Electrolyte Imbalance

Question 1

hyponatremia

Answer 1

water is drawn into the cell causing swelling
Etiology - diuretic therapy, burns, sweating, SIADH, FLE
S&S -N/V, abd cramps, confusion, HA, seizures, convulsion, coma
SALT -Seizure, Anorexia N/V, Lethargy, T

Question 2

hypernatremia

Answer 2

Etiology -increased Na intake, dehydration, diarrhea
S&S -dry, sticky tongue, thirst, dry, flushed skin, restlessness, weakness, irritable
FRIED- Fever, Retention, Irritable Increased BP, Edema, Decreased output

Question 3

hypokalemia

Answer 3

Etiology -diuretics/prescription, V/D
S&S -ECG: flat T waves, presence of U waves, weakness, paresthesia/numbness, cramping in legs, fatigue **increased risk of digoxin toxicity

Question 4

hyperkalemia

Answer 4

Etiology -acidosis, hyper-alimentation & K replacement, impaired renal function
S&S- ECG: peaked T waves, wide QRS, arrhythmias, paralysis, muscle weakness, oliguria/anuria, decreased cardiac contractility, ECG changes
have pt on cardiac monitor

Question 5

hypocalcemia

Answer 5

Etiology -removal of parathyroid gland, vit. D deficiency, furosemide, malnutrition
S&S EARLY -numbness&tingling of finger/toes/lips
LATER- TETANY, muscle spasms, +chovstek’s or trousseus, diarrhea, ECG: prolonged QT interval

Question 6

hypercalcemia

Answer 6

Etiology -overuse of Ca supplements, excessive Vit D, malignancy, prolonged immobilization, thiazide diuretics
S&S -shortened QT interval, muscle weakness/incoordination, anorexia, constipation

Question 7

hypomagnesemia

Answer 7

Etiology -alcoholism, GI losses, medications, rapid admin citrated blood, DKA
S&S -neuromuscular irritability/confusion, hyperactive DTR, tremors/twitches, tachycardia, HTN
Treatment - magnesium sulfate

Question 8

hypermagnesemia

Answer 8

Etiology -use of Mg antacids, renal failure, Mg medication, DKA
S&S -hypoactive DTR, oliguria, respiratory depression/arrest, flushing
Treatment -Calcium gluconate

Question 9

hypophosphatemia

Answer 9

Etiology -alcoholism, re-feeding starvation pt, pain, heat stroke, respiratory alkalosis
S&S -neurologic symptoms, confusion, muscle weakness, tissue hypoxia

Question 10

hyperphosphatemia

Answer 10

Etiology -tissue trauma, chemotherapy, PO4 containing medication, osteoporosis
S&S -few symptoms, soft-tissue calcification, symptoms occur due to associated hypocalcemia

Question 11

digoxin

Answer 11

low levels of potassium levels increase the risk of digoxin toxicity (S/E-N/V. vision changes yellow/green halo lights, dysrrhymias. often seen in levels greater than 2.0)

Question 12

Furosemide (‘-ide’ furosemide, bumetanide)

Answer 12

increase risk for hyponatremia, hypokalemia, hypocalcemia

Question 13

calcium gluconate

Answer 13

given for hypermagnesemia

Question 14

Thiazide diuretics (‘hydro-‘, hydrochlorothiazide)

Answer 14

increase risk for hypercalcemia