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Fluid and electrolytes > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

Sodium

A

135-145

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2
Q

Pottassium

A

3.5- 5.0

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3
Q

Phosphate

A

3-4.5

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4
Q

Magnesium

A

1.3-2.1

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5
Q

Chloride

A

97-107

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6
Q

Calcium

A

9.0-10.5

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7
Q

Importance of electrolytes

A
  • Regulate water distribution.
  • Govern acid-base balance.
  • Transmit nerve impulses.
  • Contribute to energy generation and blood clotting.
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8
Q

Major ICF electrolytes

A

Potassium
Magnesium
Phosphate

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9
Q

major cations

A

hydrogen
magnesium
pottassium
calcium
sodium

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10
Q

Major anions

A

bicarbonate
phosphate
chloride

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11
Q

Major ECF

A

Sodium
Chloride
Bicarbonate

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12
Q

Functions of sodium

A

Fluid distribution
Nerve/muscle impulses
Acid-base balance

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13
Q

How is sodium regulated

A

In the kidneys by the SODIUM POTASSIUM pump
Regulated by secretion of aldosterone and ANP

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14
Q

Sources of sodium

A

Breads, cereals, chips, cheese, processed meats such as lunch meats, hot dogs, bacon, ham
Commercially canned foods
Table salt

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15
Q

In hyponatremia Water moves from
_________to the ______causing
the cells to swell

A

From ECF to cells

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16
Q

Causes of hyponatremia

A

**Increased excretion: **
* Vomiting/diarrhea/sweat
* Wound drainage
* SIADH- ↑ADH holds on to water and dilutes Na
* Addisson’s disease-↓Aldosterone causes wasting of Na and K retention
* Kidney disease
* Thiazide diuretics
* * Fluid Overload – CHF, hypotonic IVF, Renal Failure
Dilution of sodium via hypotonic solutions, excess intake of water, hyperglycaemia

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17
Q

Signs and symptoms of hyponatremia
SALT LOSS

A

SALT LOSS
Seizures and stupors
Abdominal cramps, overactive bowel sounds, diarrhea
Lethargy
Tendon reflexes <
Loss of appetite
Orthostatic hypotension,
Shallow respirations
spasms (Muscle)

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18
Q

Nursing interventions for hyponatremia
ADD SALT

A

Administer IV saline solutions.
Diuretics or dialysis
Daily weights
Safety due to orthostatic hypotension
Airway precautions
Limit water intake
Teach sodium diet

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19
Q

Hypernatremia is too much __________ and not enough _______

A

salt
water

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20
Q

Signs and symptoms of hypernatremia
NOFRIEDFOODS

A

NO FRIED FOODS
F = fatigue, fever
R = restless, agitated
confused
I = increased reflexes
(seizure/coma)
E = extreme thirst*
D = decreased urine
output, dry
mouth/skin

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21
Q

Causes of hypernatremia
HIGHSALT

A

HIGH SALT
Hypercortisolism ( Cushing’s syndrome)
Increased sodium intake
GI tube feeding, diabetes, diarrhea
Hypertonic IV solutions

Sodium excretion decreases (Corticosteroids)
Aldosterone problems
Loss of fluids
Thirst impairment

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22
Q

Functions of potassium

A

Fluid balance
Muscle contraction
Elecrical conductivity
Acid-base balance

23
Q

How is potassium regulated

A

Sodium
potassium pump
pH level

24
Q

Signs and symptoms of hypokalemia
7 Ls

A

L = lethargic
L = low/shallow
respirations/ pulse
L = lethal cardiac
dysrhythmias
(Also: ↓ST, ↓T,
↑U)
L = loss of urine
L = leg cramps
L = limp muscles
L = low BP & HR

25
Q

Interventions of hyperkaleamia
MDKID

A

Monitor EKG (high ST and T waves)
Diet- No salt substitutes like fruits and green leafy veggies.
K- Kayexalete
IV , Insulin, Albuterol
* Sodium bicarbonate-acidosis
* Calcium gluconate glue muscles
Diuretics/ dialysis
Furosemide- loop
hydrochlorothiazide

26
Q

Causes of hypokalemia
5Ds

A

Diuretics (loop D. wasting)
Diarrhea/vomiting/suction (laxatives,enema,ileostomy,fistula)
Drains (gastric suctioning)
Dehydration
Diet (Inadequate intake)
Corticosteroids- Cushing’s (↑ cortisol → ↓’s K and ↑’s Na)
Too much insulin
K moves into the cell
Starvation

27
Q

Nursing interventions of hypokalemia

A

High K diet
Oral K supplements
I.V. K therapy
K-sparing diuretic, if
needed

28
Q

Causes of hyperkalemia
MACHINE

A

Medications (spiranoloctone)
Acidosis (NK pump is overworking)
Cellular disruption (Burns and trauma)
Hypoaldosteronism- Addison’s disease ↓aldosterone → ↓Na, ↑K
Increased K intake
Nephron impairement
Excretion problems (Dialysis pts)
ACE inhibitors
NSAIDS

29
Q

Signs and symptoms of hyperkalemia
MURDER

A

M = muscle weakness, cramps, paralysis
U = urinary output ↓ - oliguria
R = respiratory failure
D = decreased heart contractility weak pulse, low BP and ↓HR
E = early muscle twitching/cramps
R = rhythm changes:peaked T waves & prolonged PR

30
Q

Pottassium rich foods
Potassium

A

Potatoes
Oranges
Tomatoes
Avocados
Strawberries
fIsh
Mushrooms and melons

31
Q

How is potassium administered?

A

Never administer potassium as an IV bolus or IV push. It should be administered as dilute solution.

32
Q

Functions of magnesium in the blood

A

Calming muscles (mainly in the heart and uterus)
Calcium and vitamin D absorption.
Strong bones
Blood glucose
ATP production and carbohydrate metabolism
Production of PTH

33
Q

Causes of Hypomagnesemia
CRAY

A

Consumtion of alcohol (Stops magnesium absorption).
Really large fluid loss
Antibiotics (Aminoglyccerides), Alcoholism
Young mothers (Risk for malnutrition)
Diuretics, Diarrhea
Hypercalcemia
Hemodialysis

34
Q

Signs and symptoms of hypomagnesemia

A

Altered LOC
* Delusions,
hallucinations
* Dysphagia
* Increased muscle/nerve
activity (↑ or ↓?)
* increased deep tendon
reflexes (Clonus)
* ECG changes
* Arrhythmias
(tachy)
* Seizures
* Diarrhea

35
Q

Interventions of hypomagnesemia
SIM

A

Safety with swallow- increased muscle tone
IV magnesium sulfate (Give slowly)
Monitor vital signs EKG

36
Q

Foods rich in magnesium
CAMPONBANANAS

A

chocolate, cauliflower
avocado
milk
pork/peanut butter
oranges
nuts
bananas

37
Q

causes of hypermagnesemia
DARK

A

DKA- Diabetic ketoacidosis
Antacids
Renal failure
K-Excess potassium

38
Q

Symptoms of hypermagnesemia

A

Vitals calm and quiet
Cardiac dysrhythmias
GI -hypoactive bowel sounds
Drwosiness and lethargy
Dimished DTR

39
Q

Interventions of hypermagnesemia
HIM

A

Hemodialysis
IV calcium gluconate -glue muscles for less twitching
Monitor labs and DTRs

40
Q

Importance of calcium

A

Bone and teeth
Muscle and nerve
clotting
Gut absorbs, stored in bones

41
Q

Causes of hypocalcemia

A

Low parathyroid-hypoparathyroid
Oral intake reduced
Wound drainage
Celiac’s disease + Crohn’s (Malabsorption)
Acute pancreatitis
Low Vit D deficiency
Increased phosphorus
Using medications (Magnesium suppliments, laxatives, diuretics
Mobility issues
Alcoholism

LOWCALCIUM

42
Q

Causes of hypercalcemia

A

Hyperparathyroidism
Increased intake
Glucocorticosteroids
Hyperthyrodism
Calcium excretion reduced
Adrenal insuficiency
Lithium usage

43
Q

Interventions of hypocalcemia

A

Calcium and vitamin D (*tetany)
Calcium gluconate (10%)
Watch for bleeding gums and mucous membranes
Watch for dysrhythmias
Calcium is very irritating so check IV site
Safety- swallow, falls

44
Q

Interventions of hypercalcemia

A

Hydrate to prevent kidney stones
Monitor cardiac, GI, renal,neuro
Decrease calcium rich foods and vitamin D

45
Q

Signs and symptoms of hypocalcemia

A

Confusion
Reflex hyperactive
Arrhythmias
Muscle spasm
Positive Trousseau’s
Sign of Chvostek’s

CRAMPS

46
Q

Signs and symptoms of hypercalcemia

The body becomes too weak.

A

The body is too WEAK
Weakness of muscles
EKG changes- short QT
Absence of reflex, abdominal distention
Kidney stones, flank pain, check urine
Safety from falls

47
Q

Uses of chloride

A

Acid-base balance
Digestion - HCL
Fluid balance (With sodium)

48
Q

Causes of hypochloremia

A

GI-vomit, gastric suction, ileostomy
Diuretics (Thiazides)
Burns and cystic fibrosis
Fluid volume overload- dilute

49
Q

Causes of hyperchloremia

A

Too much sodium
Hypertonic solutions
Not drinking
Too much diarrhea
Conn’s too much aldosteron

50
Q

Symptoms of hypochloremia

A

Dehydration
Decreased BP
Fever
Vomiting

51
Q

Symptoms and signs of hyperchloremia

A

FRIED
Fatigue
Restless
Increased respiration
EXTREME THIRST
Decreased urinary output

52
Q

Interventions of hypochloremia

A

Check sodium levels
Neuro status, respiratory status
Seizure precautions
Intake and outputs
Daily weights
Chloride/sodium rich foods

53
Q

Interventions of hyperchloremia

A

Hold sodium/chloride foods/ hypertonic solution
Instead Use lactated ringer
Collect I&Os, daily weights
May have hyperkalemia

54
Q

Foods rich in calcium

A

Yoghurt
Sardine
Cheese
Spinach
Collard greenTofu
Rhubarb
Milk

Fluid and electrolytes (6 decks)

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