Serum electrolytes

Serum levels (digoxin) may be ordered daily during the period of digitalization and periodically during maintenance therapy. Periodic electrocardiograms, serum electrolytes, hepatic and renal function tests, and other laboratory studies also may be ordered. 

The primary health care provider may also order laboratory and diagnostic tests, renal and hepatic function tests, complete blood count, serum enzymes, and serum electrolytes. The nurse reviews these test results before the first dose is given and reports any abnormalities to the primary health care provider. The patient is usually placed on a cardiac monitor before aiitiarrhytiuiric drug therapy is initiated. The primary health care provider may order an ECG to provide baseline data for comparison during therapy. 

Before administering die first dose of vasopressin for die management of diabetes insipidus, die nurse takes die patient s blood pressure, pulse, and respiratory rate. The nurse weighs the patient to obtain a baseline weight for future comparison. Serum electrolyte levels and odier laboratory tests may be ordered by die primary health care provider. 

When these drugs are given to the female patient with inoperable breast carcinoma, tire nurse evaluates the patient s current status (physical, emotional, and nutritional) carefully and records tire finding in tire patient s chart. Problem areas, such as pain, any limitation of motion, and the ability to participate in tire activities of daily living, are carefully evaluated and recorded in tiie patient s record. The nurse takes and records vital signs and weight. Baseline laboratory tests may include a complete blood count, hepatic function tests, serum electrolytes, and serum and urinary calcium levels. The nurse reviews these tests and notes any abnormalities. 

If the male or female patient is being treated for a malignancy, the nurse enters in the patient s record a general evaluation of the patient s physical and mental status. The primary health care provider may also order laboratory tests, such as serum electrolytes and liver function tests. 

During therapy, the nurse periodically obtains (daily or more frequently) serum electrolyte or bicarbonate studies to monitor therapy. 

Monitoring and Managing Adverse Reactions When electrolyte solutions are administered, adverse reactions are most often related to overdose Correcting the imbalance by decreasing tiie dosage or discontinuing the solution usually works, and the adverse reactions subside within a short period of time Frequent serum electrolyte levels are used to monitor blood levels. 

Tokutomi T, Mayagi T, Morimoto K, Kanikaya T, Shigemori M. Effect of h3fpothermia on serum electrolyte, inflammation, coagulation, and nutritional parameters in patients with severe traumatic brain injury. Neurocrit Care 2004 1(2) 171-182. 

There is a paucity of clinical trial evidence comparing the benefit of diuretics to other therapies for symptom relief or long-term outcomes. Additionally, excessive preload reduction can lead to a decrease in CO resulting in reflex increase in sympathetic activation, renin release, and the expected consequences of vasoconstriction, tachycardia, and increased myocardial oxygen demand. Careful use of diuretics is recommended to avoid overdiuresis. Monitor serum electrolytes such as potassium, sodium, and magnesium frequently to identify and correct imbalances. Monitor serum creatinine and blood urea nitrogen daily at a minimum to assess volume depletion and renal function. 

Determine and monitor the patient s serum electrolyte concentrations to determine the presence or absence of hypokalemia, hyperkalemia, hypomagnesemia, or hypermagnesemia. 

Serum electrolytes should be obtained, because frequent P2-agonist administration may decrease serum potassium, magnesium, and phosphate. 

Obtain blood urea nitrogen (BUN), serum creatinine (SCr), calculated fractional excretion of sodium (FeNa), serum electrolytes, and arterial blood gases. 

Serum electrolytes dehydration may be associated with constipation. 

Saline laxatives containing magnesium, potassium, or phosphates should be used cautiously in persons with reduced kidney function. Monitor appropriate serum electrolyte concentrations in patients with unstable renal function evidenced by changing serum creatinine or creatinine clearance. 

Serum electrolytes and chemistries may indicate metabolic causes of symptoms. 

Monitor complete blood cell count, serum electrolytes and chemistries, stool guaiac, and erythrocyte sedimentation rate yearly for changes that might signal an overlapping organic problem. 

Serum electrolytes should be monitored in patients with CKD for the development of metabolic acidosis. Metabolic acidosis in patients with CKD is generally characterized by an elevated anion gap greater than 17 mEq/L (17 mmol/L), due to the accumulation of phosphate, sulfate, and other organic anions. 

Monitor serum electrolytes and arterial blood gases regularly. Correct metabolic acidosis slowly to prevent the development of metabolic alkalosis or other electrolyte abnormalities. 

The extracellular fluid (ECF) is the fluid outside the cell and is rich in sodium, chloride, and bicarbonate. O The ECF is approximately one-third of TBW (14 L in a 70-kg man or 12 Lin a 70-kg woman) and is subdivided into two compartments the interstitial fluid and the intravascular fluid. The interstitial fluid (also known as lymphatic fluid) represents the fluid occupying the spaces between cells, and is about 25% of TBW (10.5 L in a 70-kg man or 8.8 L in a 70-kg woman). The intravascular fluid (also known as plasma) represents the fluid within the blood vessels and is about 8% of TBW (3.4 L in a 70-kg man or 2.8 L in a 70-kg woman). The ECF is approximately one-third of TBW or 14 L in a 70-kg male. Because the exact percentages are cumbersome to recall, many clinicians accept that the ECF represents roughly 20% of body weight (regardless of gender) with 15% in the interstitial space and 5% in the intravascular space.6 Note that serum electrolytes are routinely measured from the ECF. 

Normally, the number of anions and cations in each fluid compartment are equal. Cell membranes play the critical role of maintaining distinct ICF and ECF spaces which are biochemically distinct. Serum electrolyte concentrations reflect the stores of ECF electrolytes rather than that of ICF electrolytes. Table 24-4 lists the chief cations and anions along with their normal concentrations in the ECF and ICF. The principal cations are sodium, potassium, calcium, and magnesium, while the key anions are chloride, bicarbonate, and phosphate. In the ECF, sodium is the most common cation and chloride is the most abundant anion while in the ICF, potassium is the primary cation and phosphate is the main anion. Normal serum electrolyte values are listed in Table 24—5. 

TABLE 24-5. Normal Ranges for Serum Electrolyte Concentrations... 

Arterial blood gases, serum electrolytes, physical examination findings, the medical history, and the patient s recent medications must be reviewed in order to establish the etiology of a given acid-base disturbance. 

Acid-base disturbances are common clinical problems that are not difficult to analyze if approached in a consistent manner. The pH, PaC02, and HCO, should be inspected to identify all abnormal values. This should lead to an assessment of which deviations represent the primary abnormality and which represent compensatory changes. The serum electrolytes should always be used to calculate the anion gap. In cases in which the anion gap is increased, the excess anion gap should be added back to the measured HC03 . The anion gap and the excess... 

Exam General Chemistry 3 Hematologic Tests" Metabolic Tests6 Liver Function Tests Renal Function Tests Thyroid Function Tests Serum Electrolytes Dermatologic6 ... 

Carbamazepine Manufacturer recommends CBC and platelets (and possibly reticulocyte counts and serum iron) at baseline, and that subsequent monitoring be individualized by the clinician (e.g., CBC, platelet counts, and liver function tests every 2 weeks during the first 2 months of treatment, then every 3 months if normal). Monitor more closely if patient exhibits hematologic or hepatic abnormalities or if the patient is receiving a myelotoxic drug discontinue if platelets are less than 100,000/mm3, if white blood cell (WBC) count is less than 3,000/mm3 or if there is evidence of bone marrow suppression or liver dysfunction. Serum electrolyte levels should be monitored in the elderly or those at risk for hyponatremia. Carbamazepine interferes with some pregnancy tests. 

Monitor weight, blood pressure, and serum electrolytes and assess resolution of clinical features and patient s feeling of general well-being. Adjust dosages accordingly. 

Renal Effects. Blood urea nitrogen and serum electrolyte levels were normal in several individuals overcome by unknown concentrations of hydrogen sulfide gas in a pelt room (Audeau et al. 1985). One of these four patients had protein and blood in the urine initially, which was not detected upon later testing. Albumin and some granular casts were noted in the urine in another patient, but these findings were transient (Audeau et al. 1985). 

Mozambique tilapia, Tilapia mossambicus 1100 No deaths in 90 days. Increased growth and body water content disrupted serum electrolytes 23... 

Laboratory tests for identifying disorders that may cause or worsen HF include compete blood count serum electrolytes (including calcium and magnesium) renal, hepatic, and thyroid function tests urinalysis lipid... 

Routine monitoring of serum electrolytes and renal function is mandatory in patients with HF. 

The clinician also needs to monitor body weight, serum osmolality, serum electrolytes, complete blood cell count, urinalysis, and cultures (if appropriate). With an urgent or emergency situation, evaluation of the volume status of the patient is the most important outcome. 

Complex Serum electrolyte concentrations upper/lower Gl evaluation Other information Fluid input and output Medication history... 

There are currently no diagnostic laboratory tests for epilepsy. In some cases, particularly following GTC (or perhaps CP) seizures, serum prolactin levels may be transiently elevated. Laboratory tests may be done to rule out treatable causes of seizures (e.g., hypoglycemia, altered serum electrolyte concentrations, infections, etc.) that do not represent epilepsy. 

Fluid status is assessed by monitoring urine output and specific gravity, serum electrolytes, and weight changes. An hourly urine output of at least 1 mL/kg for children and 50 mL for adults is needed to ensure tissue perfusion. 

Patients with normal organ function and serum electrolyte concentrations should receive daily maintenance doses of electrolytes during PN. 

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