Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 11 Fluids and Electrolytes^447



  • Hematocrit (Hct): decreased in anemia, chronic disease, hemolytic reaction,
    adrenal insufficiency, leukemia, lymphoma. Normal range 34.3–44.4%

  • Hemoglobin (Hgb): decreased in anemia, cancer, hemolytic reaction, liver
    disease, kidney disease, hyperthyroidism, SLE; increased in chronic obstruc-
    tive pulmonary disease, hemoconcentration, polycythemia, burns. Normal
    range 11.5–15.2 g/dL

  • Erythrocyte sedimentation rate (ESR): Low means anti-inflammatories (ster-
    oids, aspirin), blood sample not processed in timely manner (allowed to
    sit); high means inflammation, hormonal effect (pregnancy, menses, oral
    contraceptives). Normal range 0–30

  • Sodium (Na): Low means diarrhea, vomiting, edema, excess water intake,
    diuretic use, nasogastric suction, Addison’s disease, hypothyroidism; high
    means dehydration, bronchitis, Cushing’s disease, diabetes insipidus, insuffi-
    cient water intake. Normal range 136–146 mmol/L

  • Calcium (Ca): Low means decreased albumin levels, hyperphosphatemia, hypo-
    parathyroidism, vitamin D deficiency, acute pancreatitis; high means cancer,
    hyperparathyroidism, hyperthyroidism, prolonged immobilization, Paget’s
    disease. Normal range 8.5–10.5 mg/dL

  • Phosphorus: Low means hyperparathyroidism, elevated insulin level, diabetic
    coma, vomiting, renal tubular acidosis; high means renal insufficiency, hypo-
    thyroidism, hypocalcemia, excess intake of alkali, Addison’s disease, healing
    fractures.

  • Magnesium: Low means hemodialysis, blood transfusion, hypoparathyroidism,
    malabsorption, chronic disease, chronic pancreatitis; high means renal fail-
    ure, diabetic acidosis, Addison’s disease, hypothyroidism, antacid use.

  • Chloride (Cl): Low means vomiting, nasogastric suctioning, chronic respir-
    atory acidosis, metabolic alkalosis, Addison’s disease, SIADH, excess water
    intake; high means dehydration, diarrhea, metabolic acidosis, hyperpara-
    thyroidism, Cushing’s syndrome, renal tubular acidosis. Normal range 99–108
    mmol/L

  • Potassium (K): Low means GI loss, renal loss, diuretic use, eating disorders,
    wound drainage, respiratory alkalosis, licorice intake; high means dehydra-
    tion, renal failure, metabolic acidosis, diabetic ketoacidosis, sickle cell ane-
    mia, interstitial nephritis. Normal range 3.4–5.2 mmol/L

  • Blood urea nitrogen (BUN): Low means fluid overload, low muscle mass,
    with low protein, low carbohydrate diet; high means renal disease, dehy-
    dration, acute MI, ketoacidosis, excess protein intake. Normal range 8–25
    mg/dL

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