Electrolyte imbalances

Question 1

Hypernatremia is Elevated serum sodium occurring with

Answer 1

water loss or sodium gain

Question 2

Hypernatremia manifestations include

Answer 2

	Thirst
	Lethargy or agitation
	Disorientation
 Hallucinations
	Seizures
	Coma

Question 3

Hypernatremia management:

Answer 3

Treating underlying cause, and giving oral fluids or an IV solution of 5% dextrose in water (D5W), or hypotonic saline

Question 4

Hyponatremia is

Decreased level of serum sodium can result from

Answer 4

a loss of sodium-containing fluids or from excess water.

Question 5

Hyponatremia Manifestations

Answer 5

• Headache
• Confusion
• Seizures
• Coma
• muscle spasm
• lethargy
• shallow respirations

Question 6

Hyponatremia management

Answer 6

 If caused by water excess, fluid restriction is needed
 If severe symptoms occur, small amounts of IV hypertonic solution (3% NaCl) are given
 If associated with abnormal fluid loss, fluid replacement with sodium-containing solution is required

Question 7

Normal renal function is needed for the maintenance of ____ balance because the majority of ____ is excreted from the body by the kidneys.

Answer 7

potassium

Question 8

Sodium normal lab value

Answer 8

135-145 mmol/L

Question 9

Potassium normal lab value

Answer 9

3.5-5

Question 10

calcium normal lab value

Answer 10

2.25-2.75 mmol/L

Question 11

Magnesium normal lab val

Answer 11

0.65-1.05

Question 12

Normal _____ function is needed for the maintenance of potassium balance

Answer 12

renal function is needed for the maintenance of potassium balance because the majority of potassium is

Question 13

Hyperkalemia Clinical manifestations:

Answer 13

 Muscle weakness or paralysis
 Paraesthesias of the face, tongue, feet, and hands
 Nausea
 Ventricular fibrillation or cardiac standstill
 Impaired cardiac depolarization, resulting in a slow HR

Question 14

Hyperkalemia management

Answer 14

 Focuses on elimination of the potassium source and potassium from the body through use of potassium-wasting diuretics, polystyrene sulfonate (Kayexalate), and dialysis
 IV insulin may be administered to force potassium from ECF to intracellular fluid (ICF).
 IV calcium gluconate may be used to reverse the membrane effects of elevated ECF potassium

Question 15

Hypokalemia manifestations

Answer 15

 Ventricular arrhythmias and impaired repolarization
 Muscle fatigue and weakness
 Cramps
 Decreased GI motility
 Altered airway responsiveness
 Impaired regulation of arterial blood flow
 Hyperglycemia

Question 16

Hypokalemia management

Answer 16

 Replacement of potassium, either orally or IV

Question 17

_______ is needed to increase the intestinal absorption of calcium, which is excreted by the intestinal and urinary tracts

Answer 17

Vit D

Question 18

Hypercalcemia manifestations

Answer 18

 Confusion, disorientation, and decreased memory
 Fatigue
 Decreased neuromuscular excitability, weakness, and decreased deep tendon reflexes

Question 19

Hypercalcemia management

Answer 19

 Loop diuretics, hydration with isotonic saline, synthetic calcitonin, and client mobilization

Question 20

Hypocalcemia manifestations

Answer 20

 Positive Trousseau’s sign, which indicates neuroexcitability; a positive sig is indicated if twitching of the hands and fingers occurs when a BP cuff is inflated 10 mm Hg above the systolic pressure
 Positive Chvostek’s sign, indicates neuroexcitability also; indicated if tapping over facial nerve (area below temple) with a finger causes muscle spasms of the mouth and cheek
 Increased neuromuscular activity; tetany
 Laryngeal stridor, dysphagia, numbness, tingling around the mouth or extremities
 Decreased myocardial contractility

Question 21

Hypocalcemia management

Answer 21

 Treating cause, replacing calcium, and ensuring that the intake of vitamin D is adequate

Question 22

Phosphate (0.97-1.45 mmol/L):

Hyperphosphatemia manifestations

Answer 22

 Hypocalcemia
 Muscle tetany
 Deposition of calcium-phosphate crystals in skin, soft tissue, cornea, viscera, and blood vessels
 Tingling of mouth and fingertips and numbness

Question 23

• Hypermagnesemia manifestations and tx

Answer 23

o Manifestations
 Lethargy, drowsiness, somnolence
 Peripheral vasodilation, causing flushing, warm skin, decreased BP, and rhythm disturbances with possible cardiac arrest
 Impaired refleces
 Possible respiratory arrest
o Management
 Prevention, increased fluids, and IV calcium chloride or calcium gluconate