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Med-Surg I > Assessment and Care of Patients with Fluid and Electrolyte Imbalances > Flashcards

Assessment and Care of Patients with Fluid and Electrolyte Imbalances Flashcards

1
Q

Sodium Levels

A

136-145

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2
Q

Potassium Levels

A

3.5-5.0

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3
Q

Calcium Levels

A

9.0-10.5

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4
Q

Magnesium Levels

A

1.3-2.1

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5
Q

Phosphorus Levels

A

3.5-4.5

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6
Q

Signs & Symptoms of Hyponatremia

A

Vital Signs: Hypothermia, tachycardia, rapid thready pulse, hypotension, orthostatic hypotension

Neuromusculoskeletal: Headache, confusion, lethargy muscles weakness to the point of respiratory compromise, fatigue, decreased DTRs, seizures

GI: Increased motility, hyperactive bowel sounds, abdominal cramping, nausea

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7
Q

Signs & Symptoms of Hypernatremia

A

Vital Signs: Hyperthermia, tachycardia, orthostatic hypotension

Neuromusculoskeletal: Restlessness, irritability, muscle twitching to muscle weakness, including respiratory compromise, decreased to absent DTRs, seizures, coma

GI: Thirst, dry mucous membranes, increased motility, hyperactive bowel sounds, abdominal cramping, nausea

Other signs: Edema, warm flushed skin, oliguria

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8
Q

Risk Factors for Hyponatremia

A
  • Vomiting, nasogastric suctioning, diarrhea, tap water enemas, GI obstructions
  • Diuretics, kidney disease, adrenal insufficiency
  • Excessive diaphoresis, burns, wound drainage, ascites
  • Excessive oral water intake
  • Heart failure, cirrhosis, nephrotic syndrome
  • Excessive hypotonic IV fluids
  • Inadequate sodium intake (NPO, older adults)
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9
Q

Risk Factors for Hypernatremia

A
  • Water deprivation (NPO)
  • Excessive sodium intake
  • Excessive sodium retention d/t kidney failure, aldosteronism, or some medications (glucocorticosteroids)
  • Fluid losses - fever, diaphoresis, burns, diarrhea
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10
Q

Signs and Symptoms of Hypokalemia

A
  • Weak irregular pulse; hypotension; respiratory distress
  • Weakness to the point of respiratory collapse and paralysis, muscle cramping, decreased muscle tone and hypoactive reflexes, paresthesias, mental confusion
  • Decreased motility, abdominal distention, constipation, ileus, nausea, vomiting, anorexia
  • Polyuria
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11
Q

Signs and Symptoms of Hyperkalemia

A
  • Slow, irregular pulse; hypotension
  • Restlessness, irritability, weakness to the point of ascending flaccid paralysis, paresthesias
  • Nausea, vomiting, increased motility, diarrhea, hyperactive bowel sounds
  • Oliguria
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12
Q

Risk Factors of Hypokalemia

A
  • Abnormal GI losses: vomiting, NG suctioning, diarrhea, excess laxative use
  • Kidney losses: excess use of diuretics
  • Skin losses: diaphoresis
  • Insufficient potassium r/t inadequate dietary intake (rare)
  • Intracellular shift r/t metabolic alkalosis, during periods of tissue repair, TPN
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13
Q

Risk Factors of Hyperkalemia

A
  • Potassium supplementation, salt substitute
  • Extracellular shift r/t decreased insulin, acidosis, tissue catabolism
  • Uncontrolled diabetes mellitus
  • Decreased excretion of potassium d/t kidney failure, severe dehydration, potassium-sparing diuretics, ACE inhibitors, NSAIDs, adrenal insufficiency
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14
Q

Function of Sodium

A

Major electrolyte found in ECF

Essential for maintaining acid-base balance, active and passive transport mechanisms, and irritability and conduction of nerve and muscle tissue

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15
Q

Function of Potassium

A

Major cation in ICF

Plays a vital role in cell metabolism; transmission of nerve impulses; functioning of cardiac, lung, and muscle tissues; and acid-base balance

Potassium has a reciprocal action with sodium

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16
Q

Function of Calcium

A

Important for maintain bone strength and density, activating enzymes, allowing skeletal and cardiac muscle contraction, controlling nerve impulse transmission, and allowing blood clotting

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17
Q

Signs and Symptoms of Hypocalcemia

A
  • “Charley horse”
  • Tingling and numbness sensations in hands
  • Muscle twitching or painful cramps and spasms
  • Trousseau’s and Chvostek’s sign
  • Heart rate may be decreased or increased with a weak, thready pulse
  • Prolonged ST interval
  • Prolonged QT interval
18
Q

Risk Factors of Hypocalcemia

A
  • Inadequate oral intake of calcium
  • Lactose intolerance
  • Malabsorption syndromes
  • Inadequate intake of vitamin D
  • End-stage kidney disease
  • Diarrhea
  • Wound drainage
19
Q

Signs and Symptoms of Hypercalcemia

A
  • Increased heart rate and BP
  • Cyanosis or pallor may be present
  • Shortened QT interval
  • Slowed or impaired blood flow
  • Blood clots to form more easily
  • Severe muscle weakness
  • Decreased DTRs
  • Confusion and lethargy
  • Decreased peristalsis
  • Hypoactive bowel sounds
20
Q

Risk Factors of Hypercalcemia

A
  • Excessive intake of calcium or vitamin D
  • Kidney failure
  • Use of thiazide diuretics
21
Q

Function of Phosphorus

A

Needed for activating vitamins and enzymes, forming energy supplies, and assisting in cell growth and metabolism.

Also functions in acid-base balances and calcium homeostasis

22
Q

Signs and Symptoms of Hypophosphatemia

A
  • Weak skeletal muscles that may progress to acute muscle breakdown
  • Respiratory failure if muscle weakness is profound
  • Bone density is decreased
  • Irritability
  • Seizures
  • Coma
23
Q

Risk Factors of Hypophosphatemia

A
  • Malnutrition
  • Starvation
  • Use of aluminum hydroxide-based antacids
  • Use of magnesium-based antacids
  • Hyperparathyroidism
  • Hypercalcemia
  • Kidney failure
  • Hyperglycemia
  • Respiratory alkalosis
  • Uncontrolled DM
  • Alcohol abuse
24
Q

Signs and Symptoms of Hyperphosphatemia

A
  • Increased serum phosphorus levels

- Similar to symptoms of hypocalcemia

25
Q

Risk Factors of Hyperphosphatemia

A
  • Decreased kidney excretion resulting from kidney disease
  • Tumor lysis syndrome
  • Increased intake of phosphorus
  • Hypoparathyroidism
26
Q

Function of Magnesium

A

Important for skeletal muscle contraction, carbohydrate metabolism, generation of energy stores, vitamin activation, blood coagulation, and cell growth

Regulation of magnesium occurs through the kidney and the intestinal tract

27
Q

Signs and Symptoms of Hypomagnesemia

A
  • Increased impulse transmission from nerve to nerve or from nerve to skeletal muscle
  • Hyperactive DTRs
  • Numbness and tingling
  • Painful muscle contraction
  • Positive Chvostek’s and Trousseau’s sign may be present
  • Reduce motility, anorexia, nausea, constipation, abdominal distention
28
Q

Risk Factors of Hypomagnesemia

A
  • Malnutrition
  • Starvation
  • Diarrhea
  • Celiac Disease
  • Crohn’s Disease
  • Drugs - diuretics
  • Citrate (blood products)
  • Ethanol ingestion
29
Q

Signs and Symptoms of Hypermagnesemia

A
  • Bradycardia, peripheral vasodilation, and hypotension
  • Prolonged PR interval with widened QRS complex
  • Drowsy or lethargic
  • Reduced or absent DTRs
  • Voluntary skeletal muscle contractions become progressively weaker and finally stop
30
Q

Risk Factors of Hypermagnesemia

A
  • Increased magnesium intake

- Decreased kidney excretion of magnesium resulting from kidney disease

31
Q

Homeostasis

A

Proper functioning of all body systems; requires fluid and electrolyte balances

32
Q

Filtration

A

Movement of fluid through cell or blood vessel membrane because of differences in water pressure

33
Q

Hydrostatic Pressure

A

“Water-pushing pressure”

Force that pushes water outward from a confined space through a membrane

Ex: Blood pressure

34
Q

Diffusion

A

Free movement of particles (solute) across permeable membrane from area of higher to lower concentration

35
Q

Osmosis and Filtration

A

Act together at capillary membranes to maintain normal ECF and ICF volumes

Ex: Thirst mechanism

36
Q

Aldosterone

A

Hormone secreted by the adrenal cortex whenever sodium levels in the ECF are decreased. It prevents both water and sodium loss.

Prevents excessive kidney excretion of sodium and blood potassium levels from becoming too high

37
Q

Antidiuretic Hormone (ADH)

A

Released from the posterior pituitary gland in response to changes in blood osmolarity

38
Q

Natriuretic Peptides (NPs)

A

Hormones secreted by special cells that line the atria and ventricles of the heart

Secreted in response to increased blood volume and blood pressure which stretch the heart tissue

39
Q

How much does 1 L of water weigh?

A

2.2 lbs or 1 kg

40
Q

What does weight change of 1 lb equal in mL?

A

Fluid volume change of about 500 mL

Med-Surg I (7 decks)

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