Electrolyte imbalances (Davis advantage)

Question 1

What are the 5 most important ions in the body?

Answer 1

Sodium(Na+)
Potassium(K+)
Calcium(Ca++)
Phosphorus(PO4 3-)
Magnesium (Mg++)

Question 2

Hyervolemic hyponatremia=

Answer 2

Excess water dilutes sodium levels

Results in cell swelling.

Question 3

Hypovolemic hyponatremia=

Answer 3

Water and sodium are lost
\
Due to diarrea or kidney failure

Question 4

hyperkalemia causes what to the heart?

Answer 4

Wide QRS complexes

Peacked T waves

hyperkalemia=high potasssium lvls

Question 5

Hypokalemia causes what to the heart?

Answer 5

Cardiac arrhythmias

Prolonged PR INTERVALS

Hypokalemia= LOW POTASSIUM

Question 6

False hyperkalemia occurs during ?

Answer 6

Acidosis

Question 7

Pairing of Calcium and phosphorus levels are often

Answer 7

Reciprocated:

Calcium high= phosphorus low
Calcium low = phosphorus high

Question 8

(PTH ) parathyroid decreasing tumor may cause what to the pairing of calcium and phosphorus?

Answer 8

Hypercalcemia & hypophosphatemia
Bone pain and muscle weakness

(Extra info; hypocalcemia tends to cause muscle spasms)

Question 9

Causes of Hypermagnesimia

Answer 9

Mediactions

Kidney failure

Question 10

Causes of hypomagnesemia

Answer 10

Alchol

Question 11

Louise recently had thyroid surgery for a tumor at the acute care clinic where you work as a nurse. She comes into the office today complaining of tingling around her mouth and fingers and small muscle spasms. She is surprised when you ask if you can tap along her cheekbone. When you do this, you note a slight twitch in her facial muscles. Louise wonders if any of this could be related to her surgery.

What tissues do you suspect may have been damaged during Louise’s surgery?

Parathyroid glands
Muscles of the jaw
Muscles of the eyes
Nerves affecting the lips
Check Answer

Answer 11

Parathyroid glands
The parathyroid glands are small structures located near the posterior aspect of the thyroid gland. Surgery of the thyroid gland may inadvertently damage the parathyroid glands. Parathyroid glands are involved with calcium homeostasis.

Question 12

Recall that Louise complained about tingling around her mouth and in her fingers and muscle spasms. Based on Louise’s symptoms, what electrolyte imbalance do you suspect?
Hypokalemia
Hyperkalemia
Hypocalcemia
Hyponatremia

Answer 12

Hypocalcemia
The signs and symptoms of hypocalcemia include neuromuscular excitability, which can be demonstrated as paresthesia around the mouth, hands, and feet; muscle spasms of the face, hands, and feet; laryngeal spasm; seizures; and death.

Question 13

You may also suspect what other electrolyte imbalance?
Hypernatremia
Hyperphosphatemia
Hyperkalemia
Hypernatremia

Answer 13

Hyperphosphatemia

Hyperphosphatemia is usually accompanied by hypocalcemia, and many of its symptoms are related to low calcium levels.

Question 14

What is the term for the twitch noted when you tapped along Louise’s jaw?
Bell’s palsy
Kernig sign
Trousseau’s sign
Chvostek’s sign

Answer 14

Chvostek’s sign

Chvostek’s sign is elicited by tapping on the patient’s face in front of the ear and below the cheek bone. Facial twitching constitutes a positive Chvostek’s sign, representing the hyperexcitability of nerves in hypocalcemia.

Question 15

John is a 41-year-old sales manager. A routine ECG on John shows a prolonged PR interval and smaller than normal T waves. When he stands up from bed, he complains of dizziness. His medical history indicates that orthostatic hypotension is a concern.

John has been in poor health for some time. He has heart failure and is currently taking digitalis and a diuretic to manage his condition. He admits he consumes a poor diet comprised mainly of processed, fast foods.

Lately, John states he has been experiencing muscle weakness and feels more tired than usual. He is frequently awakened at night with leg cramps. He also complains of difficulty breathing, especially at night. He states that he needs to prop himself up with two to three pillows.

What electrolyte imbalance do you suspect?
Hypernatremia
Hypocalcemia
Hyponatremia
Hypokalemia

Answer 15

Hypokalemia

The two keys pointing to hypokalemia in this case are the abnormalities observed with electrocardiography and the usage of diuretics.

Hypokalemia alters the resting membrane potential of cells, causing hyperpolarization. Flattened, smaller T waves appear on ECG’s as repolarization is delayed.

Hypokalemia may develop with the use of diuretics. For some diuretics, the mechanism of action is a reduction in ion reabsorption, which also reduces water reabsorption, increasing urine output.

John’s symptoms, such as leg cramps, provide further support that hypokalemia may be present.

Question 16

Which factor-may increase the risk for developing John’s electrolyte imbalance?

Being male
Sedentary lifestyle
Age
Diuretic usage

Answer 16

Diuretic usage

Diuretic therapy is the most common cause of hypokalemia; it is present in 20% to 50% of patients on nonpotassium-sparing diuretics. Thiazide and loop diuretics increase the loss of potassium ions in the urine. Inadequate potassium intake can also be a frequent cause of hypokalemia.

Question 17

Which signs and symptoms that are associated with this electrolyte imbalance? Select all that apply.

Leg cramps
Dyspnea
Prolonged PR interval
Flattened T waves
Postural hypotension

Answer 17

Leg cramps
Prolonged PR interval
Flattened T waves
Postural hypotension

The major signs and symptoms of hypokalemia include anorexia, nausea, vomiting, sluggish bowel, cardiac arrhythmias, postural hypotension, muscle fatigue, and weakness. Leg cramps are common. On ECG, there is a prolonged PR interval, flattened T wave, and prominent U wave.

Question 18

Had John also had hyponatremia, which of the following signs and symptoms may have been present? Select all that apply.

Serum sodium less than 135 mEq/L
Confusion
Headache
Decreased salivation
Thirst

Answer 18

Serum sodium less than 135 mEq/L
Confusion
Headache

Serum sodium less than 135 mEq/L is one of the criteria for hyponatremia. Hyponatremia often presents with neurological signs and symptoms, such as confusion and headache. Decreased salivation and thirst are associated with hypernatremia.

Question 19

What is reduced sodium concentration accompanied by fluid deficit called?

Hypovolemic hypernatremia
Hypovolemic hyponatremia
Hypervolemic hyponatremia
Hypervolemic hyper

Answer 19

Hypovolemic hyponatremia

Question 20

What condition may result in hyperkalemia?

Alkalosis
Acidosis
Hypernatremia
Hypermagnesemia

Answer 20

Acidosis

Question 21

What is one sign associated with hypokalemia?

Edema
Dark-colored urine
Weight gain
Prolonged PR interval on electrocardiogram

Answer 21

Prolonged PR interval on electrocardiogram

Question 22

What condition is often associated with hypercalcemia?

Hypernatremia
Hypophosphatemia
Hyponatremia
Hyperphosphatemia

Answer 22

Hypophosphatemia

Question 23

Fluid volume excess may cause which of the following signs? Select all that apply.

Weight loss
Thirst
Edema
Dark-colored urine
Crackles in the lungs

Answer 23

Edema

Crackles in the lungs