Electrolyte General Knowledge Flashcards
1
Q
When blood osmolality increases or blood volume decreases, _____ is released to conserve water.
A
ADH
2
Q
By increasing water reabsorption, ADH helps dilute the blood and reduce its osmolality. This effect is crucial for maintaining proper fluid balance and preventing dehydration.
Simultaneously, ADH’s action leads to the ( dilution /concentration) of urine, as more water is retained, and ( less / more) is excreted in the urine.
A
Concentration
Less
The purpose of ADH is to retain water.
Lower serum Osmolality
Concentrate Urine
3
Q
Osmotic diuresis
A
refers to an increased production of urine due to the presence of certain substances in the renal tubules that prevent the normal reabsorption of water. This phenomenon is often associated with the presence of osmotically active solutes in the urine.
4
Q
Difference between ISOTONIC Hyponatremia & ISOTONIC Dehydration
A
Water & Salt lost at same rate
5
Q
Low urine sodium level
A
<25
6
Q
High urine sodium level
A
> 40
7
Q
Hypovolemia due to GI loses
Renal losses due to Stopping diuretics
Third Space
Diagnostics for
Low urine sodium <25
High urine sodium >40
A
Low urine sodium <25
8
Q
Metabolic Alkalosis
Renal salt loses due to diuretics, adrenal insufficiency, or cerebral wastinG
Diagnostics
Low urine sodium <25
High urine sodium >40
A
High urine sodium >40
9
Q
Nephrotic syndrome affects fluid levels include proteinuria, hypoalbuminemia, and resulting edema.
Hypovolemia/ Hypervolemia
A
Hypovolemia
10
Q
What affext will Aldosterone have on osmolality & specific gravity of urine.
A
Reduce them.
Aldosterone holds onto water
Reducing concentration
11
Q
Cells will fire excessively or not at all due to this electrolyte
A
K
12
Q
Morphine, Nitroglycerin, Digoxin are interventions for (Hypo / Hypervolemia)
A
Hypervolemia
13
Q
Liver failure or lack of protein can cause this to be low
A
Albumin
14
Q
Acietes from liver failure (liver doesn’t produce enough Albumin) causes this type of hypovolemia
A
Third space shift
15
Q
Third space shift refers to the abnormal distribution of fluid from the intravascular space to the interstitial or “third space,” which can lead to a deceptive fluid volume status.
While it involves the movement of fluid, it is commonly associated with (hypovolemia / Hypervolemia) In third space shift, even though there is a loss of fluid from the vascular compartment, the total body water may remain the same, contributing to its deceptive nature.
What is its cause
A
Hypovolemia
Lack albumin
16
Q
Size needle size needle used for giving IV fluids
A
20
17
Q
Can you have too much fluid (Hypervolemia) and dehydration at the same time?
A
Yes, third space shift
18
Q
Severe (hyponatremia / Hypernatremia) can cause cerebral edema due to osmotic shifts of water into brain cells, leading to cellular swelling.
A
Hyponatremia
19
Q
Normal serum osmolality levels typically fall within the range of ____ to _____mOsm/kg (milliosmoles per kilogram) of water.
A
275 - 295
Higher the more Stuff in blood.
Higher the more Hypertonic
20
Q
Isotonic Dehydration (Related to Na)
(Water & Sodium lost at equal amounts from the body)
Skin ____
Eyes ____
Mucous Membranes (Dry / Moist)
Skin Tugor (Decreased/ Increased)
HR (Decreased/ Increased)
BP (Decreased/ Increased)
Headache Present?
Weakness Present?
A
Skin Dry
Eyes Sunken
Mucous Membranes Dry
Skin Tugor Decreased
HR Increased
BP Decreased
Headache Present YES
Weakness Present YES
21
Q
Isotonic Dehydration (Related to Na)
(Water & Sodium lost at equal amounts from the body)
Causes
Vomit
NG suction
Diarrhea
Hemorrhage
Cell destruction
Burns
Heat stroke
Sweating
A
Vomit
Diarrhea
Hemorrhage
Burns
Heat stroke
Sweating
22
Q
Seizures and Stupor happen at this level of sodium
A
110 LOOK UP LATER
23
Q
A patient who is dehydrated with Hypernatremia may have (Symptoms of Hypervolemia)
Elevated BP
Bounding Pulse
Dyspnea
Why?
A
Release of ADH
24
Q
Hypokalemia will have ___ Digoxin levels
A
Elevated
25
Coffee, potatoes, dried fruits, fruits, veggies contain high this electrolyte
Potassium
26
Hypokalemia interventions
When giving IV never do this.
Always do these 3
Never IV push or Bolus
Always:
Give Mg first
Use pump
Give at rate of <10 mEq/hr
27
Lasix = this type of diuretics (With this function)
Loop. Clears out everything
28
Rate at which to give Potassium in an IV pump
10 mEq/Hr
29
ACE, NSAID, ARB, cause this problem with K
Hyperkalemia
30
Elevated Ph will cause this problem with K
Hypokalemia
An elevated pH (alkalosis) can potentially cause hypokalemia, which is a decreased level of potassium in the blood.
31
DKA / insulin deficiency
Relationship to K
Hyperkalemia
32
Renal failure has this affect on K
Hyperkalemia
33
Hemorrhage shock has this problem with K
Hyperkalemia
34
Burns, tissue damage, cell destruction have this affect on K
Hyperkalemia
35
Acidosis has this affect on K
Hyperkalemia >5
36
Adrenal Insufficiency (Addisons) has this affect on K
Hyperkalemia >5
37
Assessment
Bradycardia
K
Hyperkalemia >5
38
Assessment
Hypotension
K
Hyperkalemia >5
39
Assessment
Rhythm Change
VFIB & VTACH
K
Hyperkalemia
40
Assessment
Paresthesia, Muscle Weakness, Paralysis
K
Hyperkalemia
41
Assessment
Numbness Starts in legs and progresses
K
Hyperkalemia >5
42
Assessment
Respiratory Distress
K
Hyperkalemia
43
Assessment
Decreased Urine Output
K
Hyperkalemia
44
Assessment
abdominal cramping, diarrhea
K
Hyperkalemia
45
Lack of albumin causes Hypovolemia/ Hypervolemia
Hypovolemia
The water cant enter the blood vessels and Third space shift
46
What will Aldosterone do in hyponatremia
Retain Na & H²O
47
Sodium think these types of problems
Potassium (K) think these types of problems
Na = Mental
K = Cardiac
48
Main causes of Isovolemic Hyponatremia (2)
Renal failure
Medication: Lithium
49
If <120 Na give this type of IV, slowly (cerebral edema)
ICU only
Hypertonic
50
Regular Hyponatremia <135 But >120 give this IV fluid
Isotonic
Not D5W (Iso in bag / Hypo in body)
51
Liver failure and CHF cause Hyponatremia how?
Water retention
52
Diuretics, NG suction, Renal problemas cause Hyponatremia/ Hypernatremia
Hyponatremia
53
SIADH will cause
Hyponatremia/ Hypernatremia
Hyponatremia
ADH holds onto water
54
Assessment
Fever, Flushed skin
Hyponatremia/ Hypernatremia
Hypernatremia
55
Elderly and infant are more likely to have
Hyponatremia/ Hypernatremia
Hyperkalemia
Decreased water intake
56
Osmotic diuretics can cause
Hyponatremia/ Hypernatremia
Hypernatremia
57
Gi feeding without H²O flush
Hyponatremia/ Hypernatremia
Hypernatremia
58
Diarrhea & Vomiting are common causes of Hypernatremia
True or False
False not common.
NG suction more common
59
Increased fluid retention/ increased reflexes
Hyponatremia/ Hypernatremia
Hypernatremia
60
Decreased urine output & increased thirst
Hyponatremia/ Hypernatremia
Hypernatremia
61
Use D5 / .45% or D5W
Hyponatremia/ Hypernatremia
Hypernatremia
62
Why gradual reduction of sodium in Hypernatremia
Prevent cerebral edema
63
Thirst and low grade fever are associated
Hyponatremia/ Hypernatremia
Hypernatremia
64
How is most potassium lost
80% urine
K not regulated by any means
65
Aldosterone stimulates
____ reabsorption
____ excretion
Na reabsorption
K excretion
66
(Low / High) ph can cause H+ to be sub for K to maintain ICF neutrality
Low
67
Sodium potassium pump combats ____
Diffusion
Uses ATP for active transport
68
Hypokalemia =
Severe Hypokalemia =
<3.5
<2.5
69
How does Low Mg cause Hypokalemia
It stops the sodium potassium pimp from working and potassium cant exit tje cell
70
Lasix, Steroids, Laxatives cause
Hypokalemia/ Hyperkalemia
Hypokalemia
71
Respitory Alkalosis causes
Hypokalemia/ Hyperkalemia
Hypokalemia
Alkalosis promotes the movement of potassium from the extracellular fluid into the intracellular space.
72
NG suction / High urine output causes
Hypokalemia/ Hyperkalemia
Hypokalemia
73
Hyperglycemia Osmotic Diuresis
Hypokalemia/ Hyperkalemia
Hypokalemia
uncontrolled diabetes mellitus can contribute to hypokalemia
Insulin Effect:
Elevated blood glucose levels lead to increased insulin secretion. Insulin enhances the uptake of potassium into cells, lowering serum potassium levels.
Osmotic Diuresis:
Hyperglycemia causes an osmotic diuresis, where glucose is excreted in the urine along with water and electrolytes, including potassium.
74
Insulin therapy will cause
Hypokalemia/ Hyperkalemia
Hypokalemia
75
Burns cause
Hyperkalemia/ hyponatremia
Both
Hyperkalemia 1st
Hypokalemia 2nd
76
Fluid loss in general causes
Hypokalemia/ Hyperkalemia
Hypokalemia
77
If its Low its slow refers to
Hypokalemia
Everything is decreased
Lethargic
Low resp
Lethal cardiac concern
Loss Urine limp miscle
LOW BP & HR
78
Low BP & HR
hypokalemia/ Hyperkalemia
Hypokalemia
79
Paresthesia
Hypokalemia / Hyperkalemia
Hypokalemia
80
Toxic effects of Elevated Digoxin
Hypokalemia/ Hyperkalemia
Hypokalemia
81
Danger Zone for K level (High)
>7
82
Blood transfusions
Hypokalemia/ Hyperkalemia
Hyperkalemia
83
Elevated pH
Hypokalemia/ Hyperkalemia
Hypokalemia
84
Too little output
Hypokalemia/ Hyperkalemia
Hyperkalemia
85
Tissue Injury
Hypokalemia/ Hyperkalemia
Hyperkalemia
86
Renal Failure
Hypokalemia/ Hyperkalemia
Hyperkalemia
87
DKA
Hypokalemia/ Hyperkalemia
Hyperkalemia
88
Cellular Destruction
Hypokalemia/ Hyperkalemia
Hyperkalemia
89
Hemorrhage Shock
Hypokalemia/ Hyperkalemia
Hyperkalemia
90
VFIB & VTACH
hypokalemia/Hyperkalemia
Hyperkalemia
91
Decreased pH & increased H level
Hypokalemia/ Hyperkalemia
Hyperkalemia
92
Dialysis is used for
Hypokalemia/ Hyperkalemia
Hyperkalemia
93
Sodium polystyrene sulfonate
Kayexalate (oral or enema)
Is used for
Hyperkalemia
94
Give CaCl or Ca gluconate for Hyperkalemia (combats myocardial effects)
Describe them
CaCl 3x calcium then Calcium Gluconate
Calcium Gluconate USED MORE OFTEN
95
Both Hypokalemia & Hyperkalemia should be on a _____ Diagnostic Tool
Cardiac Monitor
96
Mg levels
1.3 - 2.1
97
Maintains electric activity in nerves and muscles
Mg
98
Important for cell metabolism
Mg
99
Influences Ca absorption (electrolyte)
Mg
100
DM / DKA W/ insulin
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
101
Cause
PPI Prilosec
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
102
Causes
TPN
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
103
Causes
Laxatives
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
104
Causes
Sepsis
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
105
Causes
Cirrhosis
Hypomagnesemia /Hypermagnesemia
Hypomagnesemia
106
Causes
Hypocalcemia
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
107
Causes
ETOH (Alcohol)
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
108
Cause
Renal disease
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
Renal disease contributes hypocalcemia through:
Decreased Activation of Vitamin D:
The kidneys turn inactive vitamin D into its active form (calcitriol). Calcitriol enhances the absorption of calcium from the intestines.
Reduced Reabsorption of Calcium:
Increased Phosphorus Levels:
In renal disease, there is often an associated elevation in serum phosphorus levels.
Which lower calcium
109
Trousseau's & Chvostek
Are related to these 2 conditions
Hypocalcemia PRIMARY
Hypomagnesemia
110
Torsade de points (Fatal/ From Alcoholism)
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
111
Involuntary movement, muscle cramps, seizures
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
112
Low Mg <1.3
May see low electrolytes (2)
K & Ca
113
When assessing a patient for which electrolyte imbalance do we check for Dysphagia
Hypomagnesemia
114
For which electrolyte imbalance would we Decrease Stimuli.
Turn lights down
Sounds off
Hypomagnesemia
115
Causes
Cell damage
Hypomagnesemia/ Hypermagnesemia
Hypermagnesemia
116
Causes
DKA
Hypomagnesemia
Hypermagnesemia
Hypermagnesemia
117
Causes
Hypothyroid/ Hyperparathyroidism
Hypomagnesemia/
Hypermagnesemia
Hypermagnesemia
118
Causes
Renal dysfunction
Hypomagnesemia/
Hypermagnesemia
Hypermagnesemia >2.1
119
Causes
Certain antacids
Hypomagnesemia/
Hypermagnesemia
Hypermagnesemia >2.1
120
Causes
Dehydration
Hypomagnesemia/
Hypermagnesemia
Hypermagnesemia >2.1
121
S / S
Arrhythmia (bradycardia)
Hypomagnesemia/
Hypermagnesemia
Hypermagnesemia > 2.1
122
SS
Leathargy, Weak, Depressed
Hypomagnesemia/
Hypermagnesemia
Hypermagnesemia
123
Tendon reflexes diminished
Hypomagnesemia/ Hypermagnesemia
Hypermagnesemia
124
SS
GI issues
Hypomagnesemia/ Hypermagnesemia
Hypermagnesemia
125
Respitory Arrest Sudden
Hypomagnesemia/ Hypermagnesemia
Hypermagnesemia
126
Cardiac Arrest
Hypomagnesemia/ Hypermagnesemia
Hypermagnesemia
127
Intervention for Hypermagnesemia
This type of calcium....
Calcium Gluconate (Less Calcium)
128
Why would a Mg patient need to be on a cardiac monitor?
Because it can affect the K levels
Mg is needed to bring K out of cell
129
S S
SEIZURES & Stupor
Hyponatremia/ Hypernatremia
Hyponatremia <110
Correct
130
SS
Flushed skin & Fever
Hyponatremia/ Hypernatremia
Hypernatremia
131
SS
Anorexia
Hyponatremia / Hypernatremia
Hypernatremia
132
Symptoms of ( hyponatremia Hypernatremia) include nausea, vomiting, headache, seizures, and in severe cases, cerebral edem
Hyponatremia
133
Ataxia is associated with
Hyponatremia Hypernatremia
Hypernatremia
134
Causes
Corticosteroids
Hyponatremia/ Hypernatremia
Corticosteroids can contribute to hypernatremia
Increased Sodium Retention:
Corticosteroids, especially mineralocorticoids like aldosterone, promote sodium retention in the kidneys. They enhance the reabsorption of sodium and water.
Potassium Loss:
Corticosteroids can induce potassium loss in the urine, leading to a relative increase in sodium concentration.
135
Causes
NG suction (Loss of fluids)
Hyponatremia/ Hypernatremia
Hypernatremia
136
Osmotic diuretics cause
Hyponatremia/ Hypernatremia
Hypernatremia
Concentration of Tubular Fluid:
As osmotic diuretics prevent water reabsorption, the tubular fluid becomes more concentrated with solutes, including sodium. While water is being excreted, solutes, including sodium, become more concentrated in the remaining tubular fluid.
137
Hypercortisolism & Hyperventilation cause
Hyponatremia/ Hypernatremia
Hypernatremia
138
CHF leads to
Hyponatremia/ Hypernatremia
Hyponatremia
139
Liver failure is associated with
Hyponatremia/ Hypernatremia
Hyponatremia
140
Lots of urine
Hypokalemia/ Hyperkalemia
Hypokalemia
141
Leg cramps
Hypokalemia/Hyperkalemia
Hypokalemia
142
Low blood pressure
Hypokalemia/ Hyperkalemia
Hypokalemia
143
Heavy loss of fluid
Hypokalemia/ Hyperkalemia
Hypokalemia
144
Prepare patient for ready for dialysis. Most patient are renal patients who get dialysis regularly and will have high potassium.
Intervention for
Hyperkalemia >5
145
Kayexalate is sometimes ordered and given PO or via enema. This drug promotes GI sodium absorption which causes excretion
Intervention for....
Hyperkalemia >5
146
Administer a hypertonic solution of glucose and regular insulin to pull the potassium into the cell
Interventions for..
Hyperkalemia
147
Doctor may order potassium wasting drugs like Lasix or Hydrochlorothiazide
Intervention for...
Hyperkalemia
148
Watch other electrolytes like Magnesium (will also decrease…hard to get K+ to increase if Mag is low), watch glucose, sodium, and calcium all go hand-in-hand and play a role in cell transport
Intervention for..
Hypokalemia < 3.5
149
Other electrolyte issues are associated with a low Mg. level like (2)
hypOkalemia, hypOcalcemia
150
Glycemic issues (Diabetic Ketoacidosis, insulin administration)
Effect magnesium levels how
Hypomagnesemia
151
Signs & Symptoms of Hypomagnesemia (Excitability or Lethargy)
Hypermagnesemia (Excitability or Lethargy)
Hypomagnesemia Excitability
Hypomagnesemia Lethargy
Remember “Twitching” because the body is experiencing neuromuscular excitability. This is the OPPOSITE in hypermagnesemia where everything system of the body is lethargic.
152
May administer potassium supplements due to hypokalemia
Hypomagnesemia/ Hypermagnesemia
Hypomagnesemia
hard to get magnesium level up if potassium level is down
153
In severe cases of(hypomagnesemia/ hypermagnesemia) the release of calcium is inhibited (because the PTH is suppressed) and that is why you can see hypocalcemia if you have a severely (low/ high) magnesium level is present.
Hypermagnesemia
High
154
calcium gluconaye may be order to reverse side effects of Hyper Magnesium (watch IV for infiltration…prefer central line)
True or False
True
155
Celiac’s & Crohn’s Disease
Hypocalcemia or Hypercalcemia
Hypocalcemia
Cause Malabsorption of calcium in the GI tract
156
Acute Pancreatitis
Hypocalcemia Hypercalcemia
Hypocalcemia
157
Chronic kidney issues
Hypocalcemia Hypercalcemia
Hypocalcemia
(excessive excretion of calcium by the kidneys)
158
Mobility issues will cause this electrolyte deficit
Hypocalcemia
159
Safety (prevent falls because patient is at risk for bone fractures, seizures precautions, and watch for laryngeal spasms)
Hypocalcemia/ Hypercalcemia
Hypocalcemia
160
Administer IV calcium as ordered (ex: 10% calcium gluconate)….give slowly as ordered (be on cardiac monitor and watch for cardiac dysrhythmias).
Assess for infiltration or phlebitis because it can cause tissue sloughing (best to give via a central line).
Also, watch if patient is on Digoxin cause this can cause Digoxin toxicity.
Describes interventions for...
Hypocalcemia <8.5
161
If phosphorus level is high (remember phosphorus and calcium do the opposite) the doctor may order aluminum hydroxide antacids (Tums) to decrease phosphorus level which in turn would increase calcium levels
Describes interventions for...
Hypocalcemia <8.5
162
(This Medication)usage (affects the parathyroid and causes phosphate to decrease and calcium to increase)
Lithium
163
Decrease calcium rich foods and intake of calcium-preserving drugs like _____ & Vitamin D
thiazides
164
Which of the following is not a cause of hypocalcemia?
A. Low parathyroid hormone
B. Crohn's Disease
C. Acute Pancreatitis
D. Thiazide Diuretics
The answer is D: Thiazide Diuretics
165
Hypocalcemia / Hypercalcemia
(CRAMPS)
Relfexs Hyperactive
Muscle Spasmas
Laryngeal Spasms
Positive Trousseau & Chvostek
Hypocalcemia/ Hypercalcemia
(Weak)
Weakness
Absent Reflexes & Abdominal Distention
Kidney Stone formation
Hypocalcemia
Hypercalcemia
166
Interventions Hypercalcemia
Give
Steroids
Phosphate
True or False
True
167
Interventions Hypocalcemia
Hydration
Diuretics
Hemodialysis
True or False
False
Interventions for Hypocalcemia
168
Reduce Phosphate
(Aluminum Hydroxide Antacids)
Hypocalcemia/ Hypercalcemia
Hypocalcemia
169
Assess for stridor in which imbalance
Hypocalcemia < 8.5
170
Renal failure, bone cancer, thiazide diuretics
Hypocalcemia/ Hypercalcemia
Hypercalcemia >10.5
171
Glucocortidicoid & Lithium affect Ca levels how
Hypercalcemia
172
Chronic Kidney disease (excretion/waste)
Increased Phosphorus level
Mobility Issues
Hypocalcemia/ Hypercalcemia
Hypo <8.5
173
Hypermagnesemia check _____ per teacher
Reflexes should be absent
174
DKA is associated with these levels of Mg.
>2.1
175
Corticosteroids have this affect on NA and K
Na Hypernatremia
K hypokalemia
