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Electrolyte Imbalances Flashcards

1
Q

Sodium Function (Na+)

A

helps maintain blood volume and blood pressure

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2
Q

Potassium Function (K+)

A

helps muscles contract (including the heart muscle)

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3
Q

Calcium Function (Ca)

A

helps with heart function, blood clotting & bone formation

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4
Q

Magnesium Function (Mg+)

A

helps muscles and nerves stay healthy, helps regulate energy levels

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5
Q

Phosphorus Function (P)

A

helps create / maintain teeth and bones, helps to repair cells and body tissue

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6
Q

Chloride (Cl)

A

helps maintain acid-base balance, helps to control fluid levels in the cells

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6
Q

Hypernatremia

A

> 145 mEq/L

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7
Q

Hypernatremia S/Sx

A

FRIED SALT

flushed skin, restless, increased BP (fluid retention), edema (pitting), decreased urine output, dry skin, agitation, low-grade fever, thirst (dry mucous membranes)

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8
Q

Hypernatremia Risk Factors

A

Increased Na+ intake, oral ingestion, admin of fluids with sodium (hypertonic IV fluids)

loss of fluids from fever, burns, diabetes insipidus

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9
Q

Hypernatremia Treatment

A

restrict sodium intake

admin IV fluids if due to fluid loss: isotonic or hypotonic solutions

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10
Q

Hyponatremia

A

<135 mEq/L

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11
Q

Hyponatremia S/Sx

A

SALT LOSS

stupor/coma, anorexia, lethargy, tachycardia, limp muscles, orthostatic hypotension, seizures/headache, stomach cramping (hyperactive bowels)

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12
Q

Hyponatremia Risk Factors

A

loss of Na+ from the 5Ds:
diaphoresis, diarrhea & vomiting, drains (NGT suction), diuretics, SiaDh (dilution)

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13
Q

Hyponatremia Treatment

A

admin of fluids (hypertonic solutions)

place patient on seizure precaution

place patient on fluid restriction if due to SIADH (they are in fluid volume overload)

place patient on airway protection (NPO) - never give food or water to a patient whol is lethargic, confused, or in a comatose state

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14
Q

2 Types of Hyponatremia

A

1) Hypovolemic Hyponatremia

2) Hypervolemic Hyponatremia

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15
Q

Hypovolemic Hyponatremia

A

from decreased levels of fluid and sodium

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16
Q

Hypervolemic Hyponatremia

A

from increased levels of water in the body which dilutes the sodium

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17
Q

Potassium Imbalance (K+)

A

Hyperkalemia and Hypokalemia

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18
Q

Hyperkalemia S/Sx

A

MURDER

muscle cramps & weakness, urine abnormalities, respiratory distress, decreased cardiac contractility (decrease HR, decrease BP), EKG changes - tall, peaked T waves, reflexes (decrease in DTR - deep tendon reflexes)

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19
Q

Hyperkalemia

A

> 5mEq/L

muscles contract for TOO long = tight and contracted

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20
Q

Hyperkalemia Risk Factors

A

-intake of too much potassium (IV fluids with K +)

-adrenal gland issues (insufficiency)

-non-steroidal anti-inflammatory drugs (NSAIDs - ibuprofen, naproxen)

-potassium-sparing diuretics (spironolactone)

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21
Q

Hyperkalemia Treatment

A

STOP Potassium intake (IV/PO)

-Admin meds - IV sodium bicarbonate, IV calcium gluconate

-EKG monitoring: potassium imbalances can cause cardiac dysrhythmias that can be life threatening

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22
Q

Hypokalemia

A

<3.5 mEq/L

-generalized muscle weakness

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23
Q

Hypokalemia S/Sx

A

-weak muscles and less contraction

-decrease in reflexes

-shallow breathing

-slowing of GI system (constipation)

-decrease in BP (especially with position change)

-N/V/bloating

-EKG changes (low levels of K can cause flattened T waves, or inversion of the T-wave)

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24
Hypokalemia Risk Factors
-low K intake (not eating, NPO diet) -V/D - gastric suction -alkalosis -potassium-wasting diuretics (loop or thiazide)
25
Hypokalemia Treatment
replace the potassium with an oral K+ supplement OR IV K+, which you always dilute in fluid first, K+ can burn the vein, so infuse slowly *NEVER admin K+ via IV push
26
Calcium Imbalances (Ca+)
Hypercalcemia; Hypocalcemia
27
Hypercalcemia
>11mg/dl
28
Hypercalcemia S/Sx
BACKME bone pain, arrythmias, cardiac arrest (bounding pulses), kidney stones (aka renal calculi, muscle weakness, excessive urination
29
Hypercalcemia Treatment
STOP calcium intake (IV/PO) -admin. meds to DECREASE Ca levels - Phosphorus and Calcitonin
29
Hypercalcemia Risk Factors
-increase in calcium absorption -decrease in calcium excretion -kidney disease (unable to excrete excess calcium out of the body) -use of thiazide diuretics -HYPERparathyroidism & HYPERthyroidism -Bone breakdown from metastatic cancer -highly concentrated blood (hemoconcentration can be from dehydration) -pathological fractures
30
Hypocalcemia
<9mg/dl
31
Hypocalcemia S/Sx
CATS GO NUMB Convulsions/seizures, Arrythmias, Tetany, Spasms & Stridor Numbness in fingers, face, limbs
32
Positive Trousseau's
carpal spasm caused by inflating a blood pressure cuff
33
Chvostek's Signs
contraction of facial muscles with a light tap over the facial nerve
34
Hypocalcemia Risk Factors
-issues absorbing Ca from the GI tract -too much Ca leaving the body from excretion (kidney disease, increase in P and low vitamin D = hypocalcemia) -diuretics, diarrhea, drainage from wounds -pathological fracture
35
Hypocalcemia Treatment
- increase Ca intake in diet -Ca supplements -vitamin D -Calcium gluconate -initiate seizure precautions bc of high risk for seizures
36
Magnesium Imbalances
Hypermagnesemia and hypomagnesemia
37
Hypermagnesemia
>2.5 mg/dl LOW DECREASE in everything - sedated
38
Hypermagnesemia S/Sx
-decrease in DTR -decrease in energy -decrease in HR -decrease in RR -decrease in respirations - decrease in bowel sounds
39
Hypermagnesemia Risk Factors
-increased magnesium intake -magnesium -containing antacids ;ike TUMS & laxatives - excessive admin. of Mg IV -renal insufficiency (decrease in renal excretion of Mg = increase of Mg in the blood -DKA - diabetic ketoacidosis
40
Hypermagnesemia Treatment
-admin of loop diuretics -IV admin of Ca gluconate -restrict dietary intake of magnesium-containing foods -avoid the use of laxatives & antacids containing Mg -use of hemodialysis in severe cases
41
Hypomagnesemia
<1.5 mg/dl high in everything - NOT sedated
42
Hypomagnesemia S/Sx
-increase in DTR (hyperreflexia) -increase in HR -increase in BP -shallow respirations -twitches, paresthesias -tetany & seizures -irritability & confusion
43
Hypomagnesemia Risk Factors
-insufficient Mg intake, malnutrition/vomiting/ diarrhea -malabsorption syndrome -Celiac and Crohn's disease -increased Mg excretion (diuretics or chronic alcoholism) -intracellular movement of magnesium (hyperglycemia & insulin adm.; sepsis)
44
Hypomagnesemia Treatment
- admin of magnesium sulfate IV or PO -place pt on seizure precautions -instruct pt to increase intake of magnesium-containing foods (nuts, seeds, legumes, whole grains, milk)
45
Phosphorus Imbalances (P)
hyperphosphatemia and hypophosphatemia
46
Hyperphosphatemia
>4.5 mg/dl directly leads to LOW levels of calcium (hypocalcemia)
47
Hyperphosphatemia S/Sx
muscle spasms and tetany, cardiac arrhythmias, seizures, dry & brittle skin/nails
48
Hyperphosphatemia Risk Factors
Kidney dysfunction -consistent use of enemas and/or laxatives -Rhabdomyolysis (breakdown of muscle tissues that leads to the release of muscle fiber contents in the blood) -Vitamin D toxicity -Hypoparathyroidism -Acromegaly (overload of growth hormone)
49
Hyperphosphatemia Treatment
Diet Modifications: decrease in dietary phosphorus -use of dialysis for patients with ESRD - control hypertension to maintain kidney function
50
Hypophosphatemia
<2.5 mg/dl
51
Hypophosphatemia S/Sx
-fatigue / weakness -delayed growth & development in children -poor bone density & frequent fractures -loss of appetite -cardiac arrythmias
52
Hypophosphatemia Risk Factors
- chronic vomiting or diarrhea (Ex: eating disorders that involve vomiting) -overconsumption of diuretics -pts with significant burn injuries -malnutrition & starvation -ETOH (alcohol dependency -refeeding syndrome
53
Hypophosphatemia Treatment
-diet modifications -admin of oral or IV phosphate -reintroduce nutrients slowly in pts with history of starvation to prevent refeeding syndrome -reduce diuretic dosing /use -provide proper care & recovery of burns
54
Chloride Imbalances
Hyperchloremia and hypochloremia
55
Hyperchloremia
>105 mEq/L
56
Hyperchloremia S/Sx
-hypertension and fluid retention -generalized swelling -peripheral edema -cardiac arrhythmias
57
Hyperchloremia Risk Factors
-hypernatremia (increase in sodium -overuse of IV NaCl -Metabolic acidosis -renal damage (kidneys are not able to filter and excrete excess chloride = increase of Cl in the body) -uncontrolled glucose levels -diabetes inspidus (DI)
58
Hyperchloremia Treatment
diet modifications -sodium restriction -increase fluids to flush start -oral or IV fluids -start blood glucose management of insulin -use dialysis in pts with renal disease
59
Hypochloremia
<95 mEq/L
60
Hypochloremia S/Sx
-Hypotension and tachycardia -mental status changes -muscle weakness -fatigue
61
Hypochloremia Risk Factors
-dehydration related to large fluid volume loss through: vomiting / diarrhea, syndrome of inappropriate antidiuretic hormone secretion (SIADH), overuse of diuretics -Addison's disease -metabolic alkalosis -excessive suctioning of gastric contents -potassium imbalance
62
Hypochloremia Treatment
Diet modifications: increase dietary salt intake with meals -admin IV NaCl, IV Potassium, rehydration, limit or reduce diuretic use

Nursing Review (5 decks)

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