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NRS133: Unit 5 - Fluid/Electrolyte & Acid-Base Imbalances > Electrolyte Imbalance > Flashcards

Electrolyte Imbalance Flashcards

1
Q

Sodium (Na+) Range

A

136 - 145 mEq/L

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2
Q

Sodium Facts

A

Most Abundant Cation in ECF

Essential for nerve impulse transmission/muscle contraction

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3
Q

Hyponatremia Causes

A

<136

  • Fluid Overload
  • Psychogenic polydipsia (too much thirst)
  • Adrenal Insufficiency (Adrenals secrete Aldosterone)
  • SIADH
  • Diuretic Therapy
  • Liver Disease
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4
Q

Hyponatremia S/S

A
  • Headache (CNS problems)
  • Nausea; diarrhea, abdominal cramps
  • Tachycardia; hypotension
  • muscle weakness
  • dry skin; pale dry mucous membranes
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5
Q

Treatments for Hyponatremia

A
  • IV of 0.9% NS
  • Hypertonic saline given with dangerously low Na+ levels.
  • No free water intake
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6
Q

Hypernatremia Causes

A

> 145

  • dehydration
  • greatly increased sensible water loss
  • severe watery diarrhea
  • Insufficient ADH
  • Kidney disease
  • Excess secretion of aldosterone
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7
Q

Hypernatremia S/S

A 
S- skin flushed
A- agitation
L- low fever
T- thirst
D- Dry sticky mucous membrance; oliguria
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8
Q

Treatmentment for Hypernatremia

A
  • Hypotonic saline solution such as 0.45% NS
  • Diuretics
  • Na+ resrictions
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9
Q

Potassium Range

A

3.5 - 5.0 mEq/L

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10
Q

Potassium Facts

A
  • Most abundant Cation in ICF
  • Responsible for regular heart rhythm
  • Aids in protein synthesis
  • Aids in conversion of glucose to energy
  • Regulation of Acid-base balance
  • conduction of neuromuscular impulses.
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11
Q

Foods high in potassium

A

bananas, meat, potatoes, citrus fruits, avacados

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12
Q

Foods low in potassium

A

Eggs, Bread and Cereal grains

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13
Q

Hypokalemia Causes

A

<3.5

  • fluid overload
  • diuretic therapy
  • GI losses (vomiting or NG suction)
  • Insufficient GI absorption
  • Abnormal losses of secretions or excretions.
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14
Q

Hypokalemia S/S

A 
S-skeletal muscle weakness
U- U wave;EKG changes
C- constipation; ileus; decreased bowel sounds
T-toxic effects of digoxin
I-Irregular, weak pulse
O-orthostatic hypotension
N- numbness(paresthesia)
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15
Q

Treatment of Hypokalemia

A
  • Increase in potassium in diet

- Administer potassium (oral/IV)

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16
Q

Hyperkalemia Causes

A

> 5

  • dehydration
  • kidney disease
  • acidosid
  • adrenal insufficiency
  • massive crushing injuries
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17
Q

Hyperkalemia S/S

A
  • Early symptoms are not specific
  • First tachycardia, later bradycardia
  • Tall, peaked T wave on EKG
  • Risk for cardiac arrest
  • Muscle cramps
  • Nausea, diahrrea
  • paresthesia of face, tongue, and extremities
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18
Q

Treatment of Hyperkalemia

A
  • Avoid K+ intake
  • Give kayexalate
  • Give lasix
  • If acute, hive hypertonic IV solutions of D5 of D1/4 with IV regular insulin
  • In severe cases Ca++ to stimulate heart
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19
Q

Calcium (Ca++) Range

A

9.0 - 10.5 mEq/L

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20
Q

Calcium Facts

A
  • 99% stored in bone
  • 0.5% bound with protein in plasma
  • regulates cell permeability to Na+ and K+
  • Important for transmission of nerve impulses
  • Contraction of muscle tissue, maintain normal heart rhythm
  • blood clotting process
  • absorption and utilization of B12
  • Levels regulated by PTH
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21
Q

Hypocalcemia Causes

A

<9.0

  • Removal of parathyroid glands
  • Increased loss of intestinal secretions
22
Q

Hypocalcemia S/S

A
  • Neuromuscular irritability
  • Carpopedal spasms (Trousseaus Sign)
  • Facial twitches (chvostek’s sign)
  • EKG changes, Heart failure
23
Q

Treatment of Hypocalcemia

A
  • Adjust diet
  • Oral or IV calcium
  • Vitamin D oral or IM
24
Q

Hypercalcemia Causes

A

> 10.5

  • Parathyroid tumor
  • Excessive vitamin D administration
  • Multiple fractures
  • Prolonged immobilization or bed rest
25
Q

Hypercalcemia S/S

A
  • fatigue, lethargy
  • decreased muscle tone/weakness
  • deep bone pain, kidney stones, confusion
  • N/V, thirst, constipation
26
Q

Treatment of Hypercalcemia

A

-IV fluids to dilute Ca++, Lasix to force diuresis

27
Q

Magnesium (Mg++) Range

A

1.3 - 2.1 mEq/L

28
Q

Magnesium Facts

A
  • Found in ICF
  • regulated by parathyroid glands
  • essential for enzyme activities, neurochemical activities, muscular excitability
29
Q

Hypomagnesemia causes

A

<1.3

  • Inadequate intake, excessive loss
  • Inadequate absorption
  • Hypoparathyroidism
30
Q

Hypomagnesemia S/S

A
  • weakness, tremors, muscle cramps
  • N/V, esophageal spasms
  • hyperactive deep tendon reflexes
  • confusion; tachycardia, HTN
31
Q

Treatment of Hypomagnesemia

A

Dietary replacement, antacids, IV or Im. Oral may cause diarrhea

32
Q

Hypermagnesemia Causes

A

> 2.1

  • Renal insufficiency
  • Severe dehydration with oliguria
  • Magnesium based laxatives/cathartics (eg.MOM)
33
Q

Hypermagnesemia S/S

A
  • Depressed deep tendon reflexes
  • Depressed respirations, hypotension
  • Sense of warmth
34
Q

Treatment of Hypermagnesemia

A

Correct underlying cause, Dialysis may be necessary.

35
Q

Chloride (Cl-) Range

A

98 - 106 mEq/L

36
Q

Chloride Facts

A
  • Major anion in ECF
  • Componenet of hydrochloric acid
  • Role of transport of carbon dioxide by RBCs
  • Excreted by kidney
  • Affected by aldosterone secretion
  • Sodium and chloride are closely linked; a change in level of one causes a change in level of the other
37
Q

Hypochloremia Causes

A

<98 mEq/L

  • Fluid overload
  • Excessive vomiting, diarrhea
  • Lost with Na+ in diuretic therapy
38
Q

Hypochloremia S/S

A

Same as hyponatremia

39
Q

Treatment of Hypochloremia

A

IV replacement

40
Q

Hyperchloremia Causes

A

> 106 mEq/L

  • will occur with hypernatremia
  • Metabolic acidosis
  • Respiratory alkalosis
  • Hyperalsodteronism
41
Q

Hyperchloremia S/S

A
  • Lethargy, weakness, confusion, stupor
  • Deep, labored respiration
  • Associated with acid-base imbalance
42
Q

Treatment of hyperchloremia

A

IV sodium bicarbonate to reverse acidosis

43
Q

Phosphate (PO4) Range

A

3.0 - 4.5 mg/dL

44
Q

Phosphate facts

A
  • levels vary inversely with Ca++ levels
  • parathyroid hormone inhibits absorption
  • promotes normal neuromuscular action
  • carbohyrate metabolism
  • assists in acid-base regulation
  • blood buffer!
45
Q

Hypophosphatemia Causes

A

<3.0

  • Inadequate intake
  • poor absorption
  • loss by diuretics
  • hyperparathyroidism
46
Q

Hypophosphatemia S/S

A

Same as hypercalcemia

47
Q

Treatment of Hypophosphatemia

A
  • Oral sodium phosphates and potassium phosphates

- dietary intake

48
Q

Hyperphosphatemia Causes

A

> 4.5

  • Renal failure
  • hypoparathyroidism
49
Q

Hyperphosphatemia S/S

A

Same as hypocalcemia

50
Q

Treatment of Hyperphosphatemia

A
  • Dietary restriction
  • Administering phosphate binding agent (PhosL0)
  • all on for dialysis.

NRS133: Unit 5 - Fluid/Electrolyte & Acid-Base Imbalances (3 decks)

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