Chapter 17: Focused Review on Electrolyte Lab Values Flashcards
bicarbonate range
22-26 mEq/L
chloride range
98-106 mEq/L
phosphate range
3.0-4.5 mg/dL
calcium range
9.0-10.5 mg/dL
magnesium range
1.3-2.1 mEq/L
potassium range
3.5-5.0 mEq/L
sodium range
136-145 mEq/L
__________ leaves the body through urine, sweat, and feces.
a. calcium
b. sodium
c. potassium
d. magnesium
b. sodium
hypernatremia lab value
> 145 mEq/L
Which lab values can occur with inadequate water intake, excess water loss, or, rarely, sodium gain?
a. hypercalcemia
b. hypernatremia
c. hyperkalemia
d. hyperphosphatemia
b. hypernatremia
CLINICAL MANIFESTATIONS
the result of water shifting out of cells into ECF with resultant dehydration and shrinkage of the cells
a. hypernatremia
b. hyperkalemia
c. hyperphosphatemia
d. hypercalcemia
a. hypernatremia
CLINICAL MANIFESTATIONS
- change in mental status
- postural hypotension
- tachycardia
- weakness
a. hyperkalemia
b. hyperphosphatemia
c. hypercalcemia
d. hypernatremia
d. hypernatremia
MANIFESTATIONS
- agitation, restlessness, twitching, seizures, coma
- edema, peripheral, and pulmonary
- intense thirst, flushed skin
- weight gain, increased BP, increased CVP
a. hypercalcemia
b. hyperphosphatemia
c. hypernatremia
d. hyperkalemia
c. hypernatremia
hyponatremia lab value
< 136 mEq/L
MANIFESTATIONS
- apprehension, irritability, confusion, dizziness, personality changes, tremors, seizures, coma
- cold and clammy skin
- dry mucous membranes
- postural hypotension, decreased CVP, decreased jugular venous filling, tachycardia, thread pulse
a. hyponatremia
b. hypomagnesemia
c. hypocalcemia
d. hypophosphatemia
a. hyponatremia
hyperkalemia lab value
> 5.0 mEq/L
CLINICAL MANIFESTATIONS
- abdominal cramping, diarrhea, vomiting
- confusion
- fatigue, irritability
- irregular pulse
- loss of muscle tone
- muscle weakness, cramps
- paresthesias, decreased reflexes
- tetany
a. hypernatremia
b. hypermagnesemia
c. hyperkalemia
d. hypercalcemia
c. hyperkalemia
hypokalemia lab value
< 3.5 mEq/L
CLINICAL MANIFESTATIONS
- constipation, nausea, paralytic ileus
- fatigue
- hyperglycemia
- irregular, weak pulse
- muscles soft, flabby
- muscle weakness, leg cramps
- paresthesias, decreased reflexes
- shallow respirations
a. hypokalemia
b. hypophosphatemia
c. hyponatremia
d. hypomagnesemia
a. hypokalemia
hypercalcemia lab value
> 10.5 mg/dL
CLINICAL MANIFESTATIONS
- increased BP
- bone pain, fractures
- confusion, psychosis
- fatigue, lethargy, weakness
- depressed reflexes
- decreased memory
- kidney stones
- nausea, vomiting, anorexia
- polyuria, dehydration
- seizures, coma
a. hyperkalemia
b. hypermagnesemia
c. hyperphosphatemia
d. hypercalcemia
d. hypercalcemia
hypocalcemia lab value
< 9.0 mg/dL
CLINICAL MANIFESTATIONS
- decreased BP
- Chvostek sign
- confusion, depression, irritability
- fatigue, weakness
- hyperreflexia, muscle cramps
- laryngeal and bronchial spasms
- numbness and tingling in extremities and around mouth
- tetany, seizures
- Trousseau sign
a. hypophosphatemia
b. hypocalcemia
c. hyponatremia
d. hypokalemia
b. hypocalcemia
hyperphosphatemia lab value
> 4.5 mg/dl
CLINICAL MANIFESTATIONS
- hyperreflexia, muscle cramps
- hypocalcemia
- numbness and tingling in extremities and around mouth
- tetany, seizures
- calcium-phosphate precipitates in skin, soft tissues, cornea, viscera, blood vessels
a. hypernatremia
b. hypermagnesemia
c. hyperphosphatemia
d. hyperkalemia
c. hyperphosphatemia
hypophosphatemia lab value
<3.0 mg/dL
CLINICAL MANIFESTATIONS
- CNS depression
- heart problems
- muscle weakness, including respiratory muscle weakness
- polyneuropathy, seizures
- rhabdomyolysis
- rickets, osteomalacia
a. hypomagnesemia
b. hyponatremia
c. hypophosphatemia
d. hypocalcemia
c. hypophosphatemia
hypermagnesemia lab value
> 2.1 mEq/L
MANIFESTATIONS
- decreased deep tendon reflexes
- flushed, wark skin, especially facial
- lethargy, drowsiness
- nausea, vomiting
- muscle weakness
- decreased HR, decreased BP
- urinary retention
a. hypermagnesemia
b. hyperphosphatemia
c. hyperkalemia
d. hypercalcemia
a. hypermagnesemia
hypomagnesemia lab value
< 1.3 mEq/L
MANIFESTATIONS
- Chvostek and Trousseau signs
- confusion
- hyperactive deep tendon reflexes
- muscle cramps
- increased HR, increased BP, dysrhythmias
- tremor, seizures
- vertigo
a. hyponatremia
b. hypomagnesemia
c. hypophosphatemia
d. hypokalemia
b. hypomagnesemia
The nursing care for a patient with hyponatremia and fluid volume excess includes
a. fluid restriction
b. administration of hypotonic IV fluids
c. administration of a cation-exchange resin
d. placement of an indwelling urinary catheter
a. fluid restriction
The nurse should be alert for which manifestations in a patient receiving a loop diuretic?
a. restlessness and agitation
b. paresthesias and irritability
c. weak, irregular pulse and poor muscle tone
d. increased blood pressure and muscle spasms
a. restlessness and agitation
Which patient is at greatest risk for developing hypermagnesmia?
A. 83-year-old man with lung cancer and hypertension
B. 65-year-old woman with hypertension taking B-adrenergic blockers
C. 42-year-old woman with systemic lupus erythematosus and renal failure
D. 50-year-old man with benign prostatic hyperplasia and a UTI
C. 42-year-old woman with systemic lupus erythematosus and renal failure
It is important for the nurse to assess for which manifestation(s) in a patient who has just undergone a total thyroidectomy? (SATA)
A. confusion
B. weight gain
C. depressed reflexes
D. circumoral numbness
E. positive Chvestek sign
A. confusion
D. circumoral numbness
E. positive Chvestek sign
The nurse expects the long-term treatment of a patient with hyperphosphatemia from renal failure will include:
A. fluid restriction
B. calcium supplements
C. magnesium supplements
D. increased intake of dairy products
B. calcium supplements
A patient who is taking a potassium-depleting diuretic for treatment of hypertension reports generalized weakness. Which action would the nurse to take?
a. Assess for facial muscle spasms.
b. Ask the patient about loose stools.
c. Recommend the patient avoid drinking orange juice with meals.
d. Suggest that the health care provider order a basic metabolic panel.
d. Suggest that the health care provider order a basic metabolic panel.
A patient with new-onset confusion and hyponatremia is being admitted. Which action would the charge nurse take when making room assignments?
a. Assign the patient to a semiprivate room.
b. Assign the patient to a room near the nurse‘s station.
c. Place the patient in a room nearest to the water fountain.
d. Place the patient on telemetry to monitor for peaked T waves.
b. Assign the patient to a room near the nurse‘s station.
A patient who had surgery for a perforated gastric ulcer has been receiving nasogastric suction for 3 days. The patient‘s serum sodium level is 127 mEq/L (127 mmol/L). Which prescribed therapy would the nurse question?
a. Infuse 5% dextrose in water intravenously at 125 mL/hr.
b. Administer IV morphine sulfate 4 mg every 2 hours PRN.
c. Give IV metoclopramide 10 mg every 6 hours PRN for nausea.
d. Administer 3% saline intravenously at 50 mL/hr for a total of 200 mL.
a. Infuse 5% dextrose in water intravenously at 125 mL/hr.
A patient receives 3% NaCl solution for correction of hyponatremia. Which assessment is most important for the nurse to monitor while the patient is receiving this infusion?
a. Lung sounds
b. Urinary output
c. Peripheral pulses
d. Peripheral edema
a. Lung sounds
A patient who has been receiving diuretic therapy is admitted to the emergency department with a serum potassium level of 3.0 mEq/L. The nurse would alert the health care provider immediately that the patient is on which medication?
a. Digoxin (Lanoxin) 0.25 mg/day
b. Ibuprofen 400 mg every 6 hours
c. Lantus insulin 24 U every evening
d. Metoprolol (Lopressor) 12.5 mg/day
a. Digoxin (Lanoxin) 0.25 mg/day
The nurse is caring for a patient who has a calcium level of 12.1 mg/dL. Which action would the nurse include in the plan of care?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Encourage fluid intake up to 4000 mL daily.
d. Monitor for Trousseau‘s and Chvostek‘s signs.
c. Encourage fluid intake up to 4000 mL daily.
A patient has a serum calcium level of 7.0 mEq/L. Which assessment finding is most important for the nurse to report to the health care provider?
a. Stridor
b. Fatigue
c. Constipation for 4 days
d. Numbness around the lips
a. Stridor
A patient is receiving a 3% saline continuous IV infusion for hyponatremia. Which assessment data require the most rapid response by the nurse?
a. The patient‘s radial pulse is 105 beats/min.
b. There are crackles throughout both lung fields.
c. There is sediment and blood in the patient‘s urine.
d. The patient‘s blood pressure increases to 142/94 mm Hg.
b. There are crackles throughout both lung fields.
The nurse notes a serum calcium level of 7.9 mg/dL for a patient who has chronic malnutrition. Which action would thenurse expect to take first?
a. Monitor ionized calcium level.
b. Give oral calcium citrate tablets.
c. Check parathyroid hormone level.
d. Administer vitamin D supplements.
a. Monitor ionized calcium level.
After receiving change-of-shift report, which patient would the nurse assess first?
a. Patient with serum sodium level of 145 mEq/L who is asking for water
b. Patient with serum potassium level of 5.0 mEq/L who reports abdominal cramping
c. Patient with serum magnesium level of 1.1 mEq/L who has tremors and hyperactive reflexes
d. Patient with serum phosphorus level of 4.5 mg/dL who has soft tissue calcium-phosphate precipitates
c. Patient with serum magnesium level of 1.1 mEq/L who has tremors and hyperactive reflexes
