ELECTROLYTES

Question 1

Sodium range

Answer 1

135-145mEq/L

Question 2

Hyponatremia Sx

Answer 2

abdominal cramping
HT
loss of urine
spasm on muscles
weakness
decreased RR
seizure

Question 3

Hyponatremia- Cx

Answer 3

V, D,
kidney failure
SAIDS

Question 4

Hyponatremia- Assessment

Answer 4

cardiac
GI
renal
neuro
respiration

Question 5

Hyponatremia- NI

Answer 5

hypovolemic- administer IV saline 3%
hypervolemic- restrictions fluids, diuretics
Na rich foods
check Li+

Question 6

Hypernatremia- Sx

Answer 6

flushed, red skin
edema
thirst
confusion
fluid retention
decreased urine output
increased BP

Question 7

Hypernatremia- Cx

Answer 7

Cushing’s disease
increased Na intake

Question 8

Hypernatremia- Assessments

Answer 8

neuro
edema
respiration
cardiac
weight.

Question 9

Hypernatremia- NI

Answer 9

restrict Na intake
safety- confusion
weight

Question 10

Hypokalemia- Sx

Answer 10

heart- decreased HR, BP
EKG- ST depression, shallow T wave, prominent U wave
respiration- depressed
muscles- hypoactivity, weak, decreased reflexes
GI- hypoactivity
LATE- paralytic ileum

Question 11

Hypokalemia- Cx

Answer 11

diuretics
adrenal sufficiency- Cushing’s disease
K+ excretion- V, D, GI suction
medication- insulin, aldosterone

Question 12

Hypokalemia- Assessment

Answer 12

cardiac- EKG
GI
respiration
neuromuscular
Labs
renal
Mg. (both go down)

Question 13

Hypokalemia- Tx

Answer 13

oral supplement- with food
IV infusion
HOLD K+. wasting diuretics

Question 14

Hypokalemia- NI

Answer 14

Digoxin- check K+ levels– digoxin toxicity
K+ rich. food- green leafy food, fruits, potatoes, fish, carrots, cantaloupe

Question 15

K+ IV Infusion: Things To Remember

Answer 15

SLOW– can cause infiltration, phlebitis
urine output is adequate– NTP if <20mL for 2 straight hours

Question 16

Hyperkalemia- Cx

Answer 16

burns- leave cell to balance e-
tissue damage- rupture, K+ spills into bloodstream
acidosis- gets out of cells to balance
Adrenal insufficiency– releases aldosterone (hold Na&H2O, get. rid of K+) <- doesn’t work= Addison’s disease
renal failure- retention
Drugs- K+ sparing diuretics, ACE, NSAIDS

Question 17

Hyperkalemia Range

Answer 17

3.5-5.0mEq/L

Question 18

Hyperkalemia- Sx

Answer 18

Heart- decreased HR, BP– contracted
EKG- tall T waves, prolonged QRS segment, absent P wave
Respirations- decreased– contracted diaphragm
GI- hyperactive sounds, motility– D
Muscles- hyperactive, muscle spasm– too many stimuli
LATE- weak muscles, flaccid– give out from contractions

Question 19

Hyperkalemia- Assessment

Answer 19

cardiac- EKG
neuromuscular
renal
respiratory
K+
GI

Question 20

Hyperkalemia- Tx

Answer 20

Sodium Polystyrene Sulfonate- D
IV sodium bicarb- corrects acidosis
IV calcium gluconate- decreases muscular irritability
diuretics- waste

Question 21

Calcium range

Answer 21

8.5-10.5mEq/L

Question 22

Hypocalemia- Cx

Answer 22

decrease vitamin D intake
decreased parathyroid– regulates Ca
wound drainage- alcoholism, bulimia
wound drainage- GI absorption
Crohn’s disease.
pancreatitis- stimulates calcitonin- moves Ca from blood into bones
kidneys- excrete too much Ca
increased Phosphate levels
medication- laxative, diuretics

Question 23

Ca use

Answer 23

bones, teeth, coagulation, nerve/muscles

Question 24

What E- does the opposite of Ca?

Answer 24

Phosphate

Question 25

What goes hand-in-hand with Ca?

Answer 25

vitamin D

Question 26

Vitamin D helps Ca in what ?

Answer 26

absorption

Question 27

Hypocalemia- Sx

Answer 27

confusion hyperactive reflexes muscle spasm-- GI spasms= D Positive Trousseaus Signs of Chvostek

Question 28

Positive Trousseaus

Answer 28

BP cuff on for 3 minutes, watch hands, if flexing= POSITIVE

Question 29

Signs of Chvostek

Answer 29

hyper excitability of face-- tap on jay, if flexing= POSITIVE

Question 30

Hypocalcemia- NI

Answer 30

safety- bones are fragile, increased risk of fractures check digoxin levels- low Ca lead to toxicity monitor phosphate levels- opposite of Ca Ca rich foods- milk, cheese, yogurt, sardines, tofu take Mg & vitamin D- helps increase Ca

Question 31

Hypocalcemia- Tx

Answer 31

IV Ca glutamate oral Ca & Vitamin D- with with, absorbed in the GI

Question 32

Ca glutamate NI

Answer 32

slow, watch for infiltration, inflammation-- hard on veins

Question 33

K+ use

Answer 33

responsible for heart and muscle contractibility

Question 34

Hypercalcemia- Cx

Answer 34

hyperparathyroidism antacids low phosphate increased vitamin D intake thiazide intake Addison's disease lithium usage- decreased phosphate, increasing Ca

Question 35

Hypercalcemia- Sx

Answer 35

Heart- low HR, RR, BP Respiration- SOB, weak respiration GI- hypoactivity- C N, V- trying to. get rid of Ca Muscles- decreased DTR BONE PAIN

Question 36

Hypercalcemia- NI

Answer 36

Safety- falls Monitor I&O IV fluids- prevent kidney stones Avoid high. Ca foods- green leafy foods, sardines, dairy

Question 37

Hypercalcemia- Tx

Answer 37

Lasix IV phosphate- worst enemy, decrease Ca Calcium reabsorption inhibitors- calcitonin (back in the bone), biphosphonate, Aspirin, NSAIDS

Question 38

What precautions are put in place for low Ca?

Answer 38

seizure precaution

Question 39

Hypercalcemia- EKG

Answer 39

shortened QT, prolonged ST interval

Question 40

Hypokalemia- EKG

Answer 40

ST depression, prominent U waves, shallow T waves

Question 41

Hyperkalemia- EKG

Answer 41

Tall T waves, prolonged QRS, ST depression