Electrolytes Flashcards
What causes build - up of electrolytes in the Blood?
- Kidney failure
- Massive Blood transfusion
- Tumors
- Diseases
Hypophosphatemia
Phosphate level BELOW 3.5 Mg/dL
Hyperphosphatemia
S/S
- EKG changes
- Hypocalcemia
- Hypotension
Hyperphosphatemia
Treatment
- Phosphate binder- binds to food in GI tract & excreted - Phoslow (GIVE WITH FOOD)
- Managing bypocalcemia will help correct hyperphosphatemia
Hypokalemia
Potassium level:
BELOW 3.5 mEq/L
Hyponatremia:
Causes
- Excessive sweating, water intake, infusion of d5w
- Excess ADH
- Low Na diet
- Vomiting
- Fluid Overload
Hypermagnesia:
Treatment
- Dialysis
- Diuretics
- Give IV isotonic solution NS/LR to enhance renal excretion
Hyperphosphatemia
Phosphate level HIGH than 4.5 Mg/dL
Hyperphosphatemia
Causes
- Renal insuffiency
- Hypoparathyroidism
- Incrase intake of phosphorus: Enemas, laxitives
Hyperchloremia
Causes
- Increase chloride intake
- Increase chloride retention- renal insuffiency
- Dehydration
- Kaexalate (causes Na to be exchanged with K in the bowel, chloride follows sodium)
How do we get rid of excess Electrolytes?
- Kidneys
- Waste products
- Sweat
Hyponatremia
Sodium Value: BELOW 135mEq/L
Hyponatremia:
S/S
- Cerebral Edema (water from ECF to ICF)
- Headache
- Dioriented
- Seizures
- Weak, rapid, pulse
- Hypotension
Hypomagnesia
Causes
- Alcoholism
- Poor dietary intake
- Starvation
- Intestinal diseases
- Diarrhea
- Use of loop diuretcs
Hypokalemia:
Causes
- Vomiting & Diarrhea
- NG suction
- K+ wasting diuretics
- NPO
- Anorexia
- Increase intake of Na
- Pt recieving insulin
Hypermagneisa
Magnesium level HIGHER than 2.1 mEq/L
Hypermagnesia:
Causes
- Renal Failure
- Increased Mg intake
- Treatment for Preg Induced Hyperten
- Excessive use of anatacid, laxatives, enemas
- OVER SEDATIVE EFFECT
What role do certain hormones play in balance of electrolytes?
Insulin
grabs both K+ and glucose and takes them out of vascular space and into the cell
give glucose with insulin
PTH (parathyroid hormone)
moves Ca from bone to blood- makes Ca increase
Calcitonin (secreted by Thyroid)
Decreases Ca by making it move from vascular space into the bone.
Hypernatremia
Sodium level: HIGHER than 145mEq/L
Hyperkalemia:
Treatments
Low K+ diet
Dialysis
Medications:
- Diuretics- potassium wasting (lasix)
- insulin
- hypertonic dextrose
- sodium bicarbonate
- Calcium Gluconate (Ca decreases excitbablity effect)
- Caclium Chloride
- Kayexalate
Hypochloremia
Treatment
- Prevent excessive diaphoresis, vomiting or excessive suctioning
- Can give salty broth
- infuse NS
Hyperchloremia
Chloride level: HIGHER than 108 mEq/L
Hypernatremia:
Treatment
- Encourage water intake, Na restriction diet
- Diuretics- K & Na wasting
- Hypotonic or isotonic IV solution
Hypochloremia
Chloride level BELOW 98 mEq/L
Hypophosphatemia
Treatment
- DC antacid & calcium supplement
- Increase intake of Ph rich foods
- Decrease calcium rich foods
- Give Vit D Supplement (Increase absorption of Ph)
Hyperkalemia
Potassium level:
GREATER than 5.0 mEq/L
**Sodium **
Normal Value:135-145 mEq/L
- Dependent on how much water is in the body
- Only electrolyte affected by amount of water in body
- Increases cell membrane permeability, controls contractility & nerve impulses
- INVERSE realationship with K+ = 3Na, 2K
- Excreted through the kidneys, GI tract & sweat
Dietary sources: Canned soup & veggiee, cheese, ketchup, processed meat, table salt, salty snack food, seafood.
Hypocalcemia:
S/S
- EXCITABLE EFFECT
- Positive Chvostek’s sign
- Positive Trousseau sign
- Frequent charley horses
- Increased Peristalsis, Hyperactive Bowels
- Siezures
Potassium
MOST IMPORTANT ELECTROLYTE
Normal value: 3.5-5 mEq/L
- Regulates cardiac rhythms, neuromuscular function & allows strong heart conduction & contractility.
- K+ has an INVERSE relationship with Na+
- Excreted by kidneys
- Aldosterone helps regulate K+
- EXCITABLE effects on Heart and intestine
Dietary Sources: Bananas, organes, green leafy veggies, fruit juices, dried fruit
Hypokalemia:
S/S
DECREASED EXCITABILITY
Fatigue Nausea
Anorexia Vomiting
Muscle weakness
Resp. distress
Rapid, weak pulse
Flat T wave
Hypoactive bowel sounds
Hypocalcemia:
Causes
- Hypoparathyroidism
- Poor dietary intake
- Poor Vit D intake
- Hyperphosphatemia
- Diarrhea
- Alkalosis
- Renal failure
- EXCITABLE EFFECT
Hyperchloremia
S/S
- RARELY produces s/s of its own
- IF patient has hyperchloremia than the pt is most likely to have HYPERNATREMIA- look for those s/s
Hypomagnesia
Treatment
- DC loop diuretics
- Admin. IV Mg Sulfate
- Place on telemetry
Hypercalcemia
Caclium level: HIGHER than 10.5 Mg/dL
Hyperkalemia:
S/S
OVER EXCITABILITY
Muscle weakness
Tachycardia to Bradycardia to Cardiac arrest
Peak T wave
Intestinal cramping
Cramping & twitching
Hypernatremia:
Causes
- NPO for extended time
- Excessive Na intake: dietary & IV fluids
- Excessive Na rentention: Renal failure, crushing disease
- Fluid loss: feve, diaphoresis, burns, hyperventilation, V & D
- Tube feeding: hydrochloric acid- excessive
- Dehydration
Hypercalcemia:
Treatment
- Reduce dietary intake
- Increase excretion of Ca by hydrating with NS
- Stop supplements with calcium (anatacid)
- DC Thiazide diruetic
- Give lasix
Hypochloremia
Causes
- Excessive sweating
- vomiting
- Diarrhea
- Nasogastric suctioning
- Laxatives
- Diuretics
Hypokalemia:
Treatment
Encourage foods rich in K+
K+ supplements
K+ IV supplements- DILUTE & GIVE SLOWLY
K+ Sparing diuretics
Avoid salt subtitutes
NEVER GIVE IV PUSH
ALWAYS RUN ON PUMP
Chloride
Normal value: 98-106 mEq/L
- found in ECF
- Follows Sodium
- helps in forming CSF & produced mainly in stomach in form of hydrochloric acid
- absorbed in intestines & excreted by kidneys
Dietary sources: Fruits, veggies, table salt, salty foods, processed food.
Hypophosphatemia
Causes
- Malnutrition
- Alcohol Abuse
- Hypercalcemia
- Hyperparathyroidism
- Antacids
- Respiratory Acidosis
Hypocalcemia
Treatment
- Oral & IV Ca supplements
- Vit D supplements
- Reduce Stimulation
- Seizure precautions
- Use sheet while lifting (THIN SKIN)
Hypercalcemia:
causes
- Hyperparathyroidism
- Cancer
- Hyperthyroidism
- Immobility
- Excess Ca intake
- Excess intake of Vit D
- Thiazide Diuretics
- Renal insuffciency
- OVERLY SEDATIVE
Hypermagnesia:
S/S
- Slow resp rate
- Weakness, Lethargy
- CNS depression
- Facial Paresthia
- Hypotension
- Bradypnea
- OVER SEDATIVE EFFECT
HYPERKALEMIA:
Causes
Renal failure
K+ sparing diuretics
Excessive K+ intake
Blood transfusion of RBC
Acidosis
Hypoaldosteronism
Hypercalcemia:
S/S
- Fatigue
- Depression
- Confusion
- Fractures
- Blood Clots
- Kidney stones
- Decreased Muscle tone
- Bradycardia
- OVERLY SEDATIVE
Hyperchloremia
Treatment
- Sodium and chloride intake will be RESTRICTED
- Doctor may order Diuretics
- Infusion of Lactated Ringers to spend renal excreation
Calcium
Normal value: 9.0-10.5 mEq/L
- 99% found in teeth & bones
- effects capillary permeability, essential for blood clotting , sedative effect on the nerve & muscle activity.
- INVERSE relationship with phosphorus
- absorbed by small intestin & excteted by kidneys & BM
- vit. D needed for calcium absorption
Dietary sources: Milk, Yogert, cheese, green leafy veggies, nuts
Magnesium
Normal Level: 1.3-2.1 mEq/L
- 60% stored in bones & cartilage
- activates enzymes essental for proper carb metablolism & maintains neuromuscular stability
- absorbed in GI tract & excreted by Kidneys
- SEDITIVE EFFECT
Dietary sources: Chocolate, nuts, dry beans, green leafy veggies, seafood, whole grain, meats
Hypochloremia
S/S
- Tetany
- Hyperactive deep tendon reflexes
- Arrythmias
- Seizures
- S/s of Hyponatremia
Hypernatremia:
S/S
- Tachycardia
- Hyperthermia
- decreased urine output
- effects on brain cells
- restlessness
- lethargy, weakness, seizures, coma, confusion
Hyponatremia:
Treatment
- Fluid restriction- BEST TREATMENT
- Oral Na Supplements
- High Na Diets
Hypomagnesia
S/S
- Confusion
- psychotic behavior
- Delusions
- Decreased gastric mobility
- Constipation
- Shallow resp
- Tacycardia
- twitches
Hypomagnesia
Magnesium level BELOW 1.3 mEq/L
Hypophosphatemia
S/S
- Weak, skeletal muscles
- Decreased bone density= Fractures
- Severe Seizures
- Arrhythmias
- Shallow resp.
Phosphorus
Normal value: 3.5-4.5 mg/dL
- 85% found in bones & teeth
- essential for RBC and muscle cells, helps with the metabolism of carbs, protien, and fat
- Absorbed in the intestines and excreted thru kidneys
- Assist with acid/base balance
- INVERSE relationship with calcium
Dietary Source: Cheese, eggs, milk products, organ meats, whole grains.
Hypocalcemia
Calcium level BELOW 9.0Mg/dL
