Fluids and electrolytes

[malkieh]

Does anyone ever really understand them??

We were supposed to read this book
"fluid and electrolytes made incredibly easy"

Honestly it's not incredibly easy

[medic09]

There are a few topics that a pretty challenging. I was usually okay with the fluids part; a bit less so with the 'lytes. Acid-base balance was another one I remember folks getting stressed about, though that didn't seem so hard to me at the time.

Shanah Tovah!

[Rivka P]

Some of it is just memorization of the normal values. I remember having multiple review sessions re: fluid and electrolytes because it's something that everyone needs help with Hatzlocha!

[achot]

We used to print tables in large bold fonts and leave them posted on the wall opposite the proverbial throne in the room of solitude, thus this boring set of facts got memorized in the most time efficient manner. (Capiche?)
When you will be working, they take on a different slant and are more interesting but for now you gotta get thru this.

[chayan]

I try to remember what each electrolyte does in the cell and what symptoms they would cause, but the problem is that the effect isn't always what you think it should be! Like, hypocalcemia causes muscle weakness and hypercalcemia causes tetany, or is it the other way around? I can't keep them straight. And hypo and hyperkalemia both cause arrhythmias, but which ones? I can never remember at what stage in the cardiac cycle the k+ ions should be rushing in or rushing out, and what will cause depolarization and what will cause hyperpolarization.

[Rivka P]

Have you seen this:
The mnemonic ROME means the following:
Respiratory Opposite
pH elevated PCO2 diminished = alkalosis (respiratory)
pH diminished PCO2 elevated = acidosis (respiratory)
Metabolic Equal
pH elevated HCO3 elevated = alkalosis (metabolic)
pH diminished HCO3 diminished = acidosis (metabolic)

[medic09]

Try looking at a self-study book by Weldy called "Body Fluids and Electrolytes - A Programmed Presentation." When I first saw it I thought it was going to dumb-down the material. But, when we were back in Massachussets almost 15 years ago it turned out to be very good for the paramedic and RN programs at the local community college. I've kept a copy, and come to respect it. Very simple, clear, and step by step.

[malkieh]

Aug 30, 2010 21:50:51 GMT -5 Rivka P said:

Have you seen this:
The mnemonic ROME means the following:
Respiratory Opposite
pH elevated PCO2 diminished = alkalosis (respiratory)
pH diminished PCO2 elevated = acidosis (respiratory)
Metabolic Equal
pH elevated HCO3 elevated = alkalosis (metabolic)
pH diminished HCO3 diminished = acidosis (metabolic)

please explain... it's slightly confusing.. I am just beginning fluid and electrolytes..

[chayan]

It's easy to tell if it's acidosis or alkalosis. Normal pH is 7.35 to 7.45. If it's lower than that, it's acidosis. If it's higher than that, it's alkalosis. The question then is if its respiratory or metabolic acidosis/alkalosis. Respiratory is related to CO2 levels; metabolic is related to bicarbonate ions, usually.

Respiratory acidosis comes because the body is retaining too much CO2; alkalosis is when there is too much CO2 being blown off (like when someone hyperventilates). CO2 is an acid--when it rises, the blood gets too acidic. When it falls, the blood becomes alkalotic.

Metabolic acidosis is when the body is losing bicarbonate. Metabolic alkalosis is when there is too much bicarbonate. Remember bicarbonate is a base, so if the level rises the blood will be too basic (alkalosis).

So, back to the mnemonic.

Respiratory--Opposite. Low CO2 + high pH (alkalosis), or high CO2 + low pH (acidosis). If you see these combos, you know it's respiratory.

Metabolic--Equal. Low bicarb + low pH (acidosis) or high bicarb + high pH (alkalosis).