ELECTROLYTE IMBALANCES & IV COMPLICATIONS Flashcards
- it is the major electrolyte found in ECF.
- it is also essential for acid-base, fluid balance, active & passive transport mechanism, irritability & conduction of nerve-muscle tissue
SODIUM
what are two illness occur during sodium imbalance?
- hypernatremia
2. hyponatremia
what are the s/s of HYPERNATREMIA?
- Flushed skin
- Restless, anxious, confused irritable
- Increased BP & fluid retention
- Edema (pitting)
- Decreased Urine output
- Skin flushed and dry
- Agitation
- Low grade fever
- Thirst (dry mucous membranes)
what are the risk factors of HYPERNATREMIA?
- increased sodium intake
- increased water loss
- decreased sodium excretion
what causes the increase of sodium intake under the hypernatremia?
- excess oral sodium ingestion
- excess administration of IV fluids w/ sodium
- hypertonic IV fluids
what causes the increase of water loss under the hypernatremia?
- fever
- watery diarrhea
- diabetes insipidus
- excessive diaphoresis
what should be the management if there is a fluid loss in the patient?
administer IV infusions
what should you do as a nurse if the patient has inadequate renal excretion of sodium?
give diuretics that helps promote sodium loss
what is the appropriate diet for the patient with hypernatremia?
restricting sodium and fluid intake as prescribed
what are the s/s of HYPONATREMIA?
- Stupor / coma
- Anorexia (nausea & vomiting)
- Lethargy
- Tachycardia
- Limp muscles (muscle weakness)
- Orthostatic hypotension
- Seizures / headaches
- Stomach cramping (hyperactive bowels)
what are the risk factors of HYPONATREMIA?
- increased sodium excretion
- inadequate sodium intake
- kidney disease
- syndrome of inappropriate antidiuretic hormone secretion
- heart failure
what causes the increase of sodium excretion under the hyponatremia?
- excessive diaphoresis
- diuretics
- vomiting & diarrhea
what causes the inadequate of sodium intake under the hyponatremia?
Fasting, NPO, low-salt diet
what is the appropriate diet for the patient with hyponatremia?
increasing oral sodium intake
what should you do as a nurse if hyponatremia is due to hypovolemia?
give IV sodium chloride infusions
what should you do as a nurse if hyponatremia is due to hypervolemia?
give osmotic diuretics
it plays vital role in cell metabolism, transition of nerve impulses, functioning of heart, lungs & muscle tissues, and acid-base balance.
POTASSIUM
what are two illness occur during potassium (K) imbalance?
- hyperlakemia
2. hypolakemia
what are the s/s of HYPERLAKEMIA?
- Muscle Cramps
- Urine Abnormalities
- Respiratory Distress
- Decreased cardiac contractility
- ECG changes
- Reflexes
how does ECG change during hyperlakemia?
- Tall peaked T waves
- Flat T waves
- Widened QRS complexes
- Prolonged PR intervals
what are the risk factors of HYPERLAKEMIA?
- excessive K intake
- rapid infusions of K containing IV solutions
- decreased K excretion
- K-retaining diuretics
- kidney d/s
- adrenal insufficiency (addison’s d/s)
- tissue dmg
- acidosis
- hyperuricemia
- hypercatabolism
what are the management done for hyperlakemia?
- discontinue IV & PO potassium
- administering K-excreting diuretics
- prepare administration of IV calcium & IV hypertonic glucose
- avoid usage of salt substitutes or other K-containing substance
what should be diet required for patients with hyperlakemia?
K-restricted diet
if the sodium of the patient is in a critically high level, what should be the management?
prepare the client for dialysis
what other d/d does K imbalance causes that can be life-threatening for the patient?
cardiac dysrhythmias
what are the s/s of HYPOLAKEMIA?
- Paresthesias
- Orthostatic hypotension
- Shallow respirations
- Thready, weak, irregular pulse
- Constipation (Hypoactive bowel sounds)
- Anxiety, Lethargy, confusion, coma
- Nausea, vomiting, abdominal distention
- ECG Changes
- Hyporeflexia
how does ECG change during hypolakemia?
- ST depression
- Shallow or inverted T wave
- Prominent U wave
what are the risk factors of HYPOLAKEMIA?
- Actual total body K loss
- Inadequate K intake
- Movement of K from extracellular fluid to intracellular fluid
- Dilution of serum K
what causes the inadequate of K intake under the hypolakemia?
NPO, Fasting
what causes the movement of K from extracellular fluid to intracellular fluid under the hypolakemia?
- Alkalosis
2. hyperinsulinism
what causes the dilution of serum K under the hypolakemia?
- water intoxication
2. IV therapy with K-deficient solutions
what are the management for hypokalemia?
- Administering oral K supplements
- Liquid K Cl
- K-retaining diuretics
what should be done instead since K is never administered via IV push, IM or subQ?
IV K should always be diluted & administered via an infusion device.
