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c Loss of body fluids from prolonged vomiting, diarrhea, sweating or high fever
 
   (dehydration).
 c! "c ÷? High levels of blood sodium.

Õidney failure, or kidney disorders
÷?
= ? ‘
‘

Diabetes insipidus or diabetic coma

÷?
½? is an electrolyte disturbance whereby there is an abnormally depleted
level of the chloride ion in the blood. Drugs such as: androgens, corticosteroids, estrogens, and certain
÷?
diuretics.
½? „ level below 95 mEq/L
½? ›ormal = 95 ± 108 mEq/L ÷? is often comorbid with diabetes or hyponatremia
($"
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O? prolonged vomiting
O? nasogastric suctioning ÷? Dehydration, fluid loss, or high levels of blood sodium may be noted.
O? excessive sweating ÷? xou may be experiencing other forms of fluid loss, such as diarrhea,
O? diarrhea or vomiting when suffering from hyperchloremia.
O? loss of potassium, sodium deficiency ÷? xou may be a diabetic, and have poor control over your blood sugar
O? metabolic alkalosis levels (they may be very high).
O? ë
  ÷? Could lead to poor control of blood sugar concentration, which could
O? | fluids w/o electrolyte supplementation cause it to become elevated. Hyperchloremia can be symptomatic

!#  with signs of Õussmaul's breathing, weakness, and intense thirst.
 ? neuromuscular
? tetany %&
&
? hyperactive reflexes
? seizures °? |neffective Breathing attern
 ? cardiac arrythmias °? Decrease cardiac output
 ? diagnostics °? |mbalanced nutrition greater than body requirement
? chloride level less than 98mEq/L °? ‰luid olume Excess
? sodium less than 135 mEq/L °? „ctivity |ntolerance
°? fatigue
? serum pH >7.45(as chloride decreases, HC03 increases)
°? isk for sensory/ perceptual alterations
 °? isk for injury
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%&
& °? isk for impaired skin integrity
÷? |mbalance nutrition: less than body requirements °? „nxiety
÷? isk for injury "'"
÷? „ctivity intolerance 
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°? Correct the underlying cause
÷? „ssess for clinical manifestations of hypochloremia. °? estore electrolyte, fluid and acid-base balance
÷? Vonitor |
 and obtain daily weights. °? |nfuse Hypotonic solution
÷? Vonitor blood chemistries carefully as well as fluid and electrolyte °? Lactated inger¶s Solution (to convert bicarbonate in the liver)
status. °? | Sodium Bicarbonate may be prescribed
÷? „ssess LC and muscle strength and movement and report changes °? Diuretics
to the physician promptly. °? estrict Sodium, Chloride and ‰luids
%&
÷? rovide a safe environment, particularly for the clients with
°? „ssess /S, S/S
changes in LC or mental status. °? Evaluate neuromuscular status
÷? Vonitor vital signs frequently. °? Vonitor serum/urinary Cl levels; „BG, serum ›a/Õ
÷? rovide the patient with foods high in chloride content (tomato juice, °? |nfuse | cautiously (may cause fluid shifting to cerebral cells)
bananas, dates, eggs, cheese, milk, canned vegetables, and processed °? Safety measures
meats). °? Vonitor respiratory/cardiac status
÷? estrict intake of free water (water without electrolytes) or bottled °? Vonitor |

°? „ssess LC; reorient as needed
water because it can excrete large amounts of chloride.
°? estrict ›a
Cl and ‰luid if ordered
c

"'" °? |f receiving ›aBicarb assess for S/S overcompensation (alkalosis)
÷? „dminister normal saline (0.9% sodium chloride) or half-strength '

%
"
saline (0.45% sodium chloride) via | . °? Stable ital Signs
÷? „mmonium chloride ± an acidifying agent maybe prescribed to treat °? riented to person, place and time
metabolic alkalosis. Dosage depends on the patient¶s weight and °? ‰ree from |njury
°? ›ormal gait
serum chloride level.
°? ›ormal peripheral pulses
'

%
" °? ›ormal cognitive ability
÷? Vaintains fluid and electrolyte balance. °? ›ormal Serum Chloride Level and other Lab esults
÷? 6ill have a normoactive DTs.
÷? ›o hyperexcitability, weakness, twitching, and cramping of muscles.
÷? ‰ree of signs and symptoms of metabolic alkalosis.

ë? ‘
‘


Hyperchloremia is an electrolyte imbalance and is indicated by a high level of
chloride in the blood. The normal adult value for chloride is 97-107 mEq/L.

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