Electrolyte Information Flashcards
Hypocalcemia Levels
(Serum < 8.9 mg/dL or Ionized < 4.5 mg/dL)
Hypocalcemia Causes
Inadequate vitamin D Decreased estrogen production Hypoparathyroidism Renal disease Low albumin levels Stimulant laxatives Chronic steroid use Proton pump inhibitors Inhibits H+ absorptions
Hypocalcemia S/S
Chest pain Dysrhythmias Renal calculi Numbness and tingling Muscle cramping Confusion Osteopenia Dental problems
Chcostek/Trosseau Signs
Calcium, Serum vs. Ionized
Serum calcium accounts for all calcium, whether it is in the free ionized form or if it is bound to proteins.
Ionized detects the active or unbound form of calcium in the body
Hypocalcemia Treatment
Calcium and vitamin D supplementation
Increased dietary intake
Calcium injections
Hypercalcemia Levels
(Serum >10.5 mg/dL or ionized > 5.6 mg/dL)
Hypercalcemia Causes
Cancer
Hyperparathyroidism
Vitamin D toxicity
TUMS, too much can contribute to hypercalcemia
Hypercalcemia S/S
Mild symptoms - GI Issues Constipation Abdominal pain Nausea Vomiting
Severe symptoms Confusion Renal failure Arrhythmias Coma Death
Hypercalcemia Treatment
Administer phosphate, why?
Ca and Phosphorous have an inverse relationship
Intravenous saline bolus
Loop diuretic
Hemodialysis in severe cases
Hypomagnesemia Levels
(< 1.8 mg/dL or 1.3 mEq/L)
Hypomagnesemia Causes
Crohn’s disease or celiac disease Diarrhea or pancreatitis Type 2 diabetes In the presence of hypokalemia and hypocalcemia Decreased intake Increased renal excretion
Hypomagnesemia Symptoms
Mild symptoms
Decreased appetite, fatigue, nausea, weakness
Severe
Muscle cramps, numbness and tingling, seizures, tetany, and personality changes
Hypomagnesemia Treatment
Oral or intravenous magnesium
What might have to be treated first before magnesium can be given?
Restore calcium or potassium balance
Educate clients on foods high in magnesium
Hypermagnesemia Levels
(> 2.3 mg/dL or 2.1 mEq/L)
Hypermagnesemia Causes
Kidney disease
Acidosis
Hypothyroidism
Trauma
Medications that increase dwell time of food in the intestines (opioids or anticholinergics)
Laxatives or antacids that contain magnesium
Hypermagnesemia Symptoms
Mild symptoms
Dizziness, nausea, weakness, confusion
Severe symptoms
Confusion, blurred vision, headache, bladder paralysis, bradycardia, reduced respiratory rate, loss of deep tendon reflexes, death
Hypermagnesemia Treatment
Something given to prevent cardiac problems…similar to hyperkalemia?
Calcium chloride and calcium gluconate (EKGS covered in NUR 410)
Intravenous saline with diuretics
Severe cases may require?
Hemodialysis
Dietary Sources for Electrolytes
Finish here
Hypokalemia Levels
(K < 3.5 mEq/L)
Hypokalemia Causes
Diuretics Metabolic alkalosis Folic acid deficiency Gastrointestinal losses Decreased intake of potassium
Hypokalemia S/S
Mild
Cardiac arrythmias, constipation, fatigue
Severe
Respiratory paralysis, paralytic ileus, tetany, hypotension, rhabdomyolysis, life threatening arrythmias
Hypokalemia Treatment
Priority is determining underlying cause
Potassium supplementation
Switch to a potassium sparing diuretic like spironolactone
Making dietary changes
Intravenous Potassium
ONLY given IV through a slow infusion
Hyperkalemia Levels
(K > 5.0 mEq/L)
Hyperkalemia Causes
Acute renal failure Dehydration Diabetes Burns Acidosis Blood transfusion K in packed red blood cells
CPR can damage cells and release potassium
Hyperkalemia S/S
Mild
Nausea, vomiting, muscle aches, weakness, dysrhythmias
Severe
Paralysis, heart failure, death
Hyperkalemia Treatment
Hemodialysis if the cause is acute renal failure
To reduce the effects of hyperkalemia on the heart
Calcium gluconate or calcium chloride (more on that in NUR 410)
If renal failure is not present
Loop diuretics like furosemide
Sodium polystyrene sulfonate (Kayexalate)
Bind to potassium and excrete it in feces
Intravenous insulin
Insulin helps to push potassium into the cell
Must have glucose monitored to prevent hypoglycemia
Hyponatremia Levels
(Na < 135 mEq/L)
Hyponatremia Causes
Severe vomiting or diarrhea - prolonged Drinking excess water Excess alcohol intake Thiazide diuretics Liver or Heart disease
Hyponatremia S/S
Mild
Nausea, feeling unwell
Severe
Cerebral edema, lethargy, confusion, irritability, seizure, coma
Hyponatremia Treatment
Sodium levels must be raised slowly to prevent rapid fluid shifts in neurologic cells
remember tonicity
Cells can shrink up
Fluid restriction
If the cause is due to thiazide diuretics
Isotonic IV fluids
Hypertonic is only used
in extreme situations of
cerebral edema.
Due to underlying liver or cardiac problems
Alter treatment for these problems
Hypernatremia Levels
(Na > 145 mEq/L)
Hypernatremia Causes
Causes Dehydration and things that cause a state of dehydration Vomiting Chronic kidney disease Diabetes Impaired thirst response Consumption of high sodium items
Hypernatremia S/S
Think neurological
Hypernatremia Treatment
Restore fluid status
Hypotonic, but if there is shock or low blood pressure then isotonic.
What can cause cerebral edema with treatment?
If the sodium is lowered too quickly
This is the reason that water is not used for hypernatremia treatment
Educate clients on dietary measures to reduce sodium intake
