ELECTROLYTE BALANCE Flashcards

1
Q

DEFINITION OF FLUID AND ELECTROLYTE BALANCE

A

Process of regulating the extra cellular fluid volume, body fluid osmolality, and plasma concentrations of electrolytes

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2
Q

OSMOLALITY

A

Number of particles in a solution

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3
Q

RISK FACTORS FOR ELECTROLYTE IMBALANCE

A

Very young- have more water content

Very old- do not eat or drink enough

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4
Q

INDIVIDUAL RISK FACTORS

A

Renal failure- retain fluid
Burn victims- lose fluid and electrolytes
Excessive exercise- lose sodium and fluid
CHF- retain fluid
Surgery- retain fluid
Drinking too much water

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5
Q

SODIUM (Na)

A

Extracellular
Important to nerve transmission
Vital for skeletal muscle and cardiac contraction
Important for volume of ECF

Normal 135-145

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6
Q

HYPONATREMIA

A

Low sodium draws water into the cells and causes them to swell

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7
Q

CAUSES OF HYPONATREMIA

A
Fluid dilution or loss of sodium (Na)
Renal disease
Fluid retention
CHF
Liver disease
Watery diarrhea
Sweat, diuretics
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8
Q

TREATMENT OF HYPONATREMIA

A

Restrict fluid
Give diuretics
May give Na if due to large loss such as watery diarrhea

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9
Q

POTASSIUM (K+)

A

Some control over intracellular osmolality and volume . Regulates protein synthesis, glucose, use and storage.

Normal 3.5-5.0

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10
Q

HYPERNATREMIA

A

High sodium draws water out of the cells and causes them to shrink

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11
Q

CAUSES OF HYPERNATREMIA

A

Dehydration

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12
Q

SIGNS OF HYPERNATREMIA

A
Fluid volume deficit
Tachycardia
Weak pulse
Postural hypotension
High sodium level and elevated hematocrit
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13
Q

TREATMENT OF HYPERNATREMIA

A

Replace fluids cautiously with 0.45 and 0.9 hypotonic fluids to isotonic
If fluid overload give lasting
Ensure adequate water intake

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14
Q

HYPOKALEMIA

A

May be caused by the use of laxatives or diuretics

Low K+ and effects nerve transmission, interferes with contractility of the smooth, skeletal, and cardiac muscle

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15
Q

SIGNS OF HYPOKALEMIA

A

May develop confusion, respiratory depression, lieu’s, and constipation. Keep close eye on surgery patients

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16
Q

TREATMENT OF HYPOKALEMIA

A

May give K+ PO with breakfast or with food. Always give IV replacement on a pump. If given as a bolus, 10 mEq in 100 of normal saline infused over 1 hour.
NEVER DIRECT PUSH POTASSIUM!!!!!!!!

IF ON DIGOXIN YOU MUST BRING K+ LEVELS UP TO NORMAL OR RISK DIGOXIN TOXICITY

17
Q

HYPERKALEMIA

A

Too much potassium

>5

18
Q

CAUSES OF HYPERKALEMIA

A

May be caused by renal failure, too much intake or use of salt substitutes

Potassium has been the drug used in lethal injections to stop the heart

19
Q

TREATMENT OF HYPERKALEMIA

A

Drug therapy - Kayexalate and insulin ( drives K+ into the cell. Give 5% dextrose before giving

Encourage potassium rich foods

20
Q

MANIFESTATIONS OF IMBALANCES

A

HYPOKALEMIA- EKG changes, flattened or inverted T waves, skeletal muscle weakness

HYPERKALEMIA- cardiac arrest, parathesia, abdominal cramping

21
Q

CALCIUM

A

Normal level 9.0-10.5 mg/dL

Absorption requires active form of vitamin D
Stored in bones
Parathyroid asks the bones for calcium and thyroid tells bones to stop

22
Q

HYPOCALCEMIA

A

Calcium level < 9.0

Causes painful muscle spasms

23
Q

CAUSES OF HYPOCALCEMIA

A
Parathyroidectomy
Lactose intolerance
Alcohol abuse
Vitamin D deficiencies
No sun exposure
24
Q

TREATMENT OF HYPOCALCEMIA

A

Replace slow IV push
Teach about sources of calcium
Injury prevention- use a lift to move these patients to prevent fractures

25
Q

HYPERCALCEMIA

A

> 10.5

26
Q

CAUSES OF HYPERCALCEMIA

A

Overactive parathyroid
Lung cancer
Breast cancer
Some cancers of the blood

Results in blood clots and decreased peristalsis

27
Q

MAGNESIUM

A

Normal level 1.8-2.6

Critical to skeletal muscle contraction, carb metabolism, ATP formation, vitamin activation, and growth

28
Q

HYPOMAGNESIUM

A

<1.8

29
Q

CAUSES OF HYPOMAGNESIUM

A

Alcoholism, burns over large part of the body, chronic diarrhea, fluid loss

Excessive urination, such as from uncontrolled diabetes and in recovery from kidney failure, HYPOCALCEMIA

30
Q

SYMPTOMS OF HYPOMAGNESIUM

A

Chevoskek’s sign and trousseau’s sign, hyperactive reflexes, confusion and psychosis, abdominal issues

31
Q

TREATMENT OF HYPOMAGNESIUM

A

Oral supplements, IV magnesium sulfate

Do not give too quickly, may cause hypotension

32
Q

HYPERMAGNESIUM

A

Caused by renal failure.

>2.6

33
Q

SYMPTOMS OF HYPERMAGNESIUM

A

Cardiac changes
Reduced reflexes
Lethargy
Difficult breathing

34
Q

TREATMENT OF HYPERMAGNESIUM

A

Loop diuretic

Make sure patient only receives magnesium free drugs

35
Q

PRIMARY PREVENTION OF ELECTROLYTE IMBALANCE

A

Prevention designed to minimize risk factors and to manage the disease
Patient teaching, dietary measures, oral supplements

36
Q

SECONDARY CLINICAL MANAGEMENT FOR ELECTROLYTE

A

No routine screening, monitoring serum levels may performed as part of disease management

37
Q

NURSING INTERVENTIONS OF ELECTROLYTE IMBALANCE

A
Daily weight ( most important)
I/O
Safety
Comfort measures
Oral hygiene
Patient teaching( diet)