Electrolyte imbalances Flashcards

1
Q

This electrolyte imbalance is <136 mEq/L
Underlying causes include:
-Hypovolemic hypernatremia
-GI fluid loss
-Profuse diaphoresis (sweating)
-water intoxication
-prolonged use of hypotonic IV solutions
-SIADH

A

Hyponatremia (sodium)

Interventions:
monitor vital signs
monitor intake/output
monitor lab results
encourage foods high in sodium
restrict water intake
administer hypotonic IV saline
monitor make sure saline levels only increase by only 4-6 mEq/L in any 24 hour period

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2
Q

This electrolyte imbalance is >145 mEq/L
Underlying causes include:
-Excessive sodium intake
-Hypertonic IV solutions
-Hypertonic enteral feedings without adequate water
- excessive loss of water due to diarrhea, inadequate intake of water, insensible loss due to fever

A

Hypernatremia (sodium)
Interventions:
Monitor vital signs
Monitor level of consciousness
Monitor intake and output
Monitor lab results-serum sodium/osmolality
Limit salt intake
Increase water intake
Administer hypotonic IV solutions

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3
Q

This electrolyte imbalance is <3.5 mEq/L
Underlying causes include:
-vomiting, gastric suction, diarrhea,
-laxative abuse, frequent enemas
-use of potassium-sodium wasting diuretics
-inadequate intake seen in anorexia, alcoholism, debiliated patients
-hyperaldosteronism (overproduction of aldosterone)

A

Hypokalemia (potassium)
Interventions:
Monitor vitals
monitor cardiac rhythm with EKG
Monitor labs for serum potassium
Assess for signs of digitalis toxicity
Encourage foods high in potassium
administer potassium supplements
IV potassium is diluted properly and administered slowly never administer as IV bolus or IV push

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4
Q

This electrolyte imbalance is >5.0 mEq/L
Underlying causes include:
-renal failure
-massive trauma, crushing injuries, burns
-hemolysis
-IV potassium
-potassium-sparing diuretics
-acidosis, especially diabetic ketoacidosis

A

Hyperkalemia (potassium)
Interventions:
Monitor vital signs
Monitor cardiac rhythm with ECG
Monitor labs for serum potassium
limit potassium rich foods
Administer cation exchange resins kAyexalate
Administer glucose and insulin as oredered, potassium moves back into the cell

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5
Q

This electrolyte imbalance is <9 mg/dL
Underlying causes include:
-hypoparathyroidism
-pancreatitis
-Vitamin D deficiency
-Inadequate intake of calcium rich foods
-hyperphosphatemia
-chronic alcoholism

A

Hypocalcemia (calcium)
Interventions:
Monitor heart rate
Monitor cardiac rhythm with ECG
Institute fall and seizure precaution
Administer oral and IV calcium supplements as ordered
Encourage calcium rich foods

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6
Q

This electrolyte imbalance is >10.5 mg/dL
Underlying causes include:
-prolonged bed rest
-hyperparathyroidism
-bone malignancy
-Paget disease
-osteoporosis

A

Hypercalcemia (calcium):
Interventions:
Monito heart rate
monitor cardiac rhythm with ECG
Encourage increased fluid intake
Increase patient activity including active ROM

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7
Q

This electrolyte imbalance is <98 mEq/L
Underlying conditions include:
-overhydration
-heart failure
-SIADH
-vomiting or gastric suction
-Addison’s disease
-Burns
-Metabolic alkalosis
-medications like aldosterone, bicarbonates, steroids, loop and thiazide diuretics

A

Hypochloremia (chloride)
Interventions:
monitor vital signs
monitor intake and output
monitor lab results
restrict water intake
administer hypertonic IV saline solutions as ordered

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8
Q

This electrolyte imbalance is >106 mEq/L
Underlying conditions include:
-dehydration
-anemia
-excessive normal saline infusion
-Cushing syndrome
-Kidney disease
-Metabolic acidosis
-respiratory alkalosis or hyperventilation

A

Hyperchloremia (chloride)
Interventions:
monitor vital signs
monitor level of consciousness
monitor intake and output
monitor lab results
limit salt intake
increase water intake
administer hypotonic IV solutions as ordered

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9
Q

This electrolyte imbalance is <1.3 mEq/L
Underlying conditions include:
-Decreased intake
-TPN without magnesium
-Decreased absorption
-nasogastric suction
-draining fishtulas
-prolonged diarrhea
-laxative abuse
-mlabsorption syndrome
-ulcerative colitis
-Crohn’s disease
-increased renal excretion
-Diuresis
-loop and thiazide diuretics

A

Hypomagnesemia (magnesium)
Interventions:
assess vital signs
monitor cardiac rhythm with ECG
assess mental status
monitor lab results, potassium and calcium levels
assess swallowing before medication, food, fluid
institute seizure precautions
administer oral or IV supplements as ordered

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10
Q

This electrolyte imbalance is >2.1 mEq/L
Underlying conditions include:
-excessive intake of magnesium-containing antacids or cathartics
-TPN with too much magnesium
-Prolonged use of intravenous magnesium sulfate
-renal failure
-severe dehydration
-adrenal insufficiency
-leukemia

A

Hypermagnesemia (magnesium)
Interventions:
assess vital signs
monitor cardiac rhythm with ECG
assess mental status
assess neuromuscular strength and activity
encourage increased oral intake, increased IV fluids
administer loop diuretics
provide respiratory support

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11
Q

This electrolyte imbalance is <3 mg/dL
underlying conditions include:
-abnormal shift into the cell
-hyperventilation
-respiratory alkalosis
-hyperglycemia
-absorption from the GI tract
-Phosphorous-binding antacids
-starvation
-malabsorption syndrome
-inadequate vitamin D
-chronic diarrhea, laxative abuse
-increased excretion by kidneys
-thiazides and loop diuretics
-diabetic ketoacidosis
-hyperparathyroidism
-hypocalcemia

A

Hypophosphatemia (phosphate)
Interventions:
assess vital signs, especially respirations, O2, and BP
assess muscle strength and neuromuscular function
assess for signs of heart failure
encourage phosphate-rich foods
instruct patient to avoid phosphorous-binding antacids
administer oral and IV phosphorous
administer pain medications
monitor for signs of infection

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12
Q

This electrolyte imbalance is >4.5 mg/dL
Underlying conditions include:
-impaired renal function
-hypoparathyroidism
-acid-base imbalances
-cellular injury

A

Hyperphosphatemia (phosphate)
Interventions:
monitor vital signs
monitor serum phosphorous and calcium levels
Monitor BUN and creatine
Assess signs of hypocalcemia
Monitor intake and output
teach patient to avoid phosphorous-rich foods

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13
Q

Name the electrolyte imbalance:
lethargy
confusion
weakness
muscle cramping
seizures
anorexia, nausea, vomiting
Serum osmolality <285 mOsm/kg

A

Hyponatremia

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14
Q

Name the electrolyte imbalance:
Thirst
dry and sticky mucous membranes
weakness
elevated temperature
confusion
irritability
decreased levels of consciousness
hallucinations
seizures
serum osmolality >290 mOsm/kg

A

hypernatremia

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15
Q

Name the electrolyte imbalance:
weak
irregular pulse
fatigue lethargy
anorexia
nausea
vomiting
muscle weakness
cramping
decreased persistalsis
hypoactive bowel sounds
paresthesia
cardiac dysrhythmias
increased risk for digitalis toxicity

A

Hypokalemia

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16
Q

Name the electrolyte imbalance:
anxiety
irritability
confusion
dysrhythmias
muscle weakness
flaccid paralysis
paresthesia
abdominal cramping

A

Hyperkalemia

17
Q

Name the electrolyte imbalance:
confusion
anxiety
numbness/tingling of extremities
muscle cramps turned to seizures
hyperactive reflexes
cardiac dysrhythmias
positive Chvostek
Trousseau signs

A

Hypocalcemia

18
Q

Name the electrolyte imbalance:
lethargy
stupor
coma
decreased muscle strength/tone
anorexia
nausea
vomiting
constipation
pathologic fractures
dysrhythmias
renal caculi

A

Hypercalcemia

19
Q

Name the electrolyte imbalance:
irritable nerves and muscles
tetany
hypotension
shallow breathing

A

Hypochloremia

20
Q

Name the electrolyte imbalance:
weakness
lethargy
deep breathing

A

Hyperchloremia

21
Q

Name the electrolyte imbalance:
irritable nerves and muscles
hyperactive deep tendon reflexes
seizures
dysrhythmias
ECG changes
altered level of consciousness
mood swings
delusions, hallucinations
dysphagia, nausea, vomiting

A

Hypomagnesemia

22
Q

Name the electrolyte imbalance:
warm flushed appearance
nausea
vomiting
drowsiness
lethargy
decreased muscle strength
generalized weakness
decreased deep tendon reflexes
hypotension
dysrhythmias
slow shallow respirations
respiratory arrest

A

Hypermagnesemia

23
Q

Name the electrolyte imbalance:
weak pulse
shallow respirations
hypotension
decreased cardiac output
hemolytic anemia
bleeding, increased bruising
muscle weakness
decreased deep tendon reflexes
tremors
bone pain
anorexia
increased risk of infection

A

hypophosphatemia

24
Q

Name the electrolyte imbalance:
signs of hypocalcemia
tetany
hyperreflexia
muscle spasms
tachycardia
nausea
diarrhea, cramping

A

hyperphosphatemia

25
Q
A