Fluids and electrolytes play a number of roles in a person’s health. Electrolytes are vital to your body’s chemistry. Electrolytes in your blood and urine help to catalyze the chemical reactions that keep your cells functioning. High levels or low levels of electrolytes can trigger health problems. The same is true for the water balance in your body--too much or too little causes problems. For example, pneumonia, diuretic drugs or an over-intake of fluids can lead to low sodium levels. In turn, low sodium can trigger confusion, fatigue and even seizures. A low intake of water can lead to dehydration. Chronic dehydration may lead to the development of kidney stones and fatigue. Fluid balance affects electrolyte balance and vice versa.
A nurse must be able to recognize patients who are at risk for fluid and electrolyte imbalances. He must be able to identify the symptoms of various electrolyte imbalances. He must understand how prescription drugs can disrupt the balance of fluids in the body and be able to react if such a situation occurs and endangers a patient. He needs to be able to recognize the signs of edema formation within the organs. He must also be able to take appropriate measures to determine the extent of a fluid imbalance if one is present.
The questions on the NCLEX will attempt to determine that a nursing candidate can appraise a situation with specific circumstances, recognize the signs and symptoms of an imbalance in the fluids and electrolytes and then take the appropriate action to protect the health of the patient. To that end, it is important to study not only how fluids and electrolytes affect the body’s symptoms, but also how these affects are likely to present among patients with different conditions and backgrounds.
One sample question taken from Kozier and Erb’s Fundamentals of Nursing preparatory quiz provided by Pearson Higher Education is “Which individual would least likely suffer from a disturbance in fluid volume, electrolyte, or acid-base balance?” with the possible answers being an infant with gastroenteritis, an elderly patient with type I decubitis, an adult with impaired cardiac function or a person who is confused. The correct answer, provided upon taking the sample quiz, is an elderly patient with type I decubitis because aging can disrupt fluid imbalance as can symptoms caused by decubitis.
Another question from the same quiz is “Edema that forms in clients with kidney disease is due to:” with the choices of reduced plasma oncotic pressure, decreased hydrostatic pressure in the capillaries, decreased permeability in the capillaries and obstructed lymph flow. The correct answer is reduced plasma oncotic pressure triggered by low levels of plasma protein endemic to kidney disease.