Electrolytes Flashcards
Na+
135-145 mEq/L
Cl-
96-109 mEq/L
K+
3.5 -5.0 mEq/L
Ca++
8.5-10.0 mEq/L
Mg++
1.3- 2.1 mEq/L
Osmolarity
270-300 mOsm
Sodium
Major cation in ECF Maintains ECF osmolarity Generation & transmission of action potentials Maintains Acid-Base balance Electroneutrality Where Na goes water goes
Sources of Na+
Processed or Preserved Food
Stored in Kidney
Balance regulated by kidney, under influence of aldosterone, ADH, natriuretic peptide
Hyponatremia
Level below 136 mEq/L
Causes of Hyponatremia
actual sodium deficit
Excessive Diaphoresis Diuretics Wound drainage Hyperlipidemia Renal Disease NPO Low salt diet
Causes of Hyponatremia
dilutional deficit
excessive intake hypotonic solution psychogenic polydipsia Nephrotic syndrome freshwater drowning irrigation with hypotonic solution hyperglycemia heart failure
Assessing for Hyponatremia
Cerebral changes
Neuromuscular changes
Intestinal changes
Cardiovascular Changes
Interventions for hyponatremia
drugs - stopo loop diuretics that make sodium leave
FVD- 0.9% saline or in severe cases 2-3% saline on IV pump
SIADH- lithium, declomycin
Nutrition
helpful in mild hyponatremia
increase foods high in Na+
Restrict fluid intake
Hypernatremia
Na+ level > 145 mEq/L
Causes of Hypernatremia
actual Na+ excess
Hyperaldosteronism Renal failure corticosteroids cushing's syndrome excessive oral Na+ Excessive administration of Na+ containing IV fluids
Causes of Hypernatremia
Relative Na+ excess
NPO dehydrated increased rate of metabolism fever hyperventilation infection excessive diaphoresis watery diarrhea dehydration
Assessment for Hypernatremia
Nervous system changes
Skeletal Muscle Changes
Cardiovascular Changes
Interventions for Hypernatremia
get rid of sodium but not to quickly or you’re bound to have cerebral edema
Restrict Na foods
Potassium
Major ICF cation
Plasma level 3.5 to 5.0 mEq/L
Regulates protein synthesis
Regulates glucose use and storage
Most foods that contain K+
highest in meat, fish, many vegs/fruits
lowest in eggs, bread, cereals
salt substitutes may be KCL
Controlling K+ levels
sodium potassium pump- found in membranes of all body cells moves Na+ out of ICF and moves K+ in Maintains proper balance for compartments Kidney function 80% of K+ excreted aldosterone enhances excretion
Hypokalemia
K=level < 3.5 mEq/L
Low K+ may be life threatening
Increases the difference in amy. of K+ in ICF and ECF reduces excitability of cell
If loss gradual cells adjust
Causes of Hypokalemia
Actual K+ Deficits
Inappropriate or excess use of drugs increased aldosterone cushings syndrome Diarrhea Vomiting Prolonged NGT Sx Heat induced diaphoresis Renal Disease NPO wound drainage
Causes of Hypokalemia
relative K+ deficits
Alkalosis Hyperinsulinism Hyperalimentation TPN Water Intoxication IVF with K= poor solutions
Assessment for Hypokalemia
Age Drugs Acute or chronic disease Respiratory changes Musculoskeletal changes Cardiovascular changes Neurological changes Intestinal changes
