Electrolyte Imbalances

Question 1

hyponatremia etiology - 8

Answer 1

Losses from excessive sweating, vomiting, diarrhea

Diuretic drugs + low-salt diet

Hormonal imbalances

Insufficient aldosterone

Adrenal insufficiency (Addison’s disease)

Excessive ADH

Diuresis

Excessive water intake

Question 2

hyponatremia s/s - 9

Answer 2

Fatigue and weakness

Muscle cramps

Abdominal discomfort/cramps

n/v

Hypovolemia & low BP

Headache

Cerebral edema

Confusion

Seizures

Question 3

hypernatremia etiology - 6

Answer 3

Dehydration

Imbalance in sodium & water

Insufficient ADH (diabetes insipidus)

Loss of thirst mechanism

Watery diarrhea

Prolonged periods of rapid respiration

Ingestion of large amounts of Na without water

Question 4

hypernatremia s/s - 5

Answer 4

Weakness, agitation

Dry, rough mucous membranes

Edema

Increased thirst

Increased BP

Question 5

hypokalemia etiology - 6

Answer 5

Excessive loss by diarrhea

Diuresis c diuretic drugs

Excess aldosterone or glucocorticoids (ex. Cushing syndrome)

Decreased intake PO

Chronic disease (alcoholism, eating disorders, starvation)

Treatment of DKA c insulin

Question 6

hypokalemia s/s - 6

Answer 6

Cardiac dysrhythmias - Flattened T waves; U waves; Cardiac arrest

Muscles less responsive to stimuli

Decreased GI tract motility

Paresthesias - “pins and needles”

Severe hypokalemia: Shallow respirations; polyuria; renal failure

Question 7

hyperkalemia etiology - 6

Answer 7

Renal failure

Aldosterone deficit

Potassium sparing diuretics

Leakage into ECF

Extensive tissue damage

Prolonged or severe acidosis

Question 8

hyperkalemia s/s - 7

Answer 8

Cardiac alterations: Dysrhythmias; Tall peaked T waves

Muscle weakness

Progresses to paralysis

Respiratory arrest

Fatigue, nausea

Paresthesias

Oliguria

Question 9

hypocalcemia etiology - 5

Answer 9

Hypoparathyroidism

Malabsorption syndrome

Deficient serum albumin

Increased serum pH level

Renal failure

Question 10

hypocalcemia s/s - 5

Answer 10

Muscle contraction, twitching

Carpopedal spasm

Tetany

Cardiac dysfunction: Weak contractions; Delayed conduction; Dysrhythmias

Low BP

Question 11

hypercalcemia etiology - 7

Answer 11

Uncontrolled release of Ca from bones - usually related to hyperparathyroidism

Neoplasms - malignant bone tumors

Demineralization c immobility

Decreased stress on bone

Increased Ca intake

Excessive vitamin D

Milk-alkali syndrome

Question 12

hypercalcemia s/s - 9

Answer 12

Depressed neuromuscular activity

Muscle weakness, loss of muscle tone

Lethargy, stupor, personality changes

Anorexia, nausea

Interference with ADH

Less water absorption

Decrease of renal function

Increased strength of cardiac contractions

Dysrhythmias

Question 13

hypomagnesemia etiology - 2

Answer 13

Inadequate intake/absorption

Increased excretion

Question 14

hypomagnesemia s/s - 4

Answer 14

Muscle excitability

Increased DTR (deep tendon reflexes)

Seizures

Tachycardia

Question 15

hypermagnesemia etiology - 3

Answer 15

Medications - most common cause

Hypothyroidism

Addison’s disease - adrenal insufficiency

Question 16

hypermagnesemia s/s - 4

Answer 16

Muscle relaxation

Decreased/absent DTR

Respiratory depression/arrest (diaphragm relaxation)

Cardiac dysfunction

Question 17

hypophosphatemia etiology - 4

Answer 17

Malabsorption

Diarrhea

Excessive antacids

Alcoholism

Question 18

hypophosphatemia s/s - 4

Answer 18

Muscle relaxation, weakness

Mental status changes

Irritability

Respiratory failure

Question 19

hyperphosphatemia etiology - 3

Answer 19

Renal failure

DKA

Hyperparathyroidism

Question 20

hyperphosphatemia s/s - 6

Answer 20

Muscle contractions/cramping

Tetany

Joint pain

Rash

Pruritus (itching)

Paresthesia

Question 21

hypochloremia etiology - 4

Answer 21

Excessive use of loop diuretics

Excessive nasogastric suction

Excessive emesis

Seen in metabolic alkalosis

Question 22

hypochloremia s/s -

Answer 22

Fluid loss

n/v

Dehydration

Fatigue

Weakness

Respiratory distress

Question 23

hyperchloremia etiology - 5

Answer 23

Dehydration

Elevated Na

Renal failure

Diabetes insipidus

Medications

Question 24

hyperchloremia s/s - 4

Answer 24

Fatigue

Muscle weakness

Excessive thirst

Hypertension