Laboratory tests electrolyte imbalance

Before administering any electrolyte, electrolyte salt, or a combined electrolyte solution, the nurse assesses the patient for signs of an electrolyte imbalance (see Display 58-2). All recent laboratory and diagnostic tests appropriate to the imbalance are reviewed. The nurse obtains vital signs to provide a database... 

Disorders of the intestinal tract in the neonatal period usually present with abdominal distension and dilatation of the bowel. However, not all intestinal dilatations represent obstruction. Infants with medical disorders such as sepsis, electrolyte imbalance or necrotizing enterocolitis may present ileus characterized by uniform dilatation of the bowel to the level of the rectum. Also, infants on continuous positive airways pressure may swallow an excessive amount of air and exhibit important intestinal dilatation. This dilatation must be distinguished from mechanical obstruction, because the treatment is completely different. The differentiation between these two categories can usually be made on the basis of clinical history, laboratory tests, and appropriate radiographs (Hernanz-SCHULMAN 1999). 

Knowledge of the common causes of electrolyte imbalances indicates the patient who is at risk and who should be observed most closely for signs of an electrolyte imbalance. Many symptoms and observations may result from one or a combination of electrolyte imbalances. Some symptoms are common to both hypo and hyper states of an electrolyte. Symptoms noted may indicate a need for laboratory testing to determine the exact imbalance and provide additional data to support the diagnosis. 3... 

A number of laboratory tests and assessments may be performed to determine the presence of fluid and electrolyte and acid-base imbalances. The nurse should look at all data, including laboratory values and physical assessment, and evaluate them in the context of the patient s history and chronic diseases, if present. Several key points should be noted from this diagnostics chapter ... 

Treatment of alkalosis depends on finding the specific cause. For alkalosis caused by hyperventilation, breathing into a paper bag causes more CO to be retained. Oxygen may be administered via a rebreathing mask to prevent decreased oxygenation and hypoxemia. Electrolyte supplements or medications to bind excessive electrolytes may be administered to establish an acid-base balance until the underlying problem has been corrected. Monitor treatment closely and patient responses to avoid overcompensation. Monitor vital signs and laboratory tests because acid-base imbalance and related electrolyte imbalances can result in cardiac dysfunction. 

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