Management Of Electrolyte Disturbances Research Articles

The Investigation of Nurses’ Knowledge according to Their Level of Education regarding The Pathological Electrolyte Disturbances of Patients During Their Hospitalization in A Rehabilitation Center

Background: In order to provide optimal care, health care providers should be familiar with the principles and practice of fluid and electrolyte physiology and pathophysiology. Attention to the patient's fluid and electrolyte status is essential to nurses' knowledge. The purpose of the research is to investigate the knowledge of nurses regarding the electrolyte disorders of patients during their hospitalization in a rehabilitation center and to correlate their education with the knowledge regarding electrolyte disorders. Materials and Methods: A quantitative research was carried out using a structured questionnaire. The questionnaire was tested to ensure clarity, content validity and internal consistency (Cronbach's Alpha of 0.822). The sample consisted of 50 nurses who worked at the University General Hospital in the Rehabilitation Center. Data were coded and analyzed using the statistical program IBM-SPSS version-21. Results: Through the results it was initially observed that the largest sample considers that the recording of fluid intake and output is important. The vast majority (92%) know about electrolyte disturbances. A large part (84%) has not attended any training program. Inaccurate diagnosis of electrolyte disturbances can be a risk to the patient. Conclusions: In conclusion, it was found that the nurses studied have a satisfactory level of knowledge regarding the assessment and management of electrolyte disturbances with postgraduates nurses and university education nurses emerging as better knowledgeable of patients' electrolyte disturbances during their hospitalization in a rehabilitation center. Understanding and monitoring a patient's fluid, electrolyte, and acid-base balance is critical to providing nursing care.

Fluid and Electrolyte Management in the Neonate: Sodium and Chloride.

Maintenance of electrolyte balance in the neonate is a challenge in the context of illness or prematurity. Neonatal providers' approach to fluid management changes and adapts based on the newborn's age, maintenance needs, deficits, and ongoing losses. Understanding the total body water content of the fetus and newborn is foundational to management of electrolyte disturbances. This article reviews common imbalances of sodium and chloride, identifies causes of imbalances, and discusses current evidence-based treatment options.

Perioperative Management of a Patient With Cushing Disease.

Patients with Cushing disease (CD) may present with both chronic and acute perioperative complications that necessitate multidisciplinary care. This review highlights several objectives for these patients before and after transsphenoidal surgery. Preoperative management includes treatment of electrolyte disturbances, cardiovascular comorbidities, prediabetes/diabetes, as well as prophylactic consideration(s) for thromboembolism and infection(s). Preoperative medical therapy (PMT) could prove beneficial in patients with severe hypercortisolism or in cases of delayed surgery. Some centers use PMT routinely, although the clinical benefit for all patients is controversial. In this setting, steroidogenesis inhibitors are preferred because of rapid and potent inhibition of cortisol secretion. If glucocorticoids (GCs) are not used perioperatively, an immediate remission assessment postoperatively is possible. However, perioperative GC replacement is sometimes necessary for clinically unstable or medically pretreated patients and for those patients with surgical complications. A nadir serum cortisol of less than 2 to 5µg/dL during 24 to 74 hours postoperatively is generally accepted as remission; higher values suggest nonremission, while a few patients may display delayed remission. If remission is not achieved, additional treatments are pursued. The early postoperative period necessitates multidisciplinary awareness for early diagnosis of adrenal insufficiency (AI) to avoid adrenal crisis, which may also be potentiated by acute postoperative complications. Preferred GC replacement is hydrocortisone, if available. Assessment of recovery from postoperative AI should be undertaken periodically. Other postoperative targets include decreasing antihypertensive/diabetic therapy if in remission, thromboprophylaxis, infection prevention/treatment, and management of electrolyte disturbances and/or potential pituitary deficiencies. Evaluation of recovery of thyroid, gonadal, and growth hormone deficiencies should also be performed during the following months postoperatively.

Electrolyte Disturbances in Critically Ill Cancer Patients: An Endocrine Perspective.

Electrolyte disturbances are frequently encountered in critically ill oncology patients. Hyponatremia and hypernatremia as well as hypocalcemia and hypercalcemia are among the most commonly encountered electrolyte abnormalities. In the intensive care unit, management of critical electrolyte disturbances is focused on initial evaluation and immediate treatment plan to prevent severe complications. A PubMed search was performed to identify best available evidence for evaluation and management of dysnatremias, hypocalcemia, and hypercalcemia. Current literature was reviewed regarding the management of electrolyte disturbances. The role of new therapeutic options, for example, vaptans for hyponatremia, teriparatide for hypocalcemia, and denosumab for hypercalcemia, is discussed. Early diagnosis and appropriate management are expected to reduce adverse outcomes.