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Low body water
    Contributing factors
         1. Reduced input
              a. age-related decrease in thirst sensation
              b. physical and mental disabilities restricting access to water
              c. diseases requiring dietary restriction of water (e.g., high blood pressure, congestive heart failure)
              d. intravenous (IV) therapy using solutions with high osmotic pressure
         2. Increased output
              a. profuse sweating
              b. vomiting or diarrhea
              c. fever
              d. diabetes mellitus
              e. diuretic medications
              f. inhibition of ADH secretion by alcohol ingestion
              g. possible decreased kidney response to ADH
    Effects
         1. less endurance
         2. less ability to prevent overheating
         3. nervous system malfunctions
         4. joints stiffness
         5. constipation
         6. decreased circulation and ischemia from low blood pressure
         7. reduced kidney functioning
         8. formation of urinary stones
         9. drying of the eyes, mouth, and skin
         10. sunken eyes and loose skin
         11. coma and death

High body water
    Contributing factors
         1. reduced GFR
         2. excess oral intake
         3. excess IV therapy
         4. use of IV solutions with low osmotic pressures
         5. excess ADH production
    Effects
         1. low osmotic pressure and cell swelling
         2. high total volume causing high blood pressure, an overburdened heart, and edema

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Low sodium
    Contributing factors
         1. inadequate dietary intake
         2. excess water intake
         3. profuse sweating
         4. vomiting or diarrhea
         5. diabetes mellitus
         6. certain diuretics
         7. use of dilute IV solutions
    Effects
         1. low osmotic pressure and cell swelling
         2. low blood pressure
         3. rapid heart rate
         4. muscle weakness
         5. brain malfunctions including confusion, seizures, and coma

High sodium
    Contributing factors
         1. excess dietary sodium intake
         2. low water intake
         3. excess water loss
         4. circulatory diseases that reduce kidney perfusion
         5. use of IV solutions with high sodium concentrations
    Effects
         1. high osmotic pressure and cell shrinking
         2. high total volume (see above)

Low potassium
    Contributing factors
         1. dietary deficiency
         2. excess loss
              a. vomiting or diarrhea
              b. loss accompanying starvation
              c. diabetes mellitus
    Effects
         1. mental malfunctions (confusion, disorientation)
         2. muscle weakness and muscle cramps
         3. constipation
         4. irregular heart beat
         5. reduced breathing

High potassium
    Contributing factors
         1. excess use of salt substitutes that contain potassium
         2. conditions causing extensive cell injury
         3. GI tract bleeding
         4. factors reducing kidneys' potassium secretion
              a. certain diuretics and NSAIDs
              b. conditions that raise acid levels (e.g., respiratory problems, diabetes mellitus)
    Effects
         1. irregular heart beat
         2. dangerously slow heart rate
         3. muscle weakness
         4. depression

High acid levels (low pH)
    Contributing factors
         1. respiratory insufficiency
         2. infection
         3, surgery
         4. increased protein breakdown
         5. diabetes mellitus
    Effects
         1. distortion of molecules
         2. poor cell functioning throughout body

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