Definition: proportional loss of extracellular fluid (ecf) volume and electrolytes. Loss of only water with high na related to following causes. High adh water retention and low na due to disorders of cns and lungs, infections and malignant tumors. Give prescribed isotonic/hypotonic iv fluids, prescribed prn antiemetics or andidiarrheals. Elevated u wave and flattened t wave on. Teach about foods high in potassium (melons, apricots, bananas, milk, citrus, meat, grains( Give ordered iv or oral k+ supplements. Excess na intake (near drowning in the ocean, sodium bicarbonate, hypertonic. Give ordered ivf (d5w, hypotonic solution) and prescribed diuretics. Give prescribed calcium and vitamin d supplements. Teach high-calcium foods (milk, salmon, green leafy vegetables, sardines) Increased hyperparathyroid hormone (pth) levels, low pth (with malignancy) Give prescribed ivf and meds (calcitonin, loop diurertic, bisphosphonate) Loss of acidic gastric secretions (vomiting ketoacidosis, uremia) and gastric suction) Increased rate and depth of respiration (kussmaul respiration) Decreased ventilation and co2 retention from pulmonary edema.