Electrolyte Review Flashcards

1
Q

Sodium

-Normal Levels

A

135-145 mEq/L

Most abundant electrolyte in ECF

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2
Q

Potassium (K+)

-Normal Value

A

3.5-5 mEq/L

Major Cation in ICF

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3
Q

Calcium

-Normal Value

A

8.5-10.5 mg/dL

Most abundant mineral in the body

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4
Q

Magnesium

-Normal Value

A

1.8-2.5 mEq/dL

2nd most abundant cation in ICF

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5
Q

Phosphorus

-Normal Value

A

2.5-4.5 mg/dL

Most abundant anion in ICF

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6
Q

Sodium

-Overview

A
  1. Most abundant electrolyte in ECF
  2. Regulates neuromuscular impulses in the nerve and muscle fibers
  3. Controlled by renal reabsorption and excretion
    - ADH, RAAS, ANF
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7
Q

Sodium

-Dietary Sources

A
  1. Table salt
  2. Processed or cured meat
  3. Packaged foods
  4. Seafood
  5. Cheese
  6. Junk food
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8
Q

Hyponatremia

-Causes

A
  1. Diaphoresis
  2. Wound drainage
  3. Diuretic use
  4. Inappropriate ADH secretion
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9
Q

Hyponatremia

-Manifestations

A
  1. Muscle weakness
  2. Spasm, twitching
  3. Decreased deep tendon reflexes
  4. LETHARGY
  5. N/V/ anorexia
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10
Q

Hyponatremia

-Treatment

A
  1. Treat Cause

2. IV fluids -hypertonic or isotonic

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11
Q

Hyponatremia

-Nursing Interventions

A
  1. Monitor I&0 / DAILY WEIGHT
  2. Fluid Restriction
  3. Increase dietary intake
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12
Q

Hypernatremia

-Causes

A
  1. Increase in sodium intake

2. Excess loss of water or inadequate intake of water

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13
Q

Hypernatremia

-Manifestations

A
  1. Irritability, Restlessness

2. Confusion, agitation

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14
Q

Hypernatremia

-Treatment

A
  1. Treat Cause
  2. IV fluids for dehydration
  3. Correct fluid imbalance carefully
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15
Q

Hypernatremia

-Nursing Interventions

A
  1. Monitor Vital signs
  2. Daily weight
  3. Monitor edema
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16
Q

Potassium

-Overview

A
  1. Major Cation in the ICF
  2. Important for nerve-cell comm and initiation of muscle contraction (especially in the heart)
  3. Controlled by kidneys
    - Aldosterone (promotes excretion)
    - Insulin (moves K+ into the cells)
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17
Q

Potassium

-Dietary Sources

A
  1. Bananas
  2. Cantaloupe
  3. Green leafy veggies
  4. Potatoes
  5. Avocados
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18
Q

Hypokalemia

-Causes

A
  1. Diuretics
  2. N/Diarrhea
  3. Nasogastric Suction
  4. Decreased intake
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19
Q

Hypokalemia

-Manifestations

A
  1. Cardiac arrhythmias (orthostatic hypotension)
  2. Decreased bowel motility
  3. Shallow ineffective respirations
  4. Decreased deep tendon reflexes
  5. Frequent urination
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20
Q

Hypokalemia

-Treatment

A
  1. K+ supplements
    - Take w/ food to minimize GI side effects
  2. IV potassium
    - DILUTE it
    - Max rate of 10 mEq/hr
    - can cause BURNING sensation at IV site
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21
Q

Hypokalemia

-Nursing Interventions

A
  1. Cardiac monitor
  2. Monitor respiratory status
  3. Monitor Labs
  4. Do not crush or chew
  5. Encourage dietary intake
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22
Q

Hyperkalemia

-Causes

A
  1. Renal Failure
  2. Potassium-sparing diuretics
  3. K+ supplements or IV replacement
  4. Lack of insulin (DKA)
  5. Cell destruction
  6. Hemolysis of cells w/ extended tourniquet application
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23
Q

Hyperkalemia

-Manifestations

A
  1. Low BP
  2. Bradycardia / arrhythmias
  3. Numbness or tingling of face, tongue, hands, feet
  4. Fatigue, drowsiness, confusion
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24
Q

Hyperkalemia

-Treatment

A
  1. Insulin moves K+ from ECF to ICF (give dextrose if needed)
  2. Diuretics
  3. Kayexelate (orally or via retention enema
  4. Dialysis
  5. IV calcium to minimize cardiac toxicity
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25
Q

Hyperkalemia

-Nursing Interventions

A
  1. Monitor renal function
  2. Cardiac Monitor
  3. Dialysis if needed
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26
Q

Calcium

-Overview

A
  1. Most abundant mineral in the body

2. Controlled by Vit. D, PTH, Calcitonin, and serum concentration

27
Q

Calcium

-Necessary For…

A
  1. Transmission of nerve impulses
  2. Normal muscle contraction
  3. Regulation of the heart
  4. Hormone secretion
  5. Formation of blood clots
28
Q

Calcium

-Dietary Sources

A
  1. Milk
  2. Yogurt
  3. Cheese
  4. Egg yolk
  5. cauliflower, soybeans, green leafy veggies
29
Q

Hypocalcemia

-Critical values

A
  1. <6mg/dL may cause death
30
Q

Hypocalcemia

-Causes

A
  1. Renal failure
  2. Acute pancreatitis
  3. Hypoparathyroidism
  4. Vit D deficiency
  5. Low Mg, Serum albumin or Increased phosphorus
31
Q

Hypocalcemia

-Manifestations

A
  1. Chvostek’s sign
  2. Trousseau’s sign
  3. Cardiac arrhythmias
  4. Osteoporosis
32
Q

Hypocalcemia

-Treatment

A
  1. Treat cause
  2. IV calcium gluconate
    - monitor IV for tissue necrosis
33
Q

Hypocalcemia

-Nursing Interventions

A
  1. Monitor electrolytes

2. Cardiac monitor monitor respiratory status

34
Q

Hypercalcemia

-Critical level

A

> 12mg/dL is life threatening

35
Q

Hypercalcemia

-Causes

A
  1. Hyperparathyroidism
  2. Bone cancer cause breakdown of bone
  3. Multiple fractures
  4. Prolonged immobilization
  5. prolonged use of aluminum-containing antacids
36
Q

Hypercalcemia

-Manifestations

A
  1. Anorexia, N/V/C
  2. Muscle weakness, lethargy
  3. Polydipsia, polyuria, dehydration
  4. Cardiac arrhythmias
37
Q

Hypercalcemia

-Treatment

A
  1. Treat Cause
  2. Diuretics
  3. IV hydration w/ NS to increase renal blood flow and urinary excretion
  4. IV bisphophonates (obstruct Ca release from bone)
  5. CALCITONIN - inhibits release from bone and promotes renal excretion)
38
Q

Hypercalcemia

-Nursing Interventions

A
  1. Encourage oral fluids (3-4 L/ day)
  2. Monitor VS
  3. Cardiac monitor
  4. Monitor neuro status
  5. Encourage mobility
39
Q

Magnesium

-Overview

A
  1. Activating co-factor with more than 300 enzymes
  2. 2nd most abundant cation in ICF
  3. Influences PTH and calcium levels
40
Q

Magnesium

-Important in

A
  1. Blood clotting
  2. DNA & RNA synth
  3. Cardiovascular regulation
41
Q

Magnesium

-Interactions

A
  1. Mg increases w/ K+
  2. Increased intake of Ca or P decreases absorption of Mg
  3. Decreased intake of Ca or P increases absorption of Mg
42
Q

Magnesium

-Dietary Sources

A
  1. Veggies
    -Spinach, broccoli, avocado
  2. Potatoes
  3. Whole grains
  4. Beef, chicken, tuna, milk, yogurt, raisins
    4.
43
Q

Hypomagnesemia

-Critical Value

A

Symptoms not commonly seen until less than 1 mEq/L

44
Q

Hypomagnesemia

-Causes

A
  1. Alcoholism
  2. Hypothyroidism
  3. Medications
    - Diuretics
    - Aminoglycoside antibiotics
45
Q

Hypomagnesemia

-Manifestations

A
  1. Cardiac arrhythmias
  2. Neuromuscular irritability, twitches, tremors, leg and feet cramping
  3. Restlessness, disorientation
  4. Anorexia N/V
46
Q

Hypomagnesemia

-Treatment

A
  1. IV magnesium sulfate
    - Max rate is 150 mg/min
  2. Oral Supplements
47
Q

Hypomagnesemia

-Nursing Interventions

A
  1. Discontinue meds causing it
  2. Monitor for digitalis toxicity
  3. Cardiac Monitor
  4. Monitor Neuro status and Labs
48
Q

Hypermagnesemia

- Causes

A
  1. Renal dysfunction

2. Chronic excessive use of antacids or laxatives

49
Q

Hypermagnesemia

- Manifestations

A
  1. Flushing
  2. Increased perspiration
  3. Muscle weakness
  4. Decreased deep tendon reflexes
  5. N/V and Cardiac arrhythmias
50
Q

Hypermagnesemia

- Treatment

A
  1. IV calcium

2. IV fluids increases excretion

51
Q

Hypermagnesemia

- Nursing Interventions

A
  1. Cardiac Monitoring
  2. Discontinue meds causing it
  3. Monitor renal and respiratory status
  4. Dialysis if needed
52
Q

Phosphorus

-Overview

A
  1. Most abundant anion in ICF
  2. Metabolism of protein, calcium and glucose
  3. Muscle contractions
  4. Maintaining acid-base balance
  5. Found in ATP
  6. Need Vitamin D for absorption
53
Q

Phosphorus

-Interactions

A
  1. When Ca is increased, P is decreased
  2. When Ca is decreased, P is increased

Controlled by PTH - stimulates kidney to excrete P

54
Q

Phosphorus

-Dietary sources

A
  1. Milk
  2. Cheese
  3. Egg yolk
  4. Meat
  5. Nuts
55
Q

Hypophosphatemia

-Causes

A
  1. HYPERVENTILATION (sepsis, anxiety, pain, heatstroke, DKA, alcohol withdrawal.
  2. Hyperparathyroidism
  3. Diuretic use - phosphorus-binding antacids
  4. Hyperglycemia
56
Q

Hypophosphatemia

-Manifestations

A
  1. Numbness and tingling (paresthesia)
  2. Staggering gait (ataxia)
  3. Disorientation, confusion, seizures
  4. Difficulty speaking and swallowing
  5. Unequal eye movements
  6. Bruising, GI bleeding
57
Q

Hypophosphatemia

-Treatment

A
  1. IV potassium phosphate
    - Must dilute
    - Max rate is 10 mEq/hr
58
Q

Hypophosphatemia

-Nursing Interventions

A
  1. Increase dietary intake
  2. Assess LOC
  3. Monitor electrolyte levels
59
Q

Hyperphosphatemia

-Causes

A
  1. Renal failure
  2. Increased intake and excessive use of laxatives or enemas
  3. Cell breakdown or injury (rhabdomyolysis)
  4. Hypoparathyroidism
60
Q

Hyperphosphatemia

-Manifestations

A
  1. Usually asymptomatic
  2. Tetany
  3. S/S RT HYPOCALCEMIA
61
Q

Hyperphosphatemia

-Treatment

A
  1. Aluminum-based antacids bind w/ phosphorus in GI tract
  2. Diuretics
  3. Glucose and insulin moves phosphorus from ECF to ICF
  4. Correct hypocalcemia
62
Q

Hyperphosphatemia

-Nursing Interventions

A
  1. Limit phosphorus intake (LOW PROTEIN DIET)
  2. Dialysis if needed
  3. Monitor electrolyte levels
63
Q

Renal Failure

-Causes what electrolyte imbalances

A
  1. Hyperkalemia
  2. Hypocalcemia
  3. Hypermagnesemia
  4. Hyperphosphatemia