Fluid and Electrolytes Imbalances for Nursing Students - NCLEX Review

hey everyone it's sarah with registerednessrn.com and in this video i'm going to be talking about the fluid and electrolytes that you need to know as a nurse specifically their causes and signs and symptoms now i have a complete playlist that you can access where i talk about these electrolyte imbalances individually specifically their nursing interventions and treatments so whenever you get done watching this comprehensive video you can access those videos as well so let's get started we need a proper balance of fluid and electrolytes in our body in order to maintain life we don't need too much or too little we need a specific range in fact 70 percent of our body is actually made up of water and here you can see the function of the water in our body it's found in our brain in our muscles bones it helps transport nutrients and oxygen into the cell also our blood consists of 83 of water but this just isn't plain water it consists of many things and one thing it consists of are electrolytes so what are electrolytes well we're going to be talking about six main ones such as potassium sodium chloride calcium phosphate and magnesium so these are substances that once they enter the body and they are dissolved in water hence our blood they actually produce an electrical charge hence become ions and this is very important with electrical signaling in our body so some things that electrolytes do in our body are the following they help with contraction of muscles sending nerve impulses creating bones balancing the fluids in our body like our cells via osmosis and maintaining the blood's acid-base balance therefore whenever we have these imbalances of these electrolytes you're going to start to see certain abnormalities in these processes depending on if it's high or low for example with contraction of muscle in certain electrolyte imbalances you can start to see muscle spasms or your heart which is a muscle will start to demonstrate abnormal ekg findings and it's very specific to certain electrolytes and as we go through this lecture i will highlight that for you but now let's talk about how electrolytes are maintained in our body how do we keep them from being too low or too high well we get electrolytes majority from our food whenever we eat and drink and it goes into our body and majority of them are going to be absorbed in our gut so if you have a gut problem let's say an issue with your small intestine that can affect how you are absorbing certain electrolytes then it enters into our blood and you know that your blood has to be filtered by your kidneys and just remember the kidneys really if you have any kidney problems you're probably going to have an electrolyte problem and your kidney is made up of all these little functional units called nephrons and the nephrons in a sense what they do is they take your blood and they create filtrate out of it which in the end's going to be urine and it's like a little pipe i like to think of it as it runs through the kidney and the filtrate is going to go through certain sections of that pipe we call them tubules and certain electrolytes and water and other things are going to be taken out of the blood and put in the filtrate or it's going to stay in the blood and you're going to keep it in your body so whatever your body doesn't need as it tweaks these electrolytes you will urinate out as urine so think about it this way if you have any problem with the renal system you can affect the electrolytes hence a lot of times they're going to be really high so that's why many times patients who have high abnormal electrolytes will need to go for dialysis because that dialysis machine is going to replace what that kidneys nephrons should be doing in addition we can manipulate the kidneys and by giving them diuretics so a lot of times if we give too much of a diuretic we can cause these electrolyte imbalances so other ways our electrolytes can be affected is that if we have an exit route for them and this could be anything it could be trauma it could be where we've had a lot of blood loss or we've had burns or the patient's just really sick they're throwing up a lot through vomit or they have diarrhea maybe they have um suction in g-section we're sucking off too much of those gastric juices which are rich in many of our electrolytes or the patient has some type of disease process and you're going to see that a lot with the causes like problems with aldosterone or adh the anti-diuretic hormone etc now let's look at these electrolytes individually first i want to start with sodium so sodium is a really important electrolyte that loves to hang out outside of your cell so there is a higher concentration of sodium in the extracellular part compared to the intracellular part where there's a lower concentration now sodium plays a huge role in regulating the water inside and outside of our cell along with muscle contraction and nerve impulses so if you get an imbalance of this electrolyte you're going to start to see issues with these processes a normal sodium level is about 135 to 145 milli equivalents per liter so anything less than 135 is considered hyponatremia and anything greater than 145 is considered hypernatremia and you want to remember the higher the number or lower the number with these ranges you're going to start to see more profound signs and symptoms the worse off the patient is going to be whenever it's just a little bit over a little bit under it's going to be very mild so now i want you to see a visualization of how sodium really works in that extracellular area and affects the cell here we have hypernatremia conditions so in the blood there's a lot of sodium hanging out and you want to remember that water loves sodium so wherever there's a higher concentration of sodium that is going to pull water and water wants to be there and think of it like this if you eat a lot of salty foods what do you start to crave water so it's almost the same concept so we have lots of sodium in the blood the water that's in the cell is going to be pulled outside of the cell and this is going to cause the cell to shrink up now on the flip side hyponatremia we don't have a lot of sodium in the blood in that extracellular part low amounts so the water is like hey we're lonely so there's some inside the cell remember there's a lower concentration but there's some so that's going to cause the water and the extracellular part to be pulled inside the cell so what's going to happen the cell is going to start to swell now let's talk about the main causes of hyponatremia what can cause the sodium level in the blood to drop well not consuming enough sodium can do that along with giving a patient a medication called a diuretic diuretics are typically used when a patient has fluid volume overload they have too much water in their blood so we're going to manipulate their kidneys to pull that water off and they're going to urinate that out and the diuretic family that does that tends to be the thiazide so they influence the kidneys to really waste sodium and they're going to be wasting it in their urine and it'll drop our blood level also anything that's affecting our gi system because your gastric juices have a lot of sodium in them so vomiting or gi suction with an ng tube that can waste the sodium level along with the potassium level as well diarrhea sweating which contains a lot of sodium and addison's disease so let's do a quick review about addison's disease this is where a patient has low aldosterone what is aldosterone well it plays a role with our blood pressure helping us maintain our blood pressure so normally it will cause the kidneys to keep water and sodium because that will increase your blood pressure but in exchange for that you're going to excrete potassium so if we have a low level of aldosterone how's that going to affect the water and sodium it's going to cause you to lose it so you're going to lose your sodium but on the flip side it's going to cause you to keep your potassium so that can cause that and also s-i-a-d-h which stands for syndrome of inappropriate anti-diuretic hormone secretion and this is where they secrete too much adh which again is anti-diuretic hormone what does this do well whenever we're diuresing someone we're causing them to lose lots of fluid through their urinary system well if we antibiotic anti-diuretic hormone that's going to cause them to keep water not urinated as much so we're going to have more water in the body and in turn that's going to dilute the sodium some other conditions that can do that as well is whenever we have overload of fluid in the body like with congestive heart failure giving the patient um too much of a hypotonic solution or renal failure now let's look at the signs and symptoms associated with hyponatremia so to help you remember those signs and symptoms remember the word salt loss because we have a loss of sodium s is for seizures and stupor so stupor is where you have a decrease in consciousness like confusion and this can be associated with the nerve transmission being affected along with depending on how severe it is those brain cells start to swell a is for abdominal cramping l for lethargic t for tendon reflexes diminish trouble concentrating l loss of urine and appetite o for orthostatic hypotension overactive bowel sounds s for shallow respirations and this happens late due to skeletal muscle weakness and then s is for spasm of muscles now let's talk about the main causes of hypernatremia what causes our body to keep too much sodium in our blood well if you have some issues with certain hormones like in cushing's syndrome our body is keeping too much cortisol so we have an overproduction of this and this remember from our other lectures plays a role with the stress process so some functions of cortisol would be to help us maintain our blood pressure with the inflammatory process so if we have too much of this we're actually going to keep too much sodium in our blood and we're going to waste too much potassium so we'll have hyper neutrinia but hypokalemia in addition con syndrome can cause hypernatremia and this is also known as primary aldosterone ism and this is where we have too much aldosterone being present in our body over here we had addison's where we have low aldosterone so it's going to cause the opposite effect so with this remember the normal role of aldosterone was to maintain our blood pressure with the water and sodium and excreting potassium well if we have too much of this on board we're going to keep too much water and too much sodium hypernatremia and we're going to excrete our potassium and we can drop our levels and get hypokalemia in addition hypertonic solutions giving a patient too much of a salty solution as i like to think of it in the blood and corticosteroids can do this if a patient is not drinking enough water that can concentrate the sodium in the blood or if they're losing too much water and a condition that can do this is like diabetes insipidus that can happen as well the patient is going to be urinating so much with this condition in addition burns can cause this and an increased intake of sodium can cause this condition as well now let's look at the signs and symptoms associated with hypernatremia and to help you remember those let's remember the phrase no fried foods for you and a lot of times fried foods are packed full of sodium so we know we're dealing with a lot of sodium here so the f is for fatigue they'll feel very tired rs for restless really agitated they're going to be confused because you're having central nervous changes eye for increased reflexes this can progress to seizures and coma e for extreme thirst this is a huge sign remember this one and then d is for decrease urinary output and dry skin slash dry mouth now let's look at the electrolyte chloride so i want to do chloride after sodium because these two electrolytes really go together if they are generally a loss of sodium there's also going to be a loss of chloride and you're going to see a lot of overlapping causes and signs and symptoms so chloride is very important for helping maintain our acid-base balance because of its relationship with bicarb also it plays a role in digestion because we need it in order to make hydrochloric acid and it plays a role with balancing the fluids in our body with the help of sodium a normal level is 95 to 105 milli equivalents per liter now chloride levels are maintained with the help of our kidneys they tweak our blood and decide okay how much chloride we need if we don't need a lot we're going to excrete it also it's excreted through the sweat and the gi juices so if you have some issue with the kidneys or sweating too much or gi juices chances are you can imbalance your chloride levels so let's look at hypochloremia so this is where we have low blood levels of chloride and some main causes are typically gi related where the patient is losing a lot of chloride through vomiting or they're gastric juices like suction or if they have an ileostomy an ileostomy also can cause hyponatremia because this is where a surgical procedure has been created to bring the small bowel on top of the skin so the patient is having effluent which is stool coming through that now this is really rich in sodium also chloride so if they have where they're putting out a lot of effluent that can cause these levels to drop also diuretics can cause it thiazides that was very similar to hyponatremia burns and cystic fibrosis with cystic fibrosis these patients lose a lot of chloride especially through their sweat and patients who have fluid volume overload like heart failure siadh that's going to dilute the chloride and metabolic alkalosis can do this as well this is where we have a high level of bicarb and this is going to drop our chloride level and the reason it does this is because bicarbon chloride have this like opposite relationship especially in how they shift in and out of the red blood cell to help with proper gas exchange now the signs and symptoms of hypochloremia don't have their own specific ones compared to these other fluid and electrolytes they typically are going to be associated with whatever is causing this problem and if you can really remember the signs and symptoms of hyponatremia you can remember what hypochloramine is going to be because they really overlap so you may see dehydration signs and symptoms with an increased heart rate along with a decreased blood pressure fever vomiting diarrhea or being lethargic now let's look at hyperchloremia what can drive that chloride level up well it's going to be similar to the causes of hypernatremia because again sodium and chloride really go hand in hand so consuming too much sodium can drive the chloride level up like giving the patient too many hypotonic solutions also the patient on drinking enough or losing too much water can dehydrate them raising that sodium level up along with the chloride decreased bicarb level whenever the bicarb drops that can increase the chloride because of their opposite relationship so losing too much with maybe having too much diarrhea also the con syndrome this is where they have the increased aldosterone so the patient is going to be retaining a lot of sodium but excreting potassium and that can elevate our chloride level medications like corticosteroids and then metabolic acidosis can do this as well maybe a medication leading to this condition or some type of renal problem now the signs and symptoms of hyperchloremia are similar to hypernatremia and acidosis now let's look at the electrolyte potassium so potassium has an opposite relationship with sodium compared to how chloride had the similar one so chances are if you have a high sodium level you're going to have a low potassium level if you have a high potassium level you're going to have a lot low sodium level and this is because you know potassium is mainly found inside our cell there's a higher concentration there sodium the higher concentration was on the outside of the cell so they work together to help balance that fluid within the cell plus they play a huge role together with the sodium potassium pumps now the role of potassium is big with muscle contraction and nerve impulse so if you have an imbalance of this electrolyte you're going to start seeing issues with this a normal potassium is about 3.5 to 5 milli equivalents per liter so as you can see it's a very narrow range with a very important electrolyte so let's look at whenever we have hypokalemia so we have low potassium in the blood what are some main causes of this loop diuretics can cause this like furosemide it causes your kidneys to waste potassium so that's a big thing you've got to watch on those patients corticosteroids can do this and if a patient has too much insulin the reason for this is because insulin makes potassium move inside the cell so if we're causing it to leave the blood and go inside the cell we're dropping our blood levels cushing's syndrome can cause this this was the high cortisol so again it decreases the potassium increases the sodium and we talked reason for that earlier starvation patients who have been under extreme conditions where they haven't been able to eat can cause this or losing too much potassium and this is again found richly in those gi juices they're like vomiting or gi suctioning through the ng tube now what are the signs and symptoms that you may see in a patient who has hypokalemia so we have a low potassium level in our blood remember that everything is going to be low but it's also going to be slow so remember the seven l's l represents low so the first l is that the patient is going to be very lethargic and they can be confused second l is for low shallow respirations third l is lethal cardiac dysrhythmias they may have st depression a shallow t wave or a projecting u wave fourth l is lots of urine they can have frequent urination where the kidneys are just unable to concentrate the urine fifth l is leg cramps 6l is limp muscles and they may have decreased deep tendon reflexes and then our last l is for low blood pressure and heart rate now what can cause hyperkalemia where we have too much potassium in our blood well anything that really causes the potassium in the cell to move outside of the cell into the blood it's going to raise those blood levels so if a patient has severe burns this can occur along with tissue damage such as the condition like rhabdomyolysis this is where you have the breakdown of muscle tissue so whenever that muscle tissue is breaking down it's leaking potassium into the blood hence increasing it addison's disease can do this and again this is where we have decreased aldosterone so we're going to be excreting our sodium but increasing keeping our potassium renal failure a lot of times whenever you have patients who have an elevated bun and creatinine you are going to definitely see that potassium level increase very high a lot of times they need dialysis to bring it down medications can do this as well like those potassium sparing diuretics like spironolactone and ace inhibitors can do this and nsaids now what are the signs and symptoms of hyperkalemia well to help us remember those signs and symptoms let's remember the word murder because if the potassium level gets too high in the end it's going to murder the patient so m is for muscle weakness u is for urinary output is going to be little or none this is very common in patients who have renal failure they're putting out like no urine r is for respiratory failure whenever you get so high those muscles are going to just quit working and they're not going to be able to breathe d is for decreased cardiac contractility they're going to have a weak pulse low heart rate e for early on you're probably going to see muscle twitches and cramping and then r is for rhythm changes and i would remember this they are going to have tall peaked t waves you can also sometimes see prolonged pr interval now let's talk about the electrolyte calcium this is an essential ion that plays a huge role in the health of our bones and our teeth along with muscle and nerve conduction and clotting so in order to maintain a good level of calcium we have to have a diet that's rich in calcium so our gut plays a huge role with us absorbing calcium and once we absorb it what we really don't need to maintain that good blood level is going to be stored in our bones now our bones will monitor our blood levels and if those levels are low like in hypocalcemia what will happen is that the bones will actually start to release calcium into the blood but if this keeps happening over and over it's going to make this bone really weak over time and the person can have osteoporosis break their bones now calcium is really regulated by three different things one vitamin d it's very important a person has vitamin d on board in order to absorb calcium also the parathyroid hormone pth and calcitonin play a role with this pth is produced by the parathyroid gland and calcitonin is produced by the thyroid gland so if you have destruction to these glands or maybe a patient's had surgery we can alter calcium levels if we hurt these glands now a normal calcium level is 8.5 to 10.5 milligrams per deciliter so let's talk about what happens whenever we get a really low level of calcium we start to experience hypocalcemia so what can cause this is decrease in the parathyroid hormone and typically this is going to happen with patients who've had surgery of this structure especially like a thyroidectomy so if you've had a patient who've had who's had thyroid surgery check their calcium level because we could have damaged that gland a decreased intake of calcium for some people this is very hard to keep their calcium levels maintained especially if they have lactose intolerance so they'll have to be very conscious about making sure they get enough calcium through other sources having a low vitamin d level can cause this as well because vitamin d plays a role with us absorbing calcium chronic kidney disease because the kidneys are wasting too much calcium bisphosphonates can cause this as well this is a medication that's actually used to help treat osteoporosis so to make those bones stronger and how it does this is it helps decrease the release of calcium but sometimes we need the release of calcium into the blood and if we don't get that we can have low levels also another group of medications include the aminoglycosides these are antibiotics they end in myosin my cim they cause the body to waste calcium via the kidneys and then some anti-convulsants like phenobarbital and this affects the vitamin d levels in the body now what are the signs and symptoms of hypocalcemia well we know that our muscles and our nerves are definitely going to be affected so let's remember the word cramps c is for convulsions r is for reflexes hyperactive when you check those deep tendon they will be like that a is for arrhythmias they will have a prolonged qt interval if it's severely low enough m for muscle spasms and calves are feet this is known as tetany then p is for positive signs and these are signs that you can see in a patient who has a really low calcium level so one of these signs that you definitely want to remember is called trusocine and this is where you can take a blood pressure cuff put it on the arm inflate it to a number greater than their systolic and leave it there for three minutes now if it's positive you will notice the hand will draw in toward the body and flexion will occur at the wrist thumb and mcp joints but the fingers will remain extended then another sign that you want to remember is called chavat stick sign and this is nerve hyperexcitability of the facial nerve specifically that cranial nerve seven and to elicit this response you're going to tap via the masseter muscle at the jaw's angle and the facial muscles on that same side that you tapped will contract momentarily so the lips will twitch and then s is for sensation of tingling and numbness known as paresthesia and this can be felt in the fingers and toes now what can cause hypercalcemia increasing the blood level of calcium well if you have an overactive parathyroid where you're having too much parathyroid hormone in the body because parathyroid hormone is going to cause the release of calcium if we have too much we're going to release way too much calcium in the blood next is increased vitamin d usage because vitamin d helps us increase our calcium helps us absorb it so we have too much that can increase it or using supplements with too much calcium in it if a patient has cancer that has spread to the bones this can affect calcium levels because it causes too much calcium to leak into the blood and then medications some main ones you can remember are like the thiazide diuretics can do this because it affects how the kidneys are absorbing calcium and then lithium can do this as well because lithium can affect the parathyroid hormone causing the body to have too much calcium now what are the signs and symptoms that a patient has too much calcium in their blood well this patient is going to be extremely weak so w is for weakness of the muscles it'll be very profound e is for ekg changes and remember they can have a shortened qt interval a is for absent reflexes and they can also have altered mental status and abdominal distension from constipation and then k is for kidney stone formation so these patients are at risk for the development of kidney stones now let's talk about the electrolyte magnesium so this electrolyte likes to hang out inside the cell just like potassium did it has a function in nerve and muscle which plays a role with the sodium and potassium pump so with this pump you have atp and what happens whenever magnesium binds with atp because atp needs it in order to function it's going to move three sodium ions out of the cell and two potassium ions into the cell therefore we need a proper balance of magnesium in order for this function to occur in addition it plays a role with our vessels maintaining our blood pressure and how our muscles contract and relax so with magnesium what happens with contraction you have calcium that's the big one that plays a role with that but in a nutshell magnesium competes with calcium for that binding spot so whenever relaxation is going to happen we have magnesium that allows that to happen so think about this if we didn't have enough magnesium if it allows us to have our muscles relaxed what's going to happen instead instead your muscles are going to have spasms they're going to cramp and have contraction issues so magnesium is mainly absorbed in our gut specifically our small intestines so if we have issues with our gut as you're going to see with our causes we can have issues with balancing our magnesium levels and magnesium imbalances will more than likely present with other electrolyte imbalances like that of calcium and potassium so a lot of times if your calcium levels are low your magnesium levels will be low and vice versa now a normal magnesium level is 1.5 to 2.5 milligrams per deciliter and if you can see that range it's very narrow so let's talk about low levels of magnesium in the blood this is known as hypomagnesemia and what can cause this is not consuming enough magnesium or we have some other electrolyte imbalances like we have issues with calcium or potassium or we have malabsorption disorders of that small intestine that can cause that or they are taking a ppi a proton pump inhibitor that can decrease absorption of magnesium and patients who have alcoholism can have this as well now let's talk about the signs and symptoms of a low magnesium level so with this you want to remember the word twitch because everything in the patient is really going to be excited it's going to be hyperactive on the flip side whenever you have a high mag level everything is going to be really slow and not hyperactive so t is for trusocide and chavox stick sign and this is related to also having a low calcium level so hypocalcemia w is for weakness i is for increased deep tendon reflexes again everything is going to be hyperactive t is for torsos to plant and this is an abnormal heart rhythm that can lead to sudden cardiac death and it can be a lot of times seen in patients who have alcoholism and then another t for this part is tetany those seizures and other ekg changes that go with the calcium and the potassium being decreased c is for calcium and potassium levels low they'll present together and then lastly is h for hypertension because magnesium helps with our blood pressure and having a low amount can make those vessels more likely to lead to hypertension now let's look at the main causes of what can elevate the magnesium level in the blood known as hyper magnesemia well this condition is relatively rare it tends to happen whenever we're trying to correct a low magnesium level so we give them too much or you want to monitor a patient for this condition if they're an ob patient labor and delivery the patient has preeclampsia and they're receiving magnesium sulfate so we want to monitor their mag levels to make sure we're not giving them too much and you're checking those deep tendon reflexes making sure they're there because if they're not there we may have a problem with our magnesium level also renal function can mess this level up as well causing us to keep too much magnesium now with this condition with the signs and symptoms everything in your body is going to be lethargic it's not going to be really hyperactive like over here so let's remember the word lethargic and typically with this condition you're only going to see it in severe cases mild cases may not present with signs and symptoms so l is for lethargic it may be profound e is for ekg changes with prolonged pr and qt intervals and maybe a wide qrs complex t is for tendon reflexes absent or grossly diminished h is for hypotension a is for arrhythmias like bradycardia heart blocks r is for red and hot face they're going to have flushing gi issues is for g nauseam vomiting i is for impaired breathing due to skeletal muscle weakness and c is for confusion they can have neurological impairment now let's talk about our last electrolyte phosphate so phosphate plays a role in teeth and bone building it's stored in the bones it's absorbed by the gut and excreted in the kidney so any issues with those structures we're going to have an imbalance of phosphate it's also regulated by the parathyroid gland because the parathyroid gland will tell the kidneys to inhibit inhibit reabsorption and then vitamin d influences how we absorb phosphate so are you seeing the parallels between calcium and phosphate they have some similarities so a normal phosphate level is anywhere between 2.5 to 4.5 milligrams per deciliter so let's talk about if we have a low phosphate level in the blood this is known as hypophosphatemia what can cause this overusage of aluminum based antacids too much of this will block the gut's absorption of phosphate lowering her level also starvation and refeeding syndrome can cause this refeeding syndrome occurs when a patient has experienced severe starvation they haven't had any food and then whenever we give them food it can increase their blood sugar because that's what it normally does but because they've went under such extreme conditions in their body when this insulin is released because of this high blood sugar it's going to need phosphate to change glucose into energy so that is going to further deplete those phosphate levels leading to the low blood levels of phosphate also an overactive parathyroid can do this because if we have too much parathyroid activity we're going to majorly inhibit how the kidneys are reabsorbing phosphate hence we're really wasting it all and not getting it in our system and then low vitamin d levels can cause this as well because vitamin d plays a huge role in absorbing phosphate now let's look at the signs and symptoms of hypophosphatemia and to help you remember the signs and symptoms let's remember the word bone because phosphate is huge with our bone health so b is for bone pain and fractures o is for osteomalacia and this is where you have softening of the bones and whenever you have this especially in children it can affect their growth making them shorter and it can result in the bowing of the legs how the bones are formed n is for neurostatus changes they can have irritability confusion seizures and then e is for erythrocyte destruction so phosphates play a huge role with our red blood cells so we can have our red blood cells being destroyed and this can lead to hemolytic anemia now let's look at elevated phosphate levels in the blood also known as hyperphosphatemia so overusage of phosphate containing laxatives like fleets enema can cause a high phosphate level so if a patient has renal failure you definitely want to watch using those too much vitamin d on board can cause it as well rhabdomyolysis can cause this i mentioned this earlier this is where the muscles start to become damaged when they break down that contents of the muscle is going to go to the kidneys because your kidneys filter your blood and it's going to damage your kidneys and when your kidneys get damaged we're not going to be able to deal with phosphate like we should and we'll keep too much and have high levels and then hypoparathyroidism so an underactive parathyroid what's going to happen instead of normally being able to inhibit reabsorption of phosphate by the kidneys we're not going to have that and so we're going to keep more so that will elevate the levels now the signs and symptoms of hyperphosphatemia can be similar to that in hypocalcemia so patients with high phosphate levels may be experiencing convulsions they may have hyperactive reflexes arrhythmias spasms in their muscles they may also have itching this is found in a lot of renal patients and they can have signs of trusos and chavot sticks okay so that wraps up this review over fluid and electrolytes now don't forget to access the free quiz that will test you on this material

Channel: RegisteredNurseRN

Views: 1,421,506

Keywords: fluid and electrolytes, fluid and electrolytes for nursing students, fluid and electrolytes nclex review, nursing school, potassium, chloride, sodium, magnesium, phosphate, fluid and electrolyte values, fluid and electrolytes imbalance, fluid and electrolytes balance, calcium, fluid and electrolytes nclex, hypermagnesemia, hypomagnesemia, hypercalcemia, hypocalcemia, hyperkalemia, hypokalemia, hypochloremia, hyperchloremia, hyperphosphatemia, hypophosphatemia, hyponatremia, comprehensive review

Id: -PaHC8fleO0

Length: 35min 21sec (2121 seconds)

Published: Thu Sep 23 2021