Electrolyte imbalances Flashcards
What are key roles of sodium in the body?
Maintains fluid balance, influences nerve and muscle function, regulates acid-base status, and contributes to osmotic pressure.
What are the primary causes of hyponatremia?
Diuretics (especially thiazides), vomiting, diarrhea, SIADH, excessive hypotonic fluids, adrenal insufficiency, water intoxication.
What are signs and symptoms of hyponatremia?
Nausea, vomiting, confusion, lethargy, muscle cramps or weakness, seizures and coma (severe), headache, decreased deep tendon reflexes.
What are nursing interventions for hyponatremia?
Monitor sodium levels and neuro status, fluid restriction (if dilutional), administer hypertonic saline (3% NaCl) cautiously if severe, seizure precautions, daily weights and I&O tracking.
What is the treatment for SIADH-induced hyponatremia?
Fluid restriction and vasopressin antagonists (e.g., tolvaptan).
What are common causes of hypernatremia?
Dehydration, excessive salt intake, diabetes insipidus, tube feeds without free water, watery diarrhea, burns.
What are key clinical manifestations of hypernatremia?
Intense thirst, dry mucous membranes, flushed skin, confusion, restlessness, seizures, coma, orthostatic hypotension.
What are the nursing priorities in hypernatremia?
Administer hypotonic fluids (e.g., 0.45% NaCl) slowly, encourage oral fluids, monitor neuro status, monitor for cerebral edema during correction.
What are potassium’s major physiological roles?
Nerve conduction, muscle contraction (especially cardiac), and acid-base balance.
What causes hypokalemia?
GI losses (vomiting, diarrhea), loop or thiazide diuretics, insulin, alkalosis, poor intake.
What are symptoms of hypokalemia?
Muscle weakness, leg cramps, flattened T waves, U waves on ECG, constipation, ileus, fatigue, dysrhythmias, paresthesias.
What interventions are critical for hypokalemia?
NEVER IV push K⁺ — dilute and infuse slowly (max 10 mEq/hr), encourage potassium-rich foods (bananas, spinach, oranges), cardiac monitoring, monitor magnesium and calcium (often low concurrently).
What are major causes of hyperkalemia?
Renal failure, potassium-sparing diuretics, ACE inhibitors, acidosis, tissue injury (burns, trauma).
What are hallmark signs of hyperkalemia?
Muscle cramps, flaccid paralysis, tall peaked T waves, widened QRS, bradycardia, V-fib, cardiac arrest, nausea, diarrhea.
What are key pharmacologic interventions for hyperkalemia?
Calcium gluconate (stabilizes heart), insulin + dextrose (pushes K⁺ into cells), sodium bicarbonate (if acidosis present), Kayexalate (sodium polystyrene sulfonate), dialysis (if renal failure).
What nursing care is vital in hyperkalemia?
Telemetry monitoring, monitor for cardiac arrhythmias, avoid potassium-rich foods and salt substitutes.
What is the function of calcium in the body?
Muscle contraction, nerve transmission, blood clotting, and bone/teeth structure.
What causes hypocalcemia?
Hypoparathyroidism, vitamin D deficiency, renal disease, pancreatitis, citrate from blood transfusions.
What are signs and symptoms of hypocalcemia?
Tetany, laryngospasm, numbness/tingling in face or extremities, positive Chvostek’s and Trousseau’s signs, seizures, prolonged QT on ECG.
What are key nursing interventions for hypocalcemia?
Seizure precautions, administer calcium gluconate IV, promote calcium- and vitamin D-rich foods, monitor respiratory and cardiac status.
What are major causes of hypercalcemia?
Hyperparathyroidism, bone metastases, prolonged immobility, thiazide diuretics.
What are symptoms of hypercalcemia?
Fatigue, lethargy, weakness, constipation, kidney stones, shortened QT interval, confusion.
How is hypercalcemia managed?
IV fluids to dilute calcium, loop diuretics (furosemide), bisphosphonates or calcitonin, promote ambulation, avoid calcium supplements.
What is magnesium’s role in the body?
Affects neuromuscular function, enzyme activity, and cardiac rhythm stabilization.
What causes hypomagnesemia?
Chronic alcoholism, malnutrition, diarrhea, diuretics, prolonged NG suction.
What are signs and symptoms of hypomagnesemia?
Hyperreflexia, tremors, positive Chvostek’s/Trousseau’s signs, seizures, tachycardia, ventricular dysrhythmias, confusion.
What are nursing interventions for hypomagnesemia?
IV magnesium sulfate (slowly), seizure precautions, monitor DTRs and cardiac rhythm, encourage magnesium-rich foods (nuts, leafy greens).
What causes hypermagnesemia?
Renal failure, excessive Mg intake (antacids, laxatives), adrenal insufficiency.
What are signs of hypermagnesemia?
Decreased DTRs, hypotension, bradycardia, lethargy progressing to coma, respiratory depression, prolonged PR and QRS on ECG.
What is the treatment for hypermagnesemia?
Calcium gluconate IV (antagonist), loop diuretics, dialysis (if severe), discontinue Mg-containing meds.
What does phosphate do in the body?
Energy metabolism (ATP), bone mineralization, acid-base balance.
What causes hypophosphatemia?
Malnutrition, alcohol withdrawal, DKA, antacids with aluminum, refeeding syndrome.
What are clinical manifestations of hypophosphatemia?
Muscle weakness, respiratory failure, bone pain, confusion, seizures.
What is the treatment for hypophosphatemia?
Oral or IV phosphate, correct underlying cause, prevent refeeding syndrome.
What causes hyperphosphatemia?
Renal failure, tumor lysis syndrome, hypoparathyroidism, excessive phosphate intake.
What symptoms are associated with hyperphosphatemia?
Hypocalcemia symptoms (tetany, cramps), soft tissue calcifications, numbness, tingling.
What interventions are needed for hyperphosphatemia?
Administer phosphate binders (e.g., sevelamer), limit phosphate-rich foods, administer calcium supplements, dialysis (if severe renal impairment).
