Electrolyte Imbalances

Question 1

What are the values for sodium, magnesium, calcium, potassium, chloride, phosphorus?

Answer 1

Na+ 136-145 mEq/L 
K+ 3.5-5.0 mEq/
Cl- 98-106 mEq/L
Ca+ 9.0-10.5 mg/dL
Mg 1.3-2.1 mEq/L
Ph 3.0-4.5 mg/dL

Question 2

What is the major electrolyte in the ICF and the major electrolyte in the ECF

Answer 2

ICF electrolyte = potassium

ECF electrolyte = sodium

Question 3

what are the three main things sodium is involved with?

Answer 3

1) acid-base balance
2) active/passive transport
3) conduction of nerve/muscle tissue

Question 4

what happens to water in the body with hyponatremia?

Answer 4

moves from ECF into the ICF, causing cells to swell which is called cerebral edema

Question 5

what causes hyponatremia

Answer 5

• it can be either caused by deficient ECF volume or increased/normal
  1) so for deficient ECF volume think GI losses wheter unvoluntary (eg vomitting, diarrhea) or medical (water enemas, NG suctioning)
• kidney stuff will be disease, hormones or MEDS (certain diuretics)
• skin losses: sweating, burns, ascites (ascites related to to cirrhosis)
  2) increased/normal ECF includes thinks like too much water intake or edamatous states (SIADH, heart failure, cirrhosis)

(others include too much hypotonic IV fluids if you were correcting hypernatremia for example or if patient were NPO status and has inadequate Na+ intake)

Question 6

So what are the signs/symptoms of hyponatremia?

Answer 6

• so hyponatremic states can be hypovolemic, euvolemic, or hypervolemic; this will cause different symptoms but for these vitals we’re going with more hypovolemic
  1) Vitals: hypothermia, tachycardia, rapid thready pulse, hypotension, orthostatic hypotension
  2) Neuromusc: think mainly losses (lethargy, muscle weakness to resp compromise, fatigue, decreased DTRs) + headaches, confusion, seizures)
  3) GI: think increased (up motility, up bowel sounds, ab cramping, nausea)

Question 7

Nursing Care for hyponatremia

Answer 7

• like previously mentioned, care will also depend on what the cause of hyponatremia is and what sort of fluid state is presenting
  1) if fluid overload: restrict water, provide loop diuretics and ACE inhibitors per Rx
  2) acute hyponatremia
• admin hypertonic oral/IV fluids
• admin 3% sodium chloride slowly
• encourage Na+ high foods