Susceptible to changes in serum electrolyte levels

• Diarrhea
• Excessive fluid intake
• Inadequate action to address modifiable factors
• Inadequate fluid intake
• Inadequate knowledge of modifiable factors
• Vomiting

• Compromised regulatory mechanism
• Endocrine regulatory dysfunction
• Prolonged duration of surgical procedure
• Renal dysfunction
• Treatment regimen

• Fluid and electrolyte status, weight, intake and output, urine specific gravity, skin turgor, mucous membranes
• Results of laboratory tests including serum electrolytes, blood urea nitrogen
• Vital signs including heart rate and rhythm, blood pressure, pulse
• History of renal, cardiac, and gastrointestinal disorders

• Patient will maintain electrolyte levels within normal limits.
• Patient will maintain adequate fluid balance consistent with underlying disease restrictions.
• Patient will identify health situations that increase risk for electrolyte imbalance and verbalize interventions to promote balance.
• Patient will verbalize signs and symptoms that require immediate intervention by health care provider.
• Patient will remain safe from injury associated with electrolyte imbalance.

Suggested NOC Outcomes

• Assess patient's fluid status. Patients who demonstrate fluid volume alterations are likely to have electrolyte alterations as well.
• Monitor patient for physical signs of electrolyte imbalance. Many cardiac, neurologic, and musculoskeletal symptoms are indicative of specific electrolyte abnormalities.
• Collect and evaluate serum electrolyte results as ordered to allow for prompt diagnosis and treatment of any abnormalities.
• Educate patient and family regarding risks for electrolyte disturbances associated with their particular medical condition and possible interventions if symptoms occur. Early identification and intervention may prevent life-threatening complications of electrolyte imbalance.
• Provide support and encouragement to patient and family in their efforts to participate in the management of the condition. Positive feedback will increase self-confidence and feeling of partnership in care.
• Coordinate care with other members of the health care team to provide safe environment. Electrolyte imbalances can cause poor coordination, weakness, and altered gait.

Suggested NIC Interventions

• Patient's electrolyte levels remain within normal limits.
• Patient's fluid balance is consistent with restrictions of underlying disease.
• Patient identifies health situations that increase the risk for electrolyte imbalance and interventions to promote balance.
• Patient verbalizes signs and symptoms that require immediate interventions by a health care provider.
• Patient remains safe from injury associated with electrolyte imbalance.

• Record of patient's electrolyte results and interventions
• Record of patient's fluid status
• Patient's understanding of signs and symptoms that require intervention of a health care provider
• Evaluations for expected outcomes

• Ellison, D., & Cisneros Farrar, F. (2018). Kidney influence on fluid and electrolyte balance. Nursing Clinics of North America, 53(4), 469-480.
• Giordano, M., Ciarambino, T., Castellino, P., Malatino, L., Di Somma, S., Biolo, G., … Adinolfi, L. E. (2016). Diseases associated with electrolyte imbalance in the ED: Age-related differences. American Journal of Emergency Medicine, 34(10), 1923-1926.
• Kear, T. M. (2017). Fluid and electrolyte management across the age continuum. Nephrology Nursing Journal, 44(6), 491-497.
• Walker, M. D. (2016). Fluid and electrolyte imbalances: Interpretation and assessment. Journal of Infusion Nursing, 39(6), 382-386.