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LCCC Nursing > Chapter 17 Electrolytes: Med Surg > Flashcards

Chapter 17 Electrolytes: Med Surg Flashcards

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1
Q

normal level of sodium

A

135-145, regulates osmolality, blood pressure, and nerve impulses to muscle and tissue

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2
Q

sources of sodium

A

salt, hypertonic NaCl, soda, processed foods

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3
Q

causes of hypernatremia

A

excess sodium intake, inadequate water intake, excessive water loss, disease (diabetes, primary hyperaldosteronism)

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4
Q

signs and symptoms of hypernatremia

A

restless, thirsty, weight loss, postural hypotension, sticky mucous membranes

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5
Q

treatment for hypernatremia

A

water replacement, hypotonic saline (5% dextrose in water), no sodium in diet,

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6
Q

causes of hyponatremia

A

excess sodium loss, inadequate sodium intake, excess water gain, disease (SIADH, heart failure)

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7
Q

signs and symptoms of hyponatremia

A

irritable, apprehension, dry mucous membranes and cold and clammy, tachycardia, bounding pulse

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8
Q

treatment for hyponatremia

A

fluid restriction, small amounts of hypertonic saline (3%), drugs that block ADH e.g. Vaprisol

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9
Q

normal level of potassium

A

3.5-5.0, 98% of potassium is in cells and regulates cardiac rhythm, fluid balance, ICF osmolality

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10
Q

sources of potassium

A

potatoes, brocolli, bananas

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11
Q

serious low for sodium

A

110

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12
Q

what type of diuretic for hyperkalemia?

A

loop

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13
Q

causes of hyperkalemia

A

excess potasium, shift of potassium out of cells due to acidosis or injury, failure to eliminate potassium, RENAL FAILURE, tourniquet left on too long and shaking the vial

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14
Q

signs and symptoms of hyperkalemia

A

irritable, tummy and leg cramps, weakness of lower extremities, irregular pulse

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15
Q

treatment for hyperkalemia

A

PUT ON CARDIAC MONITOR, no potassium in diet, increase elimination through loop diuretic (Lasix) or Kayexalate (sodium polystyrene sulfonate), and force potassium from ECF to ICF through insulin and maintainence glucose, calcium gluconate to reduce cardiac dysrhythmia

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16
Q

what EKG change is significant with hyperkalemia?

A

tall peaked T wave

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17
Q

causes of hypokalemia

A

potassium loss, shift of potassium into cells (too much insulin, alkalosis, stress), decreased potassium intake

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18
Q

signs and symptoms of hypokalemia

A

fatigue, muscle weakness, leg cramps, vomiting, decreased reflexes, weak pulse, polyuria, hyperglycemia

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19
Q

treatment of hypokalemia

A

KCl supplments (IV must be diluted, not IV push, inverted several times to properly mix, never add to current hanging bag) and increase potassium in diet

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20
Q

what EKG change is significant with hypokalemia?

A

shallow T wave

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21
Q

normal level of calcium

A

8.6-10.2, transmits nerve impulses, myocardial contractions, blood clotting, formation of teeth and bone, 99% of calcium is combined with phosphorus and concentrated in skeletal system

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22
Q

significant amounts of calcium

A

12= coma 14= death

23
Q

causes of hypercalcemia

A

too much calcium, malignancies with bone metastasis, prolonged immobilization, Vit D overdose

24
Q

signs and symptoms of hypercalcemia

A

lethargy, decreased reflexes, decreased memory, anorexia, bone pain, polyuria, stupor, coma

25
Q

treatment of hypercalcemia

A

excrete through urine through loop diuretic (lasix), drink 3000-4000 mL fluid/day, isotonic IV fluids, calcitonin

26
Q

causes of hypocalcemia

A

decreased parathyroid hormone, acute pancretitis, multiple blood transfusions, alcoholism, increased phosphate, decreased Vit D

27
Q

signs and symptoms of hypocalcemia

A

easy fatigued, numb around mouth, hyperflexia, laryngeal spasms (“eeeeee!”)

28
Q

chvostek’s sign

A

tap facial nerve and muscles contract; indicative of hypocalcemia

29
Q

trousseau’s sign

A

carpal spasm induced by blood pressure cuff above systolic; indicative of hypocalcemia

30
Q

treatment of hypocalcemia

A

increased calcium and Vit D in diet, TUMS

31
Q

what is the effect of phosphate on calcium

A

inverse relationship; high phosphate = low calcium, low phosphate = high calcium

32
Q

normal phosphorus level

A

2.4-4.4, essential to fx of muscle, RBCs, nervous system, bone and tooth structure, ATP, glucose, metabolism of carbs, proteins, and fat

33
Q

sources of phosphorus

A

dairy, greens, lentels

34
Q

causes of hyperphosphatemia

A

renal failure, excess ingestion, too much Vit D, chemotherapeutic agents

35
Q

signs and symptoms of hyperphosphatemia

A

hypocalcemia, muscle tetany, not may signs unless gets out of control

36
Q

treatment of hyperphosphatemia

A

no dairy, hydrate, calcium supplements, phosphate-binding agents or gels

37
Q

causes of hypophosphatemia

A

malnourished, glucose administration, alcohol withdrawal, total parenteral nutrition, phosphate-binding antacids, diabetic ketoacidosis

38
Q

signs and symptoms of hypophosphatemia

A

decreased CNS, muscle weakness, cardiac issues, osteomalacia

39
Q

treatment of hypophosphatemia

A

oral supplements, diet in phosphorus, IV sodium phosphate or potassium phosphate (watch for hypocalcemia)

40
Q

normal magnesium level

A

1.5-2.5, second most abundant intracellular cation, acts directly on myoneural junction, CNS, and cardiac fx

41
Q

sources of magnesium

A

green stuff, chocolate, milk of magnesia

42
Q

causes of hypermagnesemia

A

increased magnesium intake, renal insufficiency/failure, too much mag sulfate

43
Q

signs and symptoms of hypermagnesemia

A

lethargy, decreased deep tendon relflexes, decreased respirations, decreased urine

44
Q

treatment for hypermagnesemia

A

don’t continue the mag drugs, calcium gluconate, diuretics to increase urine

45
Q

causes of hypomagnesemia

A

prolonged fasting, starvation, chronic alcoholism, poor diabetes, prolonged parenteral nutrition

46
Q

signs and symptoms of hypomagnesemia

A

confusion, hyperactive deep tendon relflexes, tremors, seizures, cardiac dysrhythmias

47
Q

treatment for hypomagnesemia

A

diet in green veggies, nuts, bananas, oranges, peanut butter, IV or IM mag sulfate

48
Q

how is calcium regulated?

A

PTH moves Ca out of bone, increases GI absorption, and tubule reabsorption, which then Vit D aids absorption of Ca from the GI tract and calcitonin is produced by the thyroid gland and inhibits PTH & Vit D ALL MUST BE PRESENT FOR HOMEOSTASIS

49
Q

what do you hold when giving a corticosteroid?

A

salt

50
Q

what do antibiotics do?

A

decrease Mg, dehydrate, pretty much throws all electrolytes off

51
Q

who do you not give Digoxin to?

A

hypokalemic patients because of dysrhythmia

52
Q

what should you look for with electrolytes?

A

cardiac monitoring, daily weights, LOC, safety, oral hygeine

53
Q

what do electrolytes effect?

A

mobility, nutrition, elimination, cognition, perfusion, gas exchange, acid base balance

54
Q

you should get what if you suspect electrolyte issues?

A

BMP (basal metabolic panel) or CMP (comprehensive metabolic panel)

LCCC Nursing (15 decks)

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