominal distention  Severe sign Paralytic ileus (Paralyzed intestines) NCLEX TIP! NCLEX TIP! “Profound & Severe” are late & serious sign Indicates HIGH Priority patient ALWAYS Assess FIRST NURSING INTERVENTIONS  Monitor EKG  Watch Magnesium levels Potassium and Magnesium are bff’s  Watch Glucose, Calcium and Sodium levels Calcium, Sodium, Potassium are Inversely related  Administer Potassium supplements as ordered Only IV Potassium Slowly Watch for Infiltration (Never IV BOLUS or IV PUSH Potassium)  Diet (Teach) Encourage High Potassium–rich food HYPERKALEMIA — HIGH POTASSIUM 5.0 SIGNS & SYMPTOMS — TIGHT & CONTRACTED TIP!!!  Heart  Vital Signs:  Hypotension BP  Bradycardia HR  EKG Changes: Irregular pulse  Peaked T–waves, ST elevation, and widened QRS complex NCLEX TIP!  Severe sign V Fib (Ventricular Fibrillation) NCLEX TIP!  Severe sign Cardiac Standstill ( Asystole) NCLEX TIP!  Neurological  Confusion  Paresthesia (tingling, numbness)  Neuromuscular  *Early sign Increased DTR (Deep tendon reflexes)  Late / Severe Decreased DTR (Deep tendon reflexes)  Profound Muscle weakness NCLEX TIP!  Severe Paralysis NCLEX TIP!  GI tract  Increased Peristalsis Hyperactive bowel sounds Diarrhea NCLEX TIP! “Profound & Severe” are late & serious sign Indicates HIGH Priority patient ALWAYS Assess FIRST NURSING INTERVENTIONS  Monitor EKG (Peaked T–waves, & ST elevation) NCLEX TIP!  Sodium Polystyrene Sulfonate (Meds) Promotes Potassium excretion  IV Sodium Bicarbonate Corrects acidosis  IV Calcium Gluconate Decrease neuromuscular irritability  Diet (Teach) Restrict High Potassium–rich food (Fruits, Green leafy vegetables) SODIUM: 135 — 145 FUNCTION  Maintain Blood Pressure  Maintain Blood Volume  Maintain Fluid Balance  Regulated by ADH ( Antidiuretic Hormone) adds Water &  Aldosterone holds Sodium in the body