Electrolyte imbalances (Davis advantage) Flashcards
What are the 5 most important ions in the body?
Sodium(Na+) Potassium(K+) Calcium(Ca++) Phosphorus(PO4 3-) Magnesium (Mg++)
Hyervolemic hyponatremia=
Excess water dilutes sodium levels
Results in cell swelling.
Hypovolemic hyponatremia=
Water and sodium are lost
\
Due to diarrea or kidney failure
hyperkalemia causes what to the heart?
Wide QRS complexes
Peacked T waves
hyperkalemia=high potasssium lvls
Hypokalemia causes what to the heart?
Cardiac arrhythmias
Prolonged PR INTERVALS
Hypokalemia= LOW POTASSIUM
False hyperkalemia occurs during ?
Acidosis
Pairing of Calcium and phosphorus levels are often
Reciprocated:
Calcium high= phosphorus low
Calcium low = phosphorus high
(PTH ) parathyroid decreasing tumor may cause what to the pairing of calcium and phosphorus?
Hypercalcemia & hypophosphatemia
Bone pain and muscle weakness
(Extra info; hypocalcemia tends to cause muscle spasms)
Causes of Hypermagnesimia
Mediactions
Kidney failure
Causes of hypomagnesemia
Alchol
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
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.
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
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.
You may also suspect what other electrolyte imbalance? Hypernatremia Hyperphosphatemia Hyperkalemia Hypernatremia
Hyperphosphatemia
Hyperphosphatemia is usually accompanied by hypocalcemia, and many of its symptoms are related to low calcium levels.
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
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.
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
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.
Which factor-may increase the risk for developing John’s electrolyte imbalance?
Being male
Sedentary lifestyle
Age
Diuretic usage
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.
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
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.
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
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.
What is reduced sodium concentration accompanied by fluid deficit called?
Hypovolemic hypernatremia
Hypovolemic hyponatremia
Hypervolemic hyponatremia
Hypervolemic hyper
Hypovolemic hyponatremia
What condition may result in hyperkalemia?
Alkalosis
Acidosis
Hypernatremia
Hypermagnesemia
Acidosis
What is one sign associated with hypokalemia?
Edema
Dark-colored urine
Weight gain
Prolonged PR interval on electrocardiogram
Prolonged PR interval on electrocardiogram
What condition is often associated with hypercalcemia?
Hypernatremia
Hypophosphatemia
Hyponatremia
Hyperphosphatemia
Hypophosphatemia
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
Edema
Crackles in the lungs
