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Fluid and electrolyte management: putting a plan in motion.

Authors
  • Rhoda, Kristen M
  • Porter, Mary Jo
  • Quintini, Cristiano
Type
Published Article
Journal
JPEN. Journal of parenteral and enteral nutrition
Publication Date
Nov 01, 2011
Volume
35
Issue
6
Pages
675–685
Identifiers
DOI: 10.1177/0148607111421913
PMID: 22042047
Source
Medline
License
Unknown

Abstract

Fluid and electrolyte management is challenging for clinicians, as electrolytes shift in a variety of settings and disease states and are dependent on osmotic changes and fluid balance. The development of a plan for managing fluid and electrolyte abnormalities should start with correcting the underlying condition. In most cases, this is followed by an assessment of fluid balance with the goal of achieving euvolemia. After fluid status is understood and/or corrected, electrolyte imbalances are simplified. Many equations are available to aid clinicians in providing safe recommendations or at least to give a starting point for correcting the abnormalities. However, these equations do not take into consideration the vast differences between clinical scenarios, thus making electrolyte management more challenging. The supplementation plan, whether delivered intravenously or orally, must include an assessment of renal and gastrointestinal function, as most guidelines are established under the assumption of normal digestion, absorption and excretion. After the plan is developed, frequent monitoring is vital to regain homeostasis. A fluid and electrolyte management plan developed by a multidisciplinary team is advantageous in promoting continuity of care and producing safe outcomes.

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