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Nursing 105 > Electrolyte Imbalances- Exam 1 > Flashcards

Electrolyte Imbalances- Exam 1 Flashcards

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
Hypernatremia causes hyperosmolality leading to?
cellular dehydration
26
What is the body's primary protection from developing hypernatremia?
Thirst
27
What part of the brain triggers thirst?
Hypothalamus
28
Hypernatremia is not really a sodium disorder but a ? disorder
Water
29
Causes of hypernatremia
Excess Na+ intake Hypertonic IVF Fluid deprivation Heat stroke Diabetes Insipidus
30
Serum sodium levels <135 mEq/L is what disorder?
Hyponatremia
31
Causes of hyponatremia
Disease process Fluid overload in surgical/sepsis pts Exercise associated: extreme temps, excess water intake, prolonged exercise Medications: anticonvulsants, SSRIs
32
What processes in the body is potassium necessary for?
-Transmission and conduction of nerve and smooth muscle impulses -Cellular growth -Maintenance of cardiac rhythms -Acid-base balance
33
Causes of hyperkalemia
-Excessive intake -Internal shift (K+ shifting out of cells) -Retention -Crush injury -Severe burns
34
Clinical manifestations of hyperkalemia
-Increased cell excitability (wide, flat P wave; prolonged PR interval; widened QRS; tall, peak T waves, depressed ST) -Muscle weakness -Abdominal/leg cramps -Diarrhea
35
Causes of hypokalemia
-Kidney loss of K+ -GI tract losses -Increased shift of K+ from ECF to ICF -Magnesium deficiency -Metabolic alkalosis -Dietary deficiencies
36
Clinical manifestations of hypokalemia
-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
How does the P wave present on an EKG if a patient is hypokalemic?
Slightly peaked P wave
38
How does the PR interval present on an EKG if the patient is hypokalemia?
slightly prolonged PR interval
39
When is a U wave seen on EKG?
If the patient is hypokalemic
40
How does the P wave present on an EKG if a patient is hyerkalemic?
Wide and flat P wave
41
True or False Potassium is a major ICF cation
True
42
If your patient is hypo/hyperkalemic, what will the nurse monitor for?
ECG changes UOP before and after administering K+
43
How should K+ NEVER be given?
IV push or as a bolus
44
K+ administration should not exceed ? mEq/hr
10 mEq/hr
45
Why should K+ never be administered faster than 10 mEq/hr?
To prevent hyperkalemia and cardiac arrest
46
Functions of calcium in the body
-Formation of teeth and bone -Blood clotting -Transmission of nerve impulses -Myocardial contractions -Muscle contractions
47
What is needed in order for someone to absorb calcium?
Vit D
48
Serum ____ affects total calcium levels
albumin
49
Calcium balance is controlled by
parathyroid hormone
50
What is released when calcium levels are low?
Parathyroid hormone
51
What is released when calcium levels are too high?
calcitonin
52
What stimulates parathyroid hormone release?
low calcium levels
53
What stimulates release of calcitonin?
high calcium levels
54
Calcitonin is produced by?
The thyroid gland
55
Ca++ : 7.6 mg/dL What does this result tell us?
Hypocalcemia
56
Causes of hypocalcemia
-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
Clinical manifestations of hypocalcemia
-Tetany -Laryngeal stridor -Dysphagia -Perioral tingling -Cardiac dysrhythmias
58
A patient's serum calcium level shows a result of 11.6, what is this patient's diagnosis?
Hypercalcemia
59
Causes of hypercalcemia
-Hyperparathyroidism -Malignancy -Excessive intake -Prolonged immobilization -Excessive Vit D intake
60
Clinical manifestations of hypercalcemia
-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
True or False Phosphate is a primary cation in ICF
False it is a primary ANION in ICF
62
where is the majority of phosphorus located?
bones and teeth
63
Phosphorus is essential to what body functions?
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
Phosphate levels are controlled by what?
The parathyroid hormone
65
Phosphate has a reciprocal relationship with?
Calcium
66
Maintenance of phosphate levels in the body requires what?
adequate renal function
67
Causes of hyperphosphatemia
-AKI or CKD -Chemotherapy -Hypoparathyroidism -Tumor lysis -Rhabdo -Excessive intake of phosphate or Vit D
68
Clinical manifestations of hyperphosphatemia
-Often asymptomatic -Neuromuscular irritability and tetany -Calcified deposit in soft tissues like joints, arteries, skin, kidneys, corneas
69
Clinical manifestations of hypophosphatemia
-Often asymptomatic -CNS depression, confusion -Muscle weakness, pain -Cardiomyopathy -Respiratory failure
70
Your patient's phosphorus levels are 1.5, what is their diagnosis?
hypophosphatemia
71
Your patient's phosphorus levels are 8.7, what is their diagnosis?
Hyperphosphatemia
72
Causes of hypophosphatemia
-Malnourishment/malabsorption -Diarrhea -ETOH abuse -Use of phosphate-binding antacids -During parenteral nutrition with inadequate replacement
73
Drugs that block vasopressin (ADH)
Convaptan Tolvaptan
74
Tol
75
Normal serum magnesium level
1.8 mg/dL - 2.6 mg/dL
76
Functions that require magnesium
DNA & protein synthesis Na+/K+ pump Normal cardiac function
77
Where is magnesium absorbed?
GI tract
78
Where is magnesium excreted?
Kidneys and stool
79
Where is 50-60% of magnesium contained in the body?
Bone
80
What causes high serum magnesium levels?
-Increased intake with renal insufficiency -Txment of migraines or menstrual cramps -Excess IV magnesium admin -Decreased output
81
Clinical manifestations of hypermagesium
ECG changes Hypotension Lethargy/Somnolence N/V Impaired reflexes Respiratory or cardiac arrest
82
Magnesium acts as what at high doses?
A sedative
83
Magnesium serum levels <1.8 mg/dL is what?
Hypomagnesemia
84
Low serum magnesium is caused by
Prolonged fasting/starvation Chronic alcoholism Fluid loss from GI tract Prolonged parenteral nutrition w/o supplementation Diuretics Large blood transfusion
85
Clinical manifestations of hypomagnesemia
Hyperactive deep tendon reflexes Muscle cramps Tremors Seizures Cardiac dysrhythmias Corresponding hypocalcemia and hypokalemia

Nursing 105 (11 decks)

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