Electrolytes Flashcards
What the role of sodium (Na) and its expected range?
Maintains B/P, blood volume, and pH balance.
135 - 145 mEq/L
*TIP: think heart happy
Sign and symptoms of hypernatremia:
*TIP: “big and bloated”
Skin is dry and flushed
Pitting edema
Low grade fever
Polydipsia (excessive thirst)
LATE signs and symptoms of hypernatremia:
Swollen and dry tongue
Nausea/vomiting
Increased muscle tone
Signs and symptoms of hyponatremia?
*TIP: “depressed and deflated”
Seizures Coma Tachycardia Weak/thready pulse Respiratory arrest
*NOTE: Hyponatremia can occur due to too much OR too little fluid.
Treatment of hypernatremia due to fluid loss includes:
Administer IV infusions (NS first then D5W slowly)
Restrict fluid and sodium intake as prescribed
Treatment of hypernatremia due to inadequate renal secretion of sodium includes:
Administer IV fluids (NS, hypertonic sol.) Loop diuretics (encourage sodium loss) Restrict fluid and sodium intake as prescribed
Treatment of hyponatremia due to hypovolemia (decreased blood volume) includes:
Give IV sodium chloride infusions (isotonic)
Instruct client to increase oral sodium intake
Treatment of hyponatremia due to hypervolemia (increased blood volume) includes:
Osmotic diuretics
Instruct client to increase oral sodium intake
What is the role of potassium (K) and its expected range?
Maintains heart and muscle contractions, vital role in metabolism, nerve impulse transmission, and acid-base balance.
- 5 - 5 mEq/L
* TIP: think muscles
Cardiac signs and symptoms of hyperkalemia:
*TIP: “tight and contracted”
Wide QRS, peaked T wave, and ST elevation
Severe: ventricular fibrillation, cardiac standstill, hypotension, and bradycardia.
GI signs and symptoms of hyperkalemia:
*TIP: “tight and contracted”
Diarrhea
Hyperactive BS
Neuromuscular signs and symptoms of hyperkalemia:
*TIP: “tight and contracted”
Paresthesias
Paralysis in extremities
Increased DTR
Muscle weakness
Cardiac signs and symptoms of hypokalemia:
*TIP: “low and slow”
Flat T wave
ST depression
Prominent U wave
GI signs and symptoms of hypokalemia:
*TIP: “low and slow”
Decreased motility Hypoactive BS Constipation Abdominal distension Paralytic ileus (EMERGENT - may lead to sm bowel obstruction)
Neuromuscular signs and symptoms of hypokalemia:
*TIP: “low and slow”
Decreased DTR
Muscle cramping
Flaccid paralysis
Treatment of hyperkalemia includes:
Discontinue IV and PO potassium Initiate a potassium-restricted diet Potassium-excreting diuretics IV calcium and IV hypertonic glucose Avoid salt substitutes (high in K) If level is critically high = prepare client for dialysis
Treatment of hypokalemia includes:
Oral K supplements
Liquid KCl
Potassium-sparing diuretics
True or false:
Potassium is always diluted and administered with an infusion device.
TRUE
Potassium is NEVER administered by IV push, IM, or subcut routes; potassium imbalances can cause life-threatening cardiac dysrhythmias!
What is the role of calcium (Ca) and its expected range?
Maintains strength in 3 Bs:
Bones (and teeth)
Blood (clotting factor)
Beats (heart)
9 - 10.5 mEq/L
Signs and symptoms of hypercalcemia:
*TIP: “moans, groans, and stones”
Constipation Bone pain Kidney stones Decreased DTR Severe muscle weakness
Signs and symptoms of hypocalcemia:
*TIP: “signs”
Trousseau's sign (BP cuff + chef's kiss) Chvostek's sign (Facial nerve tap = twitch/smile) Diarrhea Numbness in fingers, face, and limbs Stridor and spasms Convulsions
Clients with hypocalcemia are at risk for:
Bleeding
Cardiac dysrhythmias
Treatment of hypercalcemia includes:
D/C IV or PO calcium D/C thiazide diuretics Administer NSAIDs Administer phosphorus, calcitonin, and bisphosphonates Avoid foods high in calcium
Treatment of hypocalcemia includes:
Administer calcium PO or IV (For IV, warm before administering and administer slowly)
Administer aluminum hydroxide and vitamin D
Initiate seizure precautions
Consume foods high in calcium
10% calcium for acute calcium deficit
A client with a calcium imbalance is at risk for:
Pathological fracture
*Move patient slowly and carefully.
What is the role of magnesium (Mg) and its expected range?
Think of a sheriff - Mg maintains law and order in the muscles (mainly cardiac muscles and the uterus)
1.3 - 2.1 mEq/L
- Fun facts:
1. Most Mg is found in the bones
2. Ca is its BFF
Sign and symptoms of hypermagnesemia:
*TIP: “calm and quiet” and LOW everything
Low energy
Low HR/BP/RR
Decreased DTR
Hypoactive BS
Signs and symptoms of hypomagnesemia:
*TIP: “No sheriff = buck wild!” and HIGH everything
High HR/BP/RR Increased DTR (hyperreflexia) Hyperactive BS Shallow respirations Twitches/tetany/seizures Irritability/confusion Positive Trousseau's Positive Chvostek's
Treatment of hypermagnesemia includes:
Diuretics
IV administration of CaCl or calcium gluconate
Restrict dietary intake of Mg containing foods
Avoid the use of laxatives and antacids containing Mg
Treatment of hypomagnesemia includes:
Magnesium sulfate IV or PO
Seizure precautions
Instruct client to increase Mg containing foods
