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Adult Health I > Chapter 40: Electrolytes > Flashcards

Chapter 40: Electrolytes Flashcards

1
Q

Main Intracellular fluid (ICF) Electorlytes

A

Potassium (K), Phosphorus (P), Magnesium (Mg)

Calcium is less prominent

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2
Q

Main extracellular fluid (ECF) Electrolytes

A

Sodium (Na), Chlorine (Cl), Bicarb (HCO3-)

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3
Q

Hyponatremia clinical manifestations

Severe Hyponateremia clinical manifestations

By what mechanism?

A 
Hypotension
headache
confusion
apprehension
edema
muscle cramps
weakness 
dry skin
Severe:
muscle twitching
focal weakness
hemiparesis
lethargy
coma
seizures
death

mechanism is swelling of cells
severe hyponatremia = increased intracranial pressure

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4
Q

Hyponatremia lab level

Severe hyponatremia lab level

A

Serum sodium < 135

<115

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5
Q

Hyponatremia causes

A 
Loss of Na
Excess water intake 
Syndrome of inappropriate anti-diuretic hormone (SIADH)
Diuretics
GI suctioning
Vomiting 
Diarrhea
Excess loss from GI tract, kidneys, and skin
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6
Q

Hyponatremia nursing interventions

A

Monitor VS
Monitor I/Os and daily weights
Monitor for CNS symptoms
Monitor Na level

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7
Q

Hypernatremia lab level

A

serum sodium > 145

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8
Q

Hypernatremia causes

A 
Na excess in ECF
MODEL
-Meds
-Osmotic diuretics
-Diabetes insipidus
-excessive H2O loss
-Low H20 intake
Excess sodium intake
Excess insensible water loss (hyperventilation and burns)
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9
Q

Hypernatremia clinical manifestations

A 
Thirst
Dry tongue
Swollen dry membranes
Tachycardia
Bounding pulse
Altered mental status
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10
Q

Hypokalemia lab level

A

Potassium < 3.5

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11
Q

Hypokalemia causes

A 
K deficit in the ECF
Meds (digitalis)
Diuretics
Increased exertion
Vomiting and diarrhea
GI suctioning
Alkalosis?
Decreased potassium intake
Shift from ECF to ICF
Per Lipincott:
Meds (sodium containing antibiotics, steroids, potassium wasting diuretics, adrenergics (albuterol sulfate and epi), insulin, laxatives)
Chronic kidney disease w/ tubular potassium wasting
Cushing syndrome
Excessive GI or urinary losses
Excessive licorice ingestion
Hyperglycemia
Primary hyperaldosteronism
Prolonged potassium free IV therapy
Severe serum magnesium def
Trauma
Hypothermia
Low cal diets
Dialysis
Plasmapheresis
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12
Q

Hypernatremia nursing interventions

A 
monitor VS
monitor I/Os
Daily weights
Monitor/restrict sodium intake
Monitor neuro changes
Hypotonic IV fluids*
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13
Q

Hypokalemia manifestations

A 
paresthesias
arrhythmias (irregular heart beat)
fatigue
skeletal muscle issues
decreased bowel motility
nausea
constipation
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14
Q

Hypokalemia nursing interventions

A 
Monitor VS
Monitor labs/tele
Educate patient
Assess Digitalis patients for risk
Administer K replacement
NEVER give IV push or bolus of K+
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15
Q

Hyperkalemia lab values

A

potassium > 5

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16
Q

Hyperkalemia causes

A 
K excess in ECF
Renal failure
Acidosis
Trauma
Meds
-oral potassium chloride
-potassium sparing diuretics
-ACE inhibitors
-NSAIDS
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17
Q

Hyperkalemia clinical manifestations

A 
muscle cramps --> weakness --> paralysis
drowsiness
hypotension
EKG changes
Cardiac arrest
GI symptoms (cramping diarrhea)
18
Q

Hyperkalemia nursing interventions

A 
Monitor labs/tele
D/C meds
Limit potassium intake
Meds
-Kayexelate
-IV glucose and insulin (shifts K from ECF to ICF)
19
Q

What would hypotension suggest about possible electrolyte levels?

A

Hyponatremia

Hyperkalemia

20
Q

Hypocalcemia lab values

A

Calcium < 8.9

21
Q

Hypocalcemia causes

A 
Ca deficit in ECF
Inadequate Ca intake
Impaired Ca absorption
Excessive Ca loss
Hypoparathyroidism
22
Q

Hypocalcemia clinical manifestations

A 
Numbness and tingling in fingers, mouth, feet
Tetany: rigidity of muscles
Laryngospasm
Arrhythmias, tele changes
Positive Chvostek's sign
Positive Trousseau's sign
23
Q

Hypocalcemia nursing interventions

A 
Monitor tele
Monitor airway
tx underlying cause
Vitamin D increases calcium absorption
Oral/IV replacement
24
Q

Hypercalcemia lab values

Hypercalcemia causes

A

calcium > 10.1

Malignant diseases
Hyperparathyroidism

25
Q

Hypercalcemia clinical manifestations

A 
Nausea, vomiting
constipation
Increased urination and thirst
Muscle weakness
Confusion and lethargy
Cardiac Arrhythmias
Cardiac arrest (Ca>17)
26
Q

Hypercalcemia nursing interventions

A

Tx of underlying cause
Increasing excretion of calcium (diuretics)
Monitor vitals
Assess neuro status

27
Q

Hypophosphatemia lab value

A

Phosphate < 2.5

28
Q

Hypophosphatemia Causes

A 
P deficit in ECF
Respiratory alkalosis (hyperventilation)
Diruetic uses
29
Q

Hypophosphatemia Clinical Manifestations

A 
Weakness/parasthesia
Respiratory failure
Irritability/confusion
hypotension
Chest pain
30
Q

Hyperphosphatemia lab values

A

Phosphate > 4.5

31
Q

Hyperphosphatemia causes

A

decreased excretion

hypoparathyroidism

32
Q

Hyperphosphatemia clinical manifestations

A 
\+ Chvosteks sign
\+Trousseau's sign
Confusion
Tetany and muscle cramps
Arrhythmias, tele
33
Q

Hypomagnesia lab values

A

Magnesium <1.5

34
Q

Hypomagnesia Causes

A

nasogastric suction
diarrhea
chronic alcoholism

35
Q

Hypomagnesia Causes

A

nasogastric suction
diarrhea
chronic alcoholism
loop diuretics?

36
Q

Hypomagnesia Nursing Interventions

A 
Assess for neuro changes
Seizure precautions
-low stim env
-pads
-clustered care
Oral/IV replacement
Monitor vitals
37
Q

Hypermagnesia lab values

A

Magnesium > 2.5

38
Q

Hypermagnesia causes

A

renal dysfunction/failure

excessive magnesium intake

39
Q

Hypermagnesia clinical manifestations

A 
depressed DTRs
Respiratory depression
Weakness
Flushing
Lethargy
Nausea/vomiting
40
Q

Hypermagnesia nursing interventions

A 
Tx of underlying cause
Monitor tele
Monitor respiratory status
Fluids diuretics
Dialysis if renal failure

Adult Health I (11 decks)

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