ELECTROLYTES Flashcards

1
Q

ORDER OF HYDRATION

A
  1. Infant: priority
  2. older adult/elderly
  3. male
  4. female: least
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2
Q

High risk for dehydration

A

infants followed by elderly

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3
Q

Has delay to thirst regulating center

A

Older adults

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4
Q

Thirst regulating center

A

Hypothalamus

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5
Q

First sign of dehydration among elderly

A

Constipation

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6
Q

Fluid compartment:
Blood vessel (Plasma)
Measurable; 30% fluid

A

Extracellular/ Intravascular

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7
Q

Fluid compartment:
Life-threatening dehydration/ Systemic complication

A

Blood vessel (Plasma) or Extracellular/intravascular

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8
Q

Fluid compartment:
Cell
most abundant fluid 70%
localized complications

A

Intracellular

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9
Q

Fluid compartment:
in between cells
Same manifestation with intracellular

A

Interstitial

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10
Q

Low molecular weight (small molecules)
passes through fluid compartments
low oncotic pressure

A

Crystalloid

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11
Q

Hypertonic, isotonic, hypotonic

A

Crystalloid (Low oncotic pressure)

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12
Q

Stays in blood vessel
high molecular weight
High oncotic pressure

A

Colloid

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13
Q

Packed RBC, albumin, Plasma expander

A

Colloid (high oncotic pressure)

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14
Q

> 0.9% IVF

A

hypertonic

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15
Q

PNSS

A

isotonic

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16
Q

PLRS

A

isotonic

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17
Q

D5W

A

isotonic

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18
Q

0.9% IVF

A

Isotonic

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19
Q

0.25% nacl

A

hypotonic

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20
Q

0.33% nacl

A

hypotonic

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21
Q

0.45% nacl

A

hypotonic

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22
Q

<0.9 % IVF

A

Hypotonic

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23
Q

D50W

A

Hypertonic

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24
Q

D10W

A

Hypertonic

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25
Q

D5LR

A

Hypertonic

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26
Q

D50.9% nacl

A

Hypertonic

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27
Q

TPN

A

Hypertonic

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28
Q

D50.45% NACL

A

Hypertonic

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29
Q

IVF MANIFESTATIONS: (Cells to B. vessels)
-hypervolemia
- hypertension
-poluria
-cellular dehydration (dhn)
-dry mouth
-polydipsia
-dry skin
-altered mental status (confusion/ disorientation)

A

HYPERTONIC overdose

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30
Q

IVF MANIFESTATIONS: (B. vessels to cells)
-hypovolemia
-hypotension
-oliguria
-DHN
-edema
-ascites
-Cerebral edema

A

Hypotonic overdose

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31
Q

Normal value: sodium (na)

A

135-145 meq

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32
Q

Normal value: potassium (k)

A

3.5-4.5 (5.5) meq

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33
Q

Normal value: calcium (ca)

A

4.5-5.5 meq or 8-10 mg/dl

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34
Q

Normal value: Magnesium (mg)

A

1.5-2.5 meq

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35
Q

Normal value: Phosphorus (P)

A

2.5-4.5 meq

36
Q

Normal value: chloride (cl)

A

95-105 mg/dl

37
Q

Manifestation:
Fluid volume deficit
Late edema

A

hypernatremia

38
Q

Manifestation:
Fluid volume excess
early/ immediate edema

A

Hyponatremia

39
Q

Diet for hypernatremia

A

Na restriction
increase fluid intake :dilute sodium

40
Q

IVF of choice for hypernatremia

A

hypotonic

41
Q

Diet for hyponatremia

A

Fluid restriction
Nacl- table salt
NaNitrate- preservatives
NaSaccharide- sweetener
NaAscorbate- alkali vitamin c
NaHCO3- Baking soda
MSG- monosodium glutamate (vetsin)

42
Q

IVF of choice for Hyponatremia

A

Hypertonic
Isotonic (0.9% nacl)

43
Q

Tall/ peak/ dominant T-waves

A

Hyperkalemia

44
Q

Flattened T-waves

A

Hypokalemia

45
Q

ST depression

A

hypokalemia

46
Q

Presence of U waves

A

Hypokalemia (digitalis toxicity)

47
Q

ST elevation

A

Hyperkalemia

48
Q

Widening of QRS

A

hyperkalemia

49
Q

narrowing of QRS

A

hypokalemia

50
Q

Diet for hypokalemia

A

ABCDK
Apple
Banana
Citrus/catalope
Dried fruits (raisins, prune, apricots,
dates)
Kiwi

51
Q

DOC: for hypokalemia (oral)

A

Kalium durule

52
Q

DOC: for hypokalemia (IV)

A

KCL

53
Q

Nursing alert for KCL IV:

A

Never IV push
Incorporate in suloset

54
Q

DOC: Hyperkalemia antidote

A

Calcium gluconate (antidote)
-it doesn’t treat hyperkalemia but lowers HR
-Lower muscle contraction

55
Q

DOC: hyperkalemia

A

kayexelate
-na polysterone
-exchange sodium to potassium
-eliminate thru stool

56
Q

Side effect of Kayexelate

A

Hypernatremia
Effect is within 4-6 hours

57
Q

d5w + d50w = iv

A

glucose-Insulin infusion
-Increase blood sugar = decrease k
-effect: within 30 minutes
-k+ follows glucose into cells
-insulin transport glucose into cells

58
Q

pushes potassium into the cell

A

salbutamol/albuterol

59
Q

excrete potassium into urine

A

k+ wasting diuretic (furosemide/lasix)

60
Q

DOC FOR HYPERKALEMIA (SATA)

A

-kayexelate: exchange na to k
-glucose-insulin infusion: follows glucose in the cell
-salbutamol/ albuterol: pushes k into the cells
-potassium wasting diuretic (furosemide/lasix): excrete k+
-hemodialysis: eliminates excess electrolytes

61
Q

electrolyte that intitiate muscle contracton (large & skeletal muscles)

A

Calcium

62
Q

The effect of ___ is opposite to ___ electolytes.

A

k+ & ca+

63
Q

Electrolyte manifestation:
increase Muscle contraction
high RR (hyperventilation)
increase mental alertness
insomnia
muscle spasm
leg cramps
fatigue (hypercontraction)
facial twitching
extreme facial twitching
osteoporosis

A

hypocalcemia

64
Q

decrease muscle contraction (relaxation)
low HR & RR (hypoventilation)
decrease mental alertness
drowsiness
lethargy
muscle weakness
fatigue
apathy
renal calculi (stones)

A

hypercalcemia

65
Q

DIET: hypercalemia

A

Low calcium
High sodium: it excretes ca+
increase fluidi ntake

66
Q

DOC for hypocalemia

A

calcium gluconate & Amphogel
calcium gluconate
-never give ca+ in NSS
-Given in D5 containing IV
“SODIUM LOSSES CALCIUM”
Amphogel
-phosphate binder
-increase ca+ in blood

67
Q

DOC for hypercalcemia

A

Mitharcin & Magnesium Sulfate
Mitharcin
-block parathyroid hormone to absorb ca+ in blood
Magnesium Sulfate
-maintains ca+ in bone

68
Q

DIET: HYPOCALCEMIA

A

-Increase ca+ diet
-milk dairy products
-anchioves (cheapest)
-ca+ supplement
-vit D supplement= absorb of calcium

69
Q

CARDIAC ARREST

A

METABOLIC ACIDOSIS
=(-) blood flow; leads to cell deprivation of O2 (alkaline) ; results to METABOLIC ACIDOSIS.
=Give sodium bicarbonate

70
Q

IVF for crash collision

A

Mannitol
-Returns fluids into blood vessels from cells

71
Q

DM pt with 300mg/dl RBS; Whats the nursing Dx

A

FLUID VOLUME DEFICIT
-Excess sugar dehydrates the Cell.

72
Q

Mr. Rey is admitted in the ER. Suffered from vehicular accident and develops cerebral edema. Unconscious GCS=6. Which fluid should the nurse questioned?
A.D5LRS
B.D50.9% NaCl
C.0.33% NaCl-
D.D5 half saline

A

A.D5LRS-hyper
B.D50.9% NaCl -hyper
////***C.0.33% NaCl- hypo
D.D5 half saline–hyper

73
Q

The nurse is caring for Mrs. C with dx DM insulin dependent. Pt complains of Excess thirst. Blood sugar= 200 mg/dl and pt develops polyuria at night. Which fluids should be administered.

A

HYPOTONIC IVF.

74
Q

What electrolytes is being withhold with pt. Mieniere Disease?

A

Ménière disease -is a disorder caused by build of fluid in the chambers in the inner ear.
Nurses withhold sodium minerals.
-Sodium restriction to reduce fluid pressure in the inner ear.

75
Q

presence of U-wave is due to

A

Hypokalemia due to Digitalis toxicity

76
Q

initiate contractions

A

ca+

77
Q

maintains Contractions; life threatening electrolytes

A

k+

78
Q

Pt. With renal failure has a potassium level of 6.8 MEQ. what should the nurse monitor?

A

HR & pulse rate

79
Q

IVF that promotes peristalsis. Post-op

A

KCL

80
Q

pt with renal failure with K+ level of 6.8 meq was given calcium gluconate, what is the primary purpose of Calcium gluconate

A

TO PREVENT ARRYTHMIA AND LOWERS HEART RATE, NOT LOWERS POTASSIUM LEVEL.

81
Q

What is the initial nursing action or drug to be given first for patient with hyperkalemia?
A.Glucose insulin Infusion
B.Calcium gluconate
C.Kayexelate

A

A.Glucose insulin Infusion
///***B.CALCIUM GLUCONATE
C.Kayexelate

82
Q

First sign of MGSo4 toxicity

A

Absence of knee jerk reflex

83
Q

high and fast

A

K+

84
Q

Everything is low and slow

A

ca+ & mg+

85
Q
A