General

Synonym/Acronym:
Cl⁻.

Rationale
To evaluate electrolytes, acid-base balance, and hydration level.

Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction.

Normal Findings
Method: Ion-selective electrode.

Critical Findings and Potential Interventions

• Less than 80 mEq/L or mmol/L (SI: Less than 80 mmol/L)
• Greater than 115 mEq/L or mmol/L (SI: Greater than 115 mmol/L)

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.

Consideration may be given to verification of critical findings before action is taken. Policies vary among facilities and may include requesting immediate recollection and retesting by the laboratory or retesting using a rapid point-of-care testing instrument at the bedside, if available.

The following may be seen in hypochloremia: twitching or tremors, which may indicate excitability of the nervous system; slow and shallow breathing; and decreased blood pressure as a result of fluid loss. Possible interventions relate to treatment of the underlying cause.

Signs and symptoms associated with hyperchloremia are weakness; lethargy; and deep, rapid breathing. Proper interventions include treatments that correct the underlying cause.