electrolyte imbalances

Question 1

3 sentences to memorize

Answer 1

1. Kalemias do the same as the prefix (hypo-, hyper-), except for HR and urine output which go opposite
2. Calcemias do the opposite as the prefix
3. Magnesemias do the opposite as the prefix

Question 2

Natremias

Answer 2

• HypoNatremia = Volume overload

- HyperNatremia = Dehydration

Question 3

Some S/Sx of Hyperkalemia

Answer 3

• Brain: seizures, agitation, irritability, loud down
• Heart: tented T waves, ST elevated, tachypnea
• Bowel: diarrhea, borborygmi
• Muscle: spasticity, increase tone, hyperreflexia (3+, 4+)
• Heart rate: down (bradycardia)
• UO: down (oligouria)

Question 4

Some S/Sx of Hypokalemia

Answer 4

• Lethargy, bradypnea, paralytic ileus, constipation, muscle flaccidity, hyporeflexia (0, 1+)
• Tachycardia (HR is up)
• Polyuria (UO is up)

Question 5

Some S/Sx of Hypercalcemia

Answer 5

bradycardia, bradypnea, flaccid, hypoactive reflexes, lethargy, constipation, etc.

Question 6

Some S/Sx Hypocalcemia

Answer 6

agitation, irritability, 3+ or 4+ reflexes, spasm, seizure, tachycardia, Chvostek sign (tap the cheek), Trousseau (inflate BP cuff), etc.

Question 7

Choosing answers for potassium and calcium

Answer 7

• For potassium pick answers related to heart problems

* For calcium pick answers related to muscle problems

Question 8

Some S/Sx of Hypernatrema

Answer 8

HypErnatrema = DEhydration

• Hot, flushed, dry skin, thready pulse, rapid HR … Give fluid
• Associate “E” in hypernatremia with DEhydration

Question 9

Some S/Sx of Hyponatremia

Answer 9

HypOnatremia = Overload

• Crackles, distended neck veins … Fluid restriction, Lasix - Associate “O” in hyponatremia with Overload
• Nursing Dx: Fluid Volume Excess

Question 10

The earliest sign of any electrolyte disturbance is

Answer 10

The earliest sign of any electrolyte disturbance is
o Numbness and tingling = Paresthesia
o Circumoral paresthesia = Numbness and tingling around the lips

Question 11

The universal sign of all electrolyte imbalances is

Answer 11

o Muscle weakness = Paresis

Question 12

K+ IV

Answer 12

• Never Push Potassium IV
• Potassium <40 mEq/L of IV fluid
- If >40 mEq/L, clarify dosage with physician

Question 13

K+ treatment

Answer 13

• Give D5W and regular insulin to decrease potassium (Temporary solution but quick)
  • Kayexalate is long-term solution