Chapter 17: Fluid, Electrolyte & Acid-Base Imbalances

Students learn to assess and manage fluid volume disorders, including hypovolemia and hypervolemia, understanding their diverse etiologies ranging from hemorrhage and dehydration to heart failure and renal dysfunction. The chapter provides comprehensive coverage of electrolyte imbalances, detailing the pathophysiology, clinical manifestations, and therapeutic management of sodium disorders (hypernatremia and hyponatremia), potassium disturbances (hyperkalemia and hypokalemia), calcium abnormalities (hypercalcemia and hypocalcemia), magnesium imbalances (hypermagnesemia and hypomagnesemia), and phosphate disorders (hyperphosphatemia and hypophosphatemia). Acid-base physiology receives thorough examination, including the roles of buffer systems, respiratory compensation, and renal regulation in maintaining pH homeostasis. Students explore the four primary acid-base disorders—metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis—learning to interpret arterial blood gas results and understand compensatory mechanisms. Clinical nursing management emphasizes systematic patient assessment, including daily weight monitoring, intake and output measurement, cardiovascular and respiratory evaluation, and skin integrity maintenance. The chapter concludes with detailed coverage of intravenous therapy, central venous access devices including peripherally inserted central catheters and implanted ports, and the selection of appropriate IV fluid solutions, preparing nurses to safely manage these life-threatening imbalances in acute care settings.