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chronic > chronic exam 1-electrolyte imbalance > Flashcards

chronic exam 1-electrolyte imbalance Flashcards

1
Q

etiology/risk factors for electrolyte imbalance

A

Decreased intake and availability or increase loss of an electrolyte
Increase intake and retention or decreased excretion of an electrolyte

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2
Q

diagnosis of imbalance

A

Through plasma levels in lab studies

Through clinical manifestations (signs and symptoms)

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3
Q

hyponatremia

A

sodium

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4
Q

etiology/risk factors for hyponatremia

A

Results from loss of sodium containing fluids (vomiting, diarrhea, diuretics)
Or excess fluids

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5
Q

clinical manifestations hyponatremia

A

confusion
nausea
seizures
coma

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6
Q

nursing diagnosis: hyponatremia

A

risk for injury

potential complication

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7
Q

nursing management: hyponatremia

A 
for water excess causation: fluid restriction
Severe symptoms (seizures): give a small amount of IV hypertonic saline solution (3-5% NaCl)
treat underlying cause
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8
Q

hypernatremia

A

Na+ >145 mEq/L

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9
Q

pathophysiology: hypernatremia

A

Fluid shift causing cellular dehydration

B. Increase myocardial depolarization (increased excitability of heart muscle)

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10
Q

clinical manifestations: hypernatremia

A 
thirst
Dry flushed skin
Dry tongue and mucous membranes
Polyuria, anorexia, weakness, and restlessness 
cramping
\_\_\_\_\_\_\_\_\_

Agitation, confusion, lethargy
Seizures, coma
Tremors, muscle twitching, rigid paralysis
ataxia

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11
Q

nursing diagnosis:hypernatremia

A

potential complication, seizures and coma leading to irreversible brain damage

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12
Q

nursing management: hypernatremia

A

If oral fluids cannot be ingested, IV solution of 5% dextrose in water or hypotonic saline (0.45)
Diuretics

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13
Q

Hypokalemia

A

K+

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14
Q

etiology/risk factors: hypokalemia

A

Low serum potassium caused by metabolic acidosis, abnormal losses of K+ via the kidneys or GI tract (Vomiting, Diarrhea, Diuretics)
i. K+ sparing (conserve K+)
ii. Thiazide (hydrochlorothiazide HCTZ)
iii. Loop diuretics (strongest, Lasix (furosemide))
Metabolic alkalosis

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15
Q

clinical manifestations: hypokalemia

A 
most serious are cardiac
Lose nervous impulse
•	Skeletal muscle weakness
•	Weakness of respiratory muscles
•	Decreased GI motility
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16
Q

nursing diagnosis: hypokalemia

A

risk for injury

potential complications: dysrhythmias

17
Q

nursing management: hypokalemia

A

KCL Supplements orally (Give with food or diluted (PO/IV) to minimize venous or gastric irritation)
KCL Supplements IV (Should not exceed 10 to 20 mEq/hr to prevent hyperkalemia and cardiac arrest)

18
Q

hyperkalemia

A

K+ > 5.0 mEq/L

19
Q

etiology/causes: hyperkalemia

A

Massive intake
Impaired renal excretion
Shift from ICF to ECF
Common in massive cell destruction (Burn, crush injury, or tumor lysis)

20
Q

clinical manifestations: hyperkalemia

A

Weak or paralyzed skeletal muscles
Ventricular fibrillation or cardiac standstill
Abdominal cramping or diarrhea

21
Q

nursing diagnosis: hyperkalemia

A

dysrhythmias

22
Q

nursing management: hyperkalemia

A

Eliminate oral and parenteral K+ intake

Increase elimination of K+ (diuretics, dialysis, Kayexalate oral or as enema)

23
Q

hypocalcemia

A

Ca++

24
Q

etiology: hypocalcemia

A 
Decreased production of PTH
Acute pancreatitis
Multiple blood transfusions
Alkalosis
Decreased intake
25
Q

clinical manifestations: hypocalcemia

A

Positive Trousseau’s or Chvostek’s sign
Laryngeal stridor
Dysphagia
Tingling around the mouth or in the extremities (paresthesias)

26
Q

nursing diagnosis: hypocalcemia

A

Potential complication: fracture or respiratory arrest, bleeding, tetany

27
Q

nursing management: hypocalcemia

A

Treat underlying cause
Oral or IV calcium supplements (Not IM to avoid local reactions)
Treat pain and anxiety to prevent hyperventilation-induced respiratory

28
Q

hypercalcemia

A

Ca++ >10.5-11 mg/dL

29
Q

etiology: hypercalcemia

A

Hyperparathyroidism (2/3 of cases)
Malignancy of the bone
Vitamin D overdose (helps absorb calcium in the intestine)
Prolonged immobilization

30
Q

clinical manifestations: hypercalcemia

A

Urinary (Polyuria r/t osmotic diuresis)
GI (Anorexia, constipation, abdominal distention0
Neuromuscular (Fatigue, depression, muscle weakness)

31
Q

nursing diagnosis: hypercalcemia

A

dysrhythmias

32
Q

nursing management: hypercalcemia

A

Excretion of C2+ with loop diuretic
Hydration with isotonic saline infusion
Synthetic calcitonin
Mobilization/Weight-bearing activity

33
Q

phosphate

A

Lab value (normal) 2.5-4.5mg/dl
Primary anion in ICF
Essential to function of muscle, red blood cells, and nervous system
Deposited with calcium for bone and tooth structure
Inversely related to calcium
Inverse relationship to K+

34
Q

hypomagnesemia

A

Mg++

35
Q

clinical manifestations:

A 
Confusion
Hyperactive deep tendon reflexes
Tremors
Seizures
Cardiac dysrhythmias
36
Q

nursing management: hypomagnesemia

A

Oral supplements
Increase dietary intake
Parenteral IV or IM magnesium when severe

37
Q

hypermagnesemia

A

mg++ >2.5 mEq/L or 3mg/dL

38
Q

etiology: hypermagnesemia

A

Increased intake or ingestion of products containing magnesium when renal insufficiency or failure is present

39
Q

clinical manifestations:

A

Lethargy or drowsiness
Nausea/vomiting
Impaired reflexes
Respiratory and cardiac arrest

chronic (17 decks)

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