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Nursing 105 > Electrolyte Imbalances- Exam 1 > Flashcards

Electrolyte Imbalances- Exam 1 Flashcards

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1
Q

Normal calcium range

A

8.8 - 10.4 mg/dL

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2
Q

Normal chloride range

A

96 - 106 mEq/L

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3
Q

Normal magnesium range

A

1.8 - 2.6 mg/dL

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4
Q

Normal phosphorus range

A

2.7 - 4.5 mg/dL

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5
Q

Normal potassium range

A

3.5 - 5 mEq/L

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6
Q

Normal sodium range

A

135 - 145 mEq/L

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7
Q

Substances whose molecules dissociate into ions when placed in water

A

electrolytes

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8
Q

electrolyte concentrations differ depending on?

A

fluid compartments

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9
Q

An abnormality in the concentration of electrolytes in the body

A

electrolyte imbalance

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10
Q

Electrolytes help to regulate what?

A

cardiac and neuro function
fluid balance
O2 delivery
acid-base balance

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11
Q

3 most essential electrolytes involved in neuro/cardio-function

A

K+, Na+, Ca++

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12
Q

Type of electrolyte movement of mainly molecules across a permeable membrane from high concentration to low concentration

A

Diffusion

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13
Q

Is simple diffusion active or passive?

A

Passive

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14
Q

Type of electrolyte movement that uses carriers to move molecules

A

facilitated diffusion

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15
Q

Glucose cannot enter most cell membranes without assistance from?

A

Insulin

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16
Q

Type of electrolyte movement in which molecules move against the concentration gradient

A

active transport

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17
Q

External energy is required for what type of electrolyte movement?

A

Active transport

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18
Q

Give an example of active transport

A

the sodium-potassium pump

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19
Q

Active transport uses what to move sodium into the cell and potassium out of the cell?

A

ATP

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20
Q

Sodium plays a major role in what 4 things in the body?

A
  1. ECF volume and concentration (osmolality)
  2. Generation and transmission of nerve impulses
  3. Muscle contractility
  4. Acid-base balance
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21
Q

Osmolality AKA

A

concentration

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22
Q

Excreting more sodium = _____ osmolality

A

decreased

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23
Q

Excreting less sodium = _____ osmolality

A

increased

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24
Q

Serum sodium levels >145 mEq/L is known as

A

hypernatremia

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25
Q

Hypernatremia causes hyperosmolality leading to?

A

cellular dehydration

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26
Q

What is the body’s primary protection from developing hypernatremia?

A

Thirst

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27
Q

What part of the brain triggers thirst?

A

Hypothalamus

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28
Q

Hypernatremia is not really a sodium disorder but a ? disorder

A

Water

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29
Q

Causes of hypernatremia

A

Excess Na+ intake
Hypertonic IVF
Fluid deprivation
Heat stroke
Diabetes Insipidus

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30
Q

Serum sodium levels <135 mEq/L is what disorder?

A

Hyponatremia

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31
Q

Causes of hyponatremia

A

Disease process
Fluid overload in surgical/sepsis pts
Exercise associated: extreme temps, excess water intake, prolonged exercise
Medications: anticonvulsants, SSRIs

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32
Q

What processes in the body is potassium necessary for?

A

-Transmission and conduction of nerve and smooth muscle impulses
-Cellular growth
-Maintenance of cardiac rhythms
-Acid-base balance

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33
Q

Causes of hyperkalemia

A

-Excessive intake
-Internal shift (K+ shifting out of cells)
-Retention
-Crush injury
-Severe burns

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34
Q

Clinical manifestations of hyperkalemia

A

-Increased cell excitability (wide, flat P wave; prolonged PR interval; widened QRS; tall, peak T waves, depressed ST)
-Muscle weakness
-Abdominal/leg cramps
-Diarrhea

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35
Q

Causes of hypokalemia

A

-Kidney loss of K+
-GI tract losses
-Increased shift of K+ from ECF to ICF
-Magnesium deficiency
-Metabolic alkalosis
-Dietary deficiencies

36
Q

Clinical manifestations of hypokalemia

A

-Hyperpolarization of cells impairing muscle contraction
-Cardiac (slightly peaked P wave, ST depression, U wave, heart blocks, ventricular dysrhythmias)
-Skeletal muscle weakness/leg cramps
-Weakness of resp muscles
-Decreased GI motility
-Impaired regulation of arteriolar blood flow
-Hyperglycemia

37
Q

How does the P wave present on an EKG if a patient is hypokalemic?

A

Slightly peaked P wave

38
Q

How does the PR interval present on an EKG if the patient is hypokalemia?

A

slightly prolonged PR interval

39
Q

When is a U wave seen on EKG?

A

If the patient is hypokalemic

40
Q

How does the P wave present on an EKG if a patient is hyerkalemic?

A

Wide and flat P wave

41
Q

True or False
Potassium is a major ICF cation

A

True

42
Q

If your patient is hypo/hyperkalemic, what will the nurse monitor for?

A

ECG changes
UOP before and after administering K+

43
Q

How should K+ NEVER be given?

A

IV push or as a bolus

44
Q

K+ administration should not exceed ? mEq/hr

A

10 mEq/hr

45
Q

Why should K+ never be administered faster than 10 mEq/hr?

A

To prevent hyperkalemia and cardiac arrest

46
Q

Functions of calcium in the body

A

-Formation of teeth and bone
-Blood clotting
-Transmission of nerve impulses
-Myocardial contractions
-Muscle contractions

47
Q

What is needed in order for someone to absorb calcium?

A

Vit D

48
Q

Serum ____ affects total calcium levels

A

albumin

49
Q

Calcium balance is controlled by

A

parathyroid hormone

50
Q

What is released when calcium levels are low?

A

Parathyroid hormone

51
Q

What is released when calcium levels are too high?

A

calcitonin

52
Q

What stimulates parathyroid hormone release?

A

low calcium levels

53
Q

What stimulates release of calcitonin?

A

high calcium levels

54
Q

Calcitonin is produced by?

A

The thyroid gland

55
Q

Ca++ : 7.6 mg/dL

What does this result tell us?

A

Hypocalcemia

56
Q

Causes of hypocalcemia

A

-Less Ca++ entering the blood: inadequate Vit D, malnutrition, decreased production of PTH, chronic renal failure
-Excess excretion: renal insufficiency, burns, rhabdo, pancreatitis, cirrhosis, diarrhea, laxative abuse
-Multiple blood transfusions

57
Q

Clinical manifestations of hypocalcemia

A

-Tetany
-Laryngeal stridor
-Dysphagia
-Perioral tingling
-Cardiac dysrhythmias

58
Q

A patient’s serum calcium level shows a result of 11.6, what is this patient’s diagnosis?

A

Hypercalcemia

59
Q

Causes of hypercalcemia

A

-Hyperparathyroidism
-Malignancy
-Excessive intake
-Prolonged immobilization
-Excessive Vit D intake

60
Q

Clinical manifestations of hypercalcemia

A

-Neuro: fatigue, lethargy, weakness, stupor, coma, depressed reflexes, confusion, personality changes, psychosis
-ECG changes
-Anorexia, N/V
-Bone pain
-Flank pain from kidney stones
-Polyuria, dehydration

61
Q

True or False
Phosphate is a primary cation in ICF

A

False
it is a primary ANION in ICF

62
Q

where is the majority of phosphorus located?

A

bones and teeth

63
Q

Phosphorus is essential to what body functions?

A

Functions of muscle, red blood cells, and nervous system
(also involved in acid-base buffering, ATP production, cellular uptake of glucose, metabolism of carbs, proteins, and fats)

64
Q

Phosphate levels are controlled by what?

A

The parathyroid hormone

65
Q

Phosphate has a reciprocal relationship with?

A

Calcium

66
Q

Maintenance of phosphate levels in the body requires what?

A

adequate renal function

67
Q

Causes of hyperphosphatemia

A

-AKI or CKD
-Chemotherapy
-Hypoparathyroidism
-Tumor lysis
-Rhabdo
-Excessive intake of phosphate or Vit D

68
Q

Clinical manifestations of hyperphosphatemia

A

-Often asymptomatic
-Neuromuscular irritability and tetany
-Calcified deposit in soft tissues like joints, arteries, skin, kidneys, corneas

69
Q

Clinical manifestations of hypophosphatemia

A

-Often asymptomatic
-CNS depression, confusion
-Muscle weakness, pain
-Cardiomyopathy
-Respiratory failure

70
Q

Your patient’s phosphorus levels are 1.5, what is their diagnosis?

A

hypophosphatemia

71
Q

Your patient’s phosphorus levels are 8.7, what is their diagnosis?

A

Hyperphosphatemia

72
Q

Causes of hypophosphatemia

A

-Malnourishment/malabsorption
-Diarrhea
-ETOH abuse
-Use of phosphate-binding antacids
-During parenteral nutrition with inadequate replacement

73
Q

Drugs that block vasopressin (ADH)

A

Convaptan
Tolvaptan

74
Q

Tol

A
75
Q

Normal serum magnesium level

A

1.8 mg/dL - 2.6 mg/dL

76
Q

Functions that require magnesium

A

DNA & protein synthesis
Na+/K+ pump
Normal cardiac function

77
Q

Where is magnesium absorbed?

A

GI tract

78
Q

Where is magnesium excreted?

A

Kidneys and stool

79
Q

Where is 50-60% of magnesium contained in the body?

A

Bone

80
Q

What causes high serum magnesium levels?

A

-Increased intake with renal insufficiency
-Txment of migraines or menstrual cramps
-Excess IV magnesium admin
-Decreased output

81
Q

Clinical manifestations of hypermagesium

A

ECG changes
Hypotension
Lethargy/Somnolence
N/V
Impaired reflexes
Respiratory or cardiac arrest

82
Q

Magnesium acts as what at high doses?

A

A sedative

83
Q

Magnesium serum levels <1.8 mg/dL is what?

A

Hypomagnesemia

84
Q

Low serum magnesium is caused by

A

Prolonged fasting/starvation
Chronic alcoholism
Fluid loss from GI tract
Prolonged parenteral nutrition w/o supplementation
Diuretics
Large blood transfusion

85
Q

Clinical manifestations of hypomagnesemia

A

Hyperactive deep tendon reflexes
Muscle cramps
Tremors
Seizures
Cardiac dysrhythmias
Corresponding hypocalcemia and hypokalemia

Nursing 105 (11 decks)

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