electrolytes Flashcards
potassium (K)
regulates cell excitability. conduction of cardiac rhythm assists with acid base balance
normal level: 3.5 - 5 mEq/L
lost through vomiting
foods:
bananas, oranges, dates, figs, apricots
potatoes, tomatoes, carrots, spinach
dairy, meats
sodium (Na+)
regulates fluid volume -> helps maintain blood volume
acid balance/stimulates conduction in the nerves
interacts with calcium to maintain muscle contraction
normal level: 136 - 145 mEq/L
active transport: regulated by aldosterone and ADH
lost through: perspiration, feces. excess water intake, influences H2O distribution
foods:
table salt, cheese, milk, canned products
magnesium (Mg)
protein carb metabolism. protein/DNA synthesis in the cell. maintains ICF level of potassium.
involved in electrical activity in nerve, muscle (heart)
normal level: 1.3 - 2.1 mEq/L
lost through: diuretics, poorly controlled DM, excessive alcohol intake
foods:
green veggies, cereal, grains, nuts
chloride (Cl-)
works with sodium to maintain osmotic pressure
combines with hydrogen = hydrochloric acid (gastric secretions)
buffer in oxygen - CO2 exchange in RBCs
assists with acid base balance
normal level: 98 - 106 mEq/L
lost: when potassium is lost
foods: foods high in sodium
phosphate
promotes muscle/nerve action
assists acid base
important for: cell division, transmission of hereditary traits
promotes energy storage and carbohydrate protein and fat metabolism
normal level: 3.0 - 4.5 mg/dl
foods:
meat, fish, poultry, carbonated beverages, legumes
calcium (Ca)
promotes transmission of nerve impulses
bone and teeth development
regulates muscle contractions
absorption is stimulated by vitamin D
aids coagulation
normal level: 9.0 - 10.5 mg/dL
foods:
milk (products)
dark green veggies
salmon, breads, cereals
hypocalcemia < 9 mEq/L
causes:
malabsorption
hyperphosphatemia
vitamin D deficiency
pancreatitis
hypoparathyroidism
s/s:
numbness, tingling in fingertips and lips, tetany, muscle twitches/spasms, hyperactive DTR, convulsions, positive Chvostek’s and Trousseau’s signs, diarrhea
treatment:
monitor I/Os
serum calcium
increase calcium diet
seizure precautions
calcium gluconate and emergency equipment in case of emergency: oral supplements given 1 - 1 1/2 hour post eating; calcium supplements
hyperglycemia > 10.5 mEq/L
causes:
hyperparathyroidism
malignant bone disease
prolonged immobilizations
excess supplements
thiazide diuretics
s/s:
muscle weakness, N/V, polyuria, decrease of reflexes, bone pain, polydipsia, constipation, anorexia, kidney stones, bradycardia, bizarre behavior
treatment:
monitor I/Os
strain urine for stones
encourage fluid and fiber intake
eliminate calcium supplements and foods
IV NS
loop diuretics
severe: dialysis
hyperkalemia > 5.0 mEq/L
causes:
potassium sparing diuretics
ACE inhibitors (Lisinopril)
renal failure
acidosis/DKA
major trauma
most dangerous electrolyte disorder
potential cardiac arrest if untreated regular insulin removes potassium in vascular space in cells to decrease serum level
s/s:
muscle weakness, flaccid paralysis, dysrhythmias, deep tendon reflexes decrease, tall peaked T waves on ECG, N/V/D, abdominal cramping, hyper active bowels
treatment:
monitor I/Os and K+ level
continuous cardiac monitoring
sodium polystyrene sulfate (kayexalate)
loop diuretics
regular insulin
restrict K+ diet
slow admin of calcium gluconate
severe: dialysis
hypernatremia > 145 mEq/L
causes:
excessive sodium intake
H2O deprivation
profuse sweating
heat stroke
DB insipid-us
administration of hypertonic tube feeding
kidney failure retention of Na+
s/s:
thirst, dry mouth, edea, elevated temp, tachycardia, agitation, flushed skin, oliguria, hallucination, confusion, lethargy, seizures
treatment:
monitor I/Os and Na+ level
monitor VS and LOC daily weight
restrict Na+ from diet
increase H2O intake
loop diuretics
IV solutions without Na+
hyperphosphatemia > 4.5 mEq/L
causes:
renal failure
hyperthyroidism
chemotherapy
excess phosphate laxatives
s/s:
short term tetany, paraesthesia in fingertips and mouth, muscle cramps, long term calcification in soft tissue
treatment:
correcting underlying condition
monitor serum level
monitor for tetany
severe: aluminum hydroxide with meals
increase in phosphorus = decrease in calcium
hypermagnesemia > 2.1 mEq/L
causes:
renal failure
adrenal insufficiency
excess magnesium
s/s:
flushing/warm skin, hypotension, hypoactive DTRs, bradycardia, drowsiness, lethargy, depressed respirations
treatment:
monitor VS
airway monitor DTRs
IV fluids
loop diuretics
avoid magnesium based antacids and laxatives
restrict magnesium in diet
calcium gluconate for cardiac changes
hyponatremia < 136 mEq/L
causes:
chronic diuretic use
GI fluid loss
poor intake/low Na+ diet
excessive intake of H2O, hypotonic fluids
adrenal insufficiency
syndrome of inappropriate ADH hormone (SIADH): causes the body to secrete too much ADH and hold onto fluid - this dilutes sodium level
s/s:
anorexia, lethargy, twitching seizures, N/V, confusion, weakness, muscle cramps
treatment:
monitor I/Os and Na+ level
daily weight
increase PO Na+
administer IV saline
seizure precautions
if due to fluid overload dilution of sodium H2O
if increases weight 1 - 2 lbs over 24 hr or 3 lbs in a week notify provider
hypomagnesemia < 1.3 mEq/L
causes:
chronic alcoholism
malabsorption
DKA
prolonged gastric suction
s/s:
disorientation, mood changes, neuromuscular irritability, dysrhythmias, sensitivity to digoxin, hyperactive DTR, positive Chvostek’s and Trousseau’s sign, tetany, seizures, hypoactive bowels
treatment:
monitor I/Os
encourage high magnesium foods
avoid alcohol
monitor digoxin toxicity
hypocalcemia
hyperchloremia
s/s:
lethargy, hypotension, thirst, weakness, dehydration, decrease in LOC
treatment:
restrict sodium/chloride
IV LR
