ELECTROLYTE EXCESS AND DEFICITS

Question 1

ELECTROLYTES

Answer 1

• SODIUM—– NA 135-145 mEq/L
• POTASSIUM — K 3.5-5.1 mEq/L
• CALCIUM —- CA2 8.5 - 10.mg/dl
• PHOSPHATE—- -PO4 3.5 -4.5 mg/dl
• MAGNESIUM— -MG 1.5-2.5 mg/dl

Question 2

NA 135-145mEq/L

HYPONATREMIA

Answer 2

NA LOSS WITH H20 EXCESS

• LOW NA INTAKE
• EXCESS DIURETICS / HYPOTONICS
• GI SECRETION LOSS / DIARRHEA
• WOUND DRAINAGE
• ADERENAL INSUFFICIENCY
• DIAPHORESIS

Question 3

HYPONATREMIA CLINICAL MANIFESTATIONS

Answer 3

• CONFUSION / MUSCLE CRAMPS
• TACHYCARDIA
• N/V, FATIGUE , APATHY
• DRY MUCUS MEMBRANES

Question 4

HYPONATREMIA INTERVENTIONS

Answer 4

• ID UNDERLYING CAUSE AND TREAT
• DIETARY NA
• NA IV’S
• CLIENT AND LAB ASSESSMENT
• LIMIT H20 IF PRIMARY PROBLEM

Question 5

NA –135-145

HYPERNATREMIA

Answer 5

*NA EXCESS / H2O LOSS
*HYPERTONIC TUBE FEEDINGS CAN
LEAD TO DEHYDRATION WITHOUT H2O
SUPPLEMENT
* EXCESS NA IV

Question 6

CLINICAL MANIFESTATIONS OF HYPERNATREMIA

Answer 6

• THIRST / WT. LOSS
• DRY MUCUS MEMBRANES
• UA OUTPUT DECREASE
• DISORIENTATION / WEAKNESS

Question 7

HYPERNATREMIA INTERVENTIONS

Answer 7

*ID UNDERLYING CAUSE AND TREAT
*HYPOTONIC IV SOLUTIONS (GRADUAL
INFUSION TO AVOID ICP)
*DIURETICS
*CLIENT AND LAB ASSESSMENT

Question 8

K 3.5-5.0

HYPOKALEMIA

Answer 8

*K LOSS DUE TO A SHIFT OF K FROM ECF TO 
  ICF
*EXCESS LOSS VIA KIDNEYS,AND GI 
*EXCESS DIURESIS
*INCREASE IN ALDOSTERONE 
*METABOLIC ALKALOSIS K SHIFT FROM ECF 
  TO ICF

Question 9

HYPOKALEMIA (DIABETIC KETOACIDOSIS)

Answer 9

SHIFT OF K INTO CELLS WITH
INSULIN ADMINISTRATION AND
CORRECTION OF ACIDOSIS.

Question 10

EKG CHANGES WITH

HYPOKALEMIA

Answer 10

1. FLATTENED T WAVE
2. ST WAVE DEPRESSION
   3 .U WAVE PRESENCE
3. VENTRICULAR ARRHYTHMIAS,PVC
   5 BRADYCARDIA / FATIGUE
   6 .ENHANCED DIGOXIN EFFECT
4. MUSCLE WEAKNESS

Question 11

Clinical manifestations/HYPOKALEMIA

Answer 11

• MUSCLE WEAKNESS
• ILEUS
• LEG CRAMPS
• NAUSEA/VOMITING
• DECREASED BOWEL SOUNDS
• DECREASED REFLEXES

Question 12

HYPOKALEMIA INTERVENTIONS

Answer 12

• ID UNDERLYING CAUSE AND TREAT
• DIETARY INTAKE
• K SUPPLEMENTS/ EKG MONITORING
• IV K

* RENAL FUNCTION PRIOR TO IV K
* CLIENT AND LAB ASSESSMENT

Question 13

K PRECAUTIONS

Answer 13

• NEVER GIVEN IV PUSH
• MUST BE DILUTED
• IRRITATING TO VEINS
• EKG MONITOR PRN
• IV PUMP PRN
• TYPICAL DOSE 20mEq/L of KCL
• ASSESS LABORATORY DATA