Electrolytes

Question 1

Hypokalemia
DITCH

Answer 1

Decrease of potassium in the blood
Causes: “DITCH”

D= Drugs ( Laxatives, diuretics)
I= Inadequate intake of K+
T= Too much water intake
C = Cushings disease
H = Heavy fluid loss

Question 2

Hyperkalemia
CARED

Answer 2

Too much potassium in the blood
Causes:

Cellular movement of K+ from intra-extra cellular
Adrenal Insufficiency
Renal failure
Excessive K+ intake
Drugs ( K+ sparing diuretics)

Question 3

Hypercalcemia
HIGH CAL

Answer 3

Too much calcium in the blood
Causes:
Hyperparathyroid
Inadequate intake of Ca+
Glucocorticoid
Hyperthyroid
Calcium excretion
Adrenal Insufficiency ( Addison Disease)
Lithium usage (causes decrease phos & Ca+ increase)

Question 4

Hypernatremia
( High salt)

Answer 4

Excessive salt in the blood
Causes:
Hypercortisolism
Increased NA+ intake
GI feeding w/ inadequate H2O
Hypertonic solutions
Sodium excretion (decreased)
Aldosterone reabsorption
Low fluid intake
Thirst impairment

Question 5

Hypocalcemia
Low calcium

Answer 5

Low calcium in the blood
Causes:
Low parathyroid hormone
Oral intake inadequate
Wound drainage ( GI system)
Celiac or Crohn’s disease
Acute pancreatitis
Low vitamin D
Chronic kidney disease
Increased phospho levels
Using meds ( laxatives & diuretics)
Mobility Issues

Question 6

Hypermagnesemia
MAG

Answer 6

Causes:
Less common than hypomagnesemia…can happen if you’re trying to correct low mag w/ magnesium sulfate administration

Magnesium containing antacids & laxatives
Addisons Disease (adrenal insufficiency )
Glomerular Filtration (30ml/min) R. Failure

Question 7

Hypermagnesemia
Signs and symptoms
“Lethargic “

Answer 7

Lethargy (profound) really weak
EKG Changes PR & Qt interval QRS complex
Tendon reflexes absent/ diminished
Hypotension ( low BP)
Arrhythmias (bradycardia, hrt block)
Respiratory Arrest
GI issues (nausea/vomiting)
Impaired breathing
Cardiac Arrest

Question 8

Hyponatremia
NONA+

Answer 8

• Na+ excretion increased w/ renal problems, NG suction, vomiting, diuretics, sweating & diabetes insipidus ( low aldosterone , wasting na+)

• Overload of fluids (CHF, hypotonic, fluids, liver failure)

• Na+ intake low through low salt diet, & NPO status

• Anti-diuretic hormone over secreted (SIADH) adrenal insufficiency

Question 9

Signs & Symptoms of
Hyponatremia
“SALT LOSS”

Answer 9

• Seizures & Stupor
• Abd. cramping, attitude changes
• Lethargic
• Tendon reflexes diminished,
• Loss of urine or appetite
• Orthostatic hypotension, Overactive Bowels
• Shallow respirations
•!Spasm of muscles

Question 10

Hypomagnesemia
Causes
Low Mag

Answer 10

• Limited intake of Mg+ ( starvation)
• Other electrolyte issues causes low mg+ ( Hypokalemia & hypocalcemia)
• Wasting Mg+ via kidneys

• Malabsorption issues (Celiac & crohns)
• Alcohol ( poor dietary intake) stimulates kidneys to waste magnesium
• Glycemic issues (DKA, insulin)

Question 11

Hypercalcemia
Signs and symptoms
WEAK

Answer 11

• Weak in muscles
• EKG changes (shortened QT
• Absent reflexes, absent minded
• Kidney atone formation

Question 12

Foods high in iron (FE+)
Eat lots of Iron

Answer 12

• Egg yolks
• Apricots
• Tofu
• Legumes
• Oysters
• Tuna
• Sardines or Seeds
• pOtatoes
• Fish
• Iron fortified cereals
• Red meat
• pOultry
• Nuts

Question 13

Signs and symptoms
Hypocalcemia
“CRAMPS”

Answer 13

• Confusion
• Reflexes hyperactive
• Arrhythmias
• Muscle weakness
• Positive Trousseau sign
• Sign of Chvostek sign

Question 14

Hyperphosphatemia
“PHOSHI”
Signs and symptoms

Answer 14

Excessive amount of phosphate in the blood.

•Phosphate containing (laxatives & enemas
• Hypoparathyroidism (decrease secretion of PTH)
• Overuse of vitamin D (helps w/absorption of phos.)
• Syndrome of lysis (occurs w/chemo tx)
•rHabdomyolysis (rapid necrosis of muscles)
• Insufficiency of Kidneys (ESRF)

Question 15

Signs & Symptoms
Of
Hyperkalemia
“MURDER”

Answer 15

MURDER
• Muscle weakness
• Urine production low or absent
• Respiratory failure
• Decreased Cardiac contractility
• Early signs of muscle twitching
• Rhythm changes:
• Tall peaked T-waves
• flat p-waves (absent)
• wide QRS prolonged PR interval

Question 16

Signs and symptoms
Of
Hyperphosphatemia
“CRAMPS “

Answer 16

• Confusion
• Reflexes hyperactive
• Arrhythmia
• Muscle weakness in calves/feet
• Positive Trousseaus sign
• Sign of Chvostek sign

Question 17

Nursing Interventions
Of
Hyperphosphatemia

Answer 17

• administer phosphate-binding drugs
(Phoslo)
• GI System…puts phosphate in stool
to be excreted
• 0 phosphate laxatives and enemas
• Restrict foods rich in phosphate such as: Fish, nuts, chicken, beef, organ meats, pork and whole grains

Question 18

Hypophosphatemia
“ BROKEN “

Answer 18

• Breathing problems due to muscles weakness.
• RHabdomyolysis caused by electrolyte disorder necrosis of muscles: when it releases myoglobin in blood toxic to kidneys
•Osteomalacia bone fx, bone deformity, decreased cardiac output
• Neuro changes: irritability, confusion & seizures
• Kills immune system ( suppression) decreased platelets
• Extreme weakness

Question 19

Hypophosphatemia
“Low Phosphate

Answer 19

• Pharmacy: Aluminum hydroxide-based & magnesium based antacids cause’s malabsorption of phos. Lack of Vit. D
• Hyperparathyroidism due to increased PTH. Plays a role in Ca+ & phos. Levels normally inhibits reabsorption

Question 20

HYPOKALEMIA II
Signs and symptoms

Answer 20

• Everything is low and slow
• weak pulse ( irregular thready)
•Orthostatic hypotension
• decreased bowel sounds
“ reflexes flaccid
• paralysis
• confusion
• weak shallow resp.
• diminished breath sounds
• EKG’s: depressed ST segment or
Flat or inverted T- wave or U-wave

Question 21

Hyperphosphatemia
‘Signs and symptoms
“CRAMPS

Answer 21

• Confusion
• Reflexes hyperactive
• Anorexia
•!Muscle spasm in calves, feet, tetany and seizures
• Positive Trousseau sign
• Sign of Chvostek sign