Disorders of the Gastrointestinal System, 2nd Edition
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fusion or mental status changes occur, or signs of fluid and electrolyte imbalance are present (Alexandraki & Smetana, 2021). The following are signs and symptoms of fluid and electrolyte imbalance (Sterns, 2022a): ● Thirst. ● Poor skin turgor. ● Dry skin. ● Fever.
trolyte imbalances than healthy adults (Sterns, 2022b). Signs and symptoms of hypernatremia (Sterns, 2022b) include: ● Flushed skin. ● Weakness. ● Lethargy. ● Tremors or neuromuscular excitability. ● Confusion. ● Seizures. ● Coma. ● Extreme thirst. | NURSING CONSIDERATION Patients should be encouraged to attempt to continue to drink small amounts of fluids or electrolyte re - placement liquids (broth, sports drinks), even if they are experiencing vomiting. This may decrease the se- verity of dehydration and electrolyte imbalance and reduce vomiting as flu - id volume is replaced (Sterns, 2022b). Symptoms of hypokalemia include (Mount, 2021): ● Weakness. ● Cardiovascular collapse (sudden loss of blood flow to the brain and other organs, causing altered mental status and hypotension). ● Rhabdomyolysis. In most cases, treatment is supportive until gastroenteritis signs and symptoms resolve. Patients need rest and nutritional support. Lost fluids and electrolytes can be replaced with oral fluids, but most car - bonated beverages do not contain elec- trolytes, and caffeinated drinks can wors- en dehydration. Broth, oral glucose, and ● Muscle cramps or spasms. ● Rapid or irregular heart rate. ● Psychosis, confusion.
● Dizziness. ● Weakness. ● Elevated heart rate.
● Decreased blood pressure. ● Changes in mental status. ● Seizures. ● Coma.
| NURSING CONSIDERATION
Remain alert to the signs and symp- toms of dehydration and electrolyte imbalance, especially in children, old- er adults, and debilitated patients. Symptoms can manifest differently in each of these populations. For in- stance, older adults may exhibit con- fusion, whereas babies may present with dry diapers or concentrated urine and a sunken fontanel. Weight loss, muscle cramps, profound weakness, orthostatic hypotension, tachycardia, concentrated urine, or oliguria may be present in older adults (Sterns, 2022a). Changes in mental status, seizures, and coma require immediate emergency in- tervention. Common electrolyte imbal- ances with severe vomiting and diarrhea are hypernatremia (elevated sodium) and hypokalemia (low potassium). Children and older adults are at higher risk of elec-
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