Electrolyte Imbalances Flashcards
Sodium is essential for the maintenance of:
Acid-base and fluid balance
Active and passive transport
Irritability
Conduction of nerve and muscle tissue
Hyponatremia levels, cause, result:
<136 mEq/L
Excess H20 or plasma OR loss of sodium rich fluids
Delay of depolarization of membranes, H20 moves from ECF to ICF, which causes brain and nervous system to swell.
Risk factors for Hyponatremia:
Excessive GI loss; Renal loss; Skin burns and sound drainage, peripheral edema, ascites, GI obstruction; EFV; HF, Cirrhosis, nephrotic syndrome; Increased IV admin of 5% dextrose in water; NPO status; use of hypotonic solution irrigation; hyperglycemia
Major risk factor of hyponatremia for Older Adults
chronic illness, diuretics, insufficient salt intake
Vitals for hyponatremia:
Hypothermia, increased thready pulse, hypotension, orthostatic hypotension
Headache, confusion, muscle contractions, POSSIBLE RESP. COMPROMISE, DECREASED DEEP TENDON REFLEXES, SEIZURE, COMA
Increased motility, bowel sounds, abdm cramping
Most important Nursing Care for Hyponatremia
- monitor LOC, respiratory status if muscle weakness is present.
- Restrict water when FV is normal-high
- Administer hypertonic oral and IV fluids as prescribed.
Hypernatremia: Levels, important info
> 145 mEq/L
- Neuro, endocrine, cardia disturbances
- Hypertonicity of the blood, cell dehydration
Hypernatremia: Risks
- NPO, heat stroke, increased sodium intake, hypertonic fluids, hypertonic tube feeding, bicarb intake
- Sodium retention, kidney failure, Cushing’s disease, aldosteronism, gluccocorticosteroids, fluid loss
Hypernatremia: Findings
Hypothermia, tachycardia, orthostatic hypotension
- restlessness, disorientation, muscle twitching, SEIZURES, decreased LOC, SWOLLEN TONGUE
- Edema, warm flushed skin, Oliguria.
Hypernatremia: Top Nursing Care
Monitor LOC and ensure safety.
Administer hypotonic or isotonic fluids.
Potassium is essential for:
cell metabolism, TRANSMISSION OF NERVE IMPULSES, functioning of CARDIAC, LUNG, MUSCLE TISSUES
acid-base balance
RECIPRICOL ACTION WITH SODIUM
Hypokalemia: Level, Cause, Result
<3.5
- Increased loss (diuretic), decreased intake (rare) absorption, or movement of K+ into cells
- HEART Misfunction
Risk for Hypokalemia:
-Hyperaldosteronism, prolonged admin of non-electrolyte dextrose 5% with water, total parenteral feeding, METABOLIC ALKALOSIS, GI issues, DIURETICS
What meds can cause hypokalemia?
Furosemide, Corticosteroids, Digoxin
Hypokalemia: Findings
Weak and irregular pulse, hypotension, RESPIRATORY DISTRESS, ASCENDING BILATERAL WEAKNESS W/ RESPIRATORY DISTRESS AND COLLAPSE AND PARALYSIS, ECG findings
Hypokalemia: ECG Findings
Premature muscle contractions, slow heart rate, ventricular tachycardia, flattened T waves, Increased U waves, ST depression
Important Nursing Care Reminder
NEVER IV BOLUS (high risk for cardio arrest)
Hyperkalemia: Level, Cause, Result
> 5.0 mEq/L
- Increased intake, inadequate excretion
- Uncommon in functioning kidney
- RISK OF CARDIAC ARRYTHMIA AND CARDIAC ARREST
Hyperkalemia: Risk Factors
-IV K+ admin, salt substitutes, blood transfusion
DIABETIC ACIDOSIS, Tissue catabolism (burns, sepsis, severe dehydration, MI)
-UNCONTROLLED DIABETIC MELLITUS
-kIDNEY FAILURE, POTASSIUM SPARING DIURETICS, ace INHIBIRTORS, ADRENAL INSUFFICIENCY
Hyperkalemia: Older Adult Higher Risk
-Kidney disease, meds, salt substitutes, angiotensin-converting Enzyme Inhibitors (ACE), potassium-sparing diuretics
Hyperkalemia: Findings
Decreased irregular pulse, hypotension, irritability, confusion, weakness w/ ascending flaccid paralysis, paresthesia, decreased reflexes
Increased motility, BS, diarrhea, abdm cramping
Hyperkalemia: ECG Findings
Peak T waves, widened PR and QRS.
Dysrhythmias and asystole are possible.
Hyperkalemia: Nursing Care
Dialysis may be required
-Use Sodium Polystyrene Sulfonate–> binds to K+ in digestive tract and excretes it
