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Electrolyte Balance Flashcards

1
Q

Electrolytes are…

A

charged particles in a solution

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2
Q

2 types of electrolytes

A

Cation (+)

Anion (-)

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3
Q

Types of cations (+)

A
  • Sodium
  • Potassium
  • Calcium
  • Magnesium
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4
Q

Types of Anions (-)

A
  • Chloride
  • Bicarbonate
  • Phosphate
  • Sulfate
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5
Q

Major extracellular Cation

A

Sodium

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6
Q

Major intracellular cation

A

Potassium

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7
Q

Sodium…

A

-Attracts fluid and helps to preserve fluid volume.

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8
Q

Sodium combines with

A

chloride and bicarbonate to help regulate acid-base balance

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9
Q

Normal sodium serum range

A

135-145

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10
Q

When serum sodium levels are low ____________ helps to conserve water and sodium

A

Aldosterone

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11
Q

When serum Na+ levels are high, thirst increases and _____ is released to…

A

ADH, trigger kidneys to retain water

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12
Q

Explain sodium-potassium pump.

A
  • Sodium tries to get into cells, potassium tries to get out.
  • Uses ATP, Magnesium and enzyme to maintain sodium-potassium concentrations.
  • Prevents cell swelling, creates electrical charge, allowing neuromuscular impulse transmission.
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13
Q

Sodium level of <135, r/t amount of body fluid.

A

Hyponatremia

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14
Q

Results from Na+ loss, water gain.

A

Dilutional Hyponatremia

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15
Q

Insufficient Na+ intake

A

Depletional Hyponatremia

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16
Q

Na+ loss is greater than water loss; can be renal (diuretics) or non-renal (vomiting).

A

Hypovolemic Hyponatremia

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17
Q

Water gain is greater than Na+ gain; edema occurs

A

Hypervolemic Hyponatremia

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18
Q

Normal Na+ level; too much fluid.

A

Isovolumic Hyponatremia

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19
Q

What do you see in hyponatremia?

A

-Headache, nausea, vomiting, muscle twitching, altered mental status, stupor, seizures, coma.

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20
Q

What do we do for a mild case of hyponatremia?

A
  • Restrict fluid intake for hypervolemic/isovolemic

- Iv fluids and increased po Na+ intake for hypovolemic

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21
Q

What do we do for a severe case of hyponatremia?

A
  • Infuse Hypertonic NaCl solution(3-5%)
  • Furosemide to remove excess fluid
  • Monitor client in ICU
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22
Q

Hypokalemia can be caused by…

A

Gi losses, diarrhea, insuficient intake, non-k+ sparing diuretics (thiazide, furosemide).

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23
Q

Hypokalemia= changes in ____ wave!

A

U-wave

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24
Q

When thinking hypokalemia, think…

A 
SUCTION
s-Skeletal musce weakness
u-U wave changes
c-Constipation
t-toxicity of digitalis glycosides
i-irregular/week pulse
o-orthostaic hypotension
n-numbness
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25
Q

What do we do for hypokalemic patients?

A
  • Increase dietary K+
  • Oral KCl supplements
  • IV K+ replacement
  • Change to K+-sparing diuretic
  • Monitor EKG changes
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26
Q

Hyperkalemia is _____ common than hypokalemia.

A

Less common

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27
Q

Hyperkalemia is caused by…

A

-altered kidney function, increased intake of salt substitiutes, blood transfusions, meds, cell death.

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28
Q

What do we see in Hyperkalemia?

A
  • Irritability
  • Parasthesia
  • Muscle Weakness
  • EKG changes
  • Irregular Pulse
  • Hypotension
  • Nausea, abdominal cramps, diarrhea
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29
Q

What do we do for mild hyperkalemia?

A
  • Loop diuretics (lasix)

- Dietary restriction

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30
Q

What do we do for moderate hyperkalemia?

A

Kayexalate

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31
Q

What do we do for emergency hyperkalemia?

A
  • 10% Calcium Gluconate for cardiac effects

- Sodium bicarbonate for acidosis

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32
Q

Magnesium helps to produce…

A

ATP

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33
Q

Magnesium has a role in…

A

protein synthesis & carb metabolism

34
Q

Magnesium helps the _____ function.

A

cardiovascular system (dilation)

35
Q

Magnesium regulates…

A

muscle contractions

36
Q

Hypomagnesemia is caused by…

A

Poor dietary intake, poor GI absorption, excessive GI/Urinary losses.

37
Q

Who is considered a high risk client for hypomagnesemia?

A
  • Chronic alcoholism
  • Malabsorption
  • GI/urinary disorders
  • Sepsis
  • Burns
  • Wounds needing debridement.
38
Q

What do you see in the CNS with Hypomagnesemia?

A

Altered LOC, Confusion, Hallucinations.

39
Q

What do you see in the neuromuscular with Hypomagnesemia?

A

Muscle weakness, leg/foot cramps, hyper Deep Tendon Reflex’s, tetany, Chvostek’s and Trousseau’s signs.

40
Q

What do you see in the cardiovascular system with Hypomagnesemia?

A

Tachychardia, Hypotension, EKG Changes

41
Q

What do you see in the GI system with Hypomagnesemia?

A

Dysphagia, Anorexia, Nausea/Vomiting

42
Q

What do we do for mild hypomagnesemia?

A

Dietary Replacement

43
Q

What do we do for severe hypomagnesemia?

A

IV or IM magnesium sulfate

44
Q

With Hypomagnesemia, we monitor…

A

Neuro status
Cardiac Status
Safety

45
Q

Foods high in Na+

A
  • Cheese
  • Butter
  • Canned vegetables
  • Processed foods
  • Soy sauce
  • Milk
  • Ketchup
46
Q

Foods high in K+

A
  • Avocado
  • Banana
  • Potatoes
  • Spinach
  • Beans
  • Citrus
  • Fish
47
Q

Foods high in Calcium

A
  • Almonds
  • Broccoli
  • Oranges
  • Cheese
  • Navy Beans
  • Kale
  • Milk
48
Q

Foods high in Chloride

A
  • Table Salt
  • Seaweed
  • Rye
  • Tomato
  • Lettuce
49
Q

Foods rich in Phosphate

A
  • Meat
  • Fish
  • Poultry
  • Dairy
  • Beans
  • Nuts
50
Q

Most common cause of Hypermagnesemia is…

A

Renal Disfunction

  • Renal failure
  • Addison’s disease
  • Adrenocortical insufficiency
  • Untreated DKA ( Diabetic Ketoacidosis)
51
Q

Manifestations of Hypermagnesemia

A
  • Decreased neuromuscular activity
  • Hypoactive Deep Tendon Reactions
  • Weakness
  • Nausea/vomiting
52
Q

Treatment of Hypermagnesemia

A
  • Increased fluids depending on renal function
  • Loop diuretic
  • Calcium gluconate maybe needed depending on Mg+ Level
  • Respiratory depression may require ventilation
  • Hemodialysis may be indicated
53
Q

Calcium…

A
  • Present in bones, serum & soft tissue
  • Works with phosphorus to form bones and teeth
  • Role in cell membrane permeability
  • Affects cardiac muscle & contraction of the heart
  • Blood clotting
54
Q

Parathyroid ______, calcitonin ______.

A

Pulls, Keeps.

55
Q

Hypocalcemia is cause by…

A

Inadequate intake, malabsorption, pancreatitis, thyroid or parathyroid surgery, loop diuretics, low magnesium levels

56
Q

Clinical manifestations of hypocalcemia

A 
Neuromuscular
(Anxiety, confusion, irritability, muscle twitching, paresthesias (mouth, fingers, toes), tetany)
Fractures
Diarrhea
May  alter  the affects of Digoxin 
EKG changes
57
Q

Two main causes of Hypercalcemia

A
  • Cancer

- Hyperparathyroidism

58
Q

Clinical manifestations of Hypercalcemia

A
  • Fatigue, confusion, lethargy, coma
  • Muscle weakness, decreased reflexes
  • Bradycardia may lead to cardiac arrest
  • Anorexia, nausea/vomiting, decreased bowel sounds, constipation
  • Polyuria ( increased urination)renal calculi, renal failure
59
Q

The primary electrolyte in the intracellular fluid

A

Phosphorus

60
Q

Phosphorus is responsible for…

A

muscle, neurologic function and metabolism of carbs, fats and protein
Plays a role the formation of bones and teeth

61
Q

Hyphosphatemia can lead to…

A

organ system failure.

62
Q

Hypophosphatemia is caused by…

A

respiratory alkalosis (hyperventilation), insulin release, malabsorption, diuretics, DKA, elevated parathyroid hormone levels, extensive burns

63
Q

Musculoskeletal manifestations of Hypophosphatemia

A

muscle weakness
respiratory muscle failure
osteomalacia
pathological fractures

64
Q

CNS manifestations of Hypophosphatemia

A

confusion, anxiety, seizures, coma

65
Q

Cardiac manifestations of Hypophosphatemia

A

hypotension

decreased cardiac output

66
Q

Hematologic manifestations of Hypophosphatemia

A

hemolytic anemia
easy bruising
infection risk

67
Q

What do we do for mild/moderate hypophophatemia?

A

Dietary interventions

Oral supplements

68
Q

What do we do for severe hypophosphatemia?

A

IV replacement using potassium phosphate or sodium phosphate

69
Q

What causes Hyperphosphatemia?

A

Caused by impaired kidney function, cell damage, hypoparathyroidism, respiratory acidosis, DKA, increased dietary intake

70
Q

Clinical manifestations of Hyperphosphatemia

A
  • Cardiac irregularities
  • Hyperreflexia
  • Eating poorly
  • Muscle weakness
  • Oliguria
71
Q

Interventions for Hyperphosphatemia

A

Low-phosphorus diet
Reduce intake of certain antacids that bind phosphorus
Treat underlying cause of respiratory acidosis or Diabetic Ketoacidosis

72
Q

Most significant electrolyte in (ESF) Extracellular Fluid

73
Q

What does Chloride do?

A

Sodium and chloride maintain water balance

Assists with carbon dioxide transport in blood

74
Q

What causes Hypochloremia?

A

Caused by decreased intake or decreased absorption, metabolic alkalosis, and loop, osmotic or thiazide diuretics

75
Q

Clinical Manifestations of HypoChloremia

A 
Agitation, irritability
Hyperactive DTRs, tetany
Muscle cramps
Shallow, slow respirations
Seizures, coma
Arrhythmias
76
Q

Interventions for Hypochloremia

A

Treat underlying cause

Oral or IV replacement

77
Q

Rarely occurs alone

A

Hyperchloremia

78
Q

What causes Hyperchloremia?

A

Caused by dehydration, renal failure, respiratory alkalosis, salicylate toxicity, hyperpara-thyroidism, hyperaldosteronism, hypernatremia

79
Q

Clinical manifestations of hypochloremia

A
  • Metabolic Acidosis
  • -Decreased LOC
  • -Kussmaul’s respirations
  • -Weakness
  • Hypernatremia
  • -Agitation
  • -Tachycardia, dyspnea, tachypnea, HTN
  • -Edema
80
Q

Interventions for Hyperchloremia

A

Treatment is dependent on the severity of the Dehyration

IVF replacement or resuscitation depending on clinical condition

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