Electrolytes

Question 1

Na+

Answer 1

135-145 mEq/L

Question 2

Cl-

Answer 2

96-109 mEq/L

Question 3

K+

Answer 3

3.5 -5.0 mEq/L

Question 4

Ca++

Answer 4

8.5-10.0 mEq/L

Question 5

Mg++

Answer 5

1.3- 2.1 mEq/L

Question 6

Osmolarity

Answer 6

270-300 mOsm

Question 7

Sodium

Answer 7

Major cation in ECF
Maintains ECF osmolarity 
Generation & transmission of action potentials 
Maintains Acid-Base balance 
Electroneutrality
Where Na goes water goes

Question 8

Sources of Na+

Answer 8

Processed or Preserved Food
Stored in Kidney
Balance regulated by kidney, under influence of aldosterone, ADH, natriuretic peptide

Question 9

Hyponatremia

Answer 9

Level below 136 mEq/L

Question 10

Causes of Hyponatremia

actual sodium deficit

Answer 10

Excessive Diaphoresis 
Diuretics 
Wound drainage 
Hyperlipidemia 
Renal Disease 
NPO
Low salt diet

Question 11

Causes of Hyponatremia

dilutional deficit

Answer 11

excessive intake hypotonic solution
psychogenic polydipsia 
Nephrotic syndrome
freshwater drowning
irrigation with hypotonic solution
hyperglycemia 
heart failure

Question 12

Assessing for Hyponatremia

Answer 12

Cerebral changes
Neuromuscular changes
Intestinal changes
Cardiovascular Changes

Question 13

Interventions for hyponatremia

Answer 13

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

Question 14

Hypernatremia

Answer 14

Na+ level > 145 mEq/L

Question 15

Causes of Hypernatremia

actual Na+ excess

Answer 15

Hyperaldosteronism 
Renal failure 
corticosteroids 
cushing's syndrome 
excessive oral Na+
Excessive administration of Na+ containing IV fluids

Question 16

Causes of Hypernatremia

Relative Na+ excess

Answer 16

NPO dehydrated 
increased rate of metabolism 
fever
hyperventilation
infection
excessive diaphoresis
watery diarrhea
dehydration

Question 17

Assessment for Hypernatremia

Answer 17

Nervous system changes
Skeletal Muscle Changes
Cardiovascular Changes

Question 18

Interventions for Hypernatremia

Answer 18

get rid of sodium but not to quickly or you’re bound to have cerebral edema
Restrict Na foods

Question 19

Potassium

Answer 19

Major ICF cation
Plasma level 3.5 to 5.0 mEq/L
Regulates protein synthesis
Regulates glucose use and storage

Question 20

Most foods that contain K+

Answer 20

highest in meat, fish, many vegs/fruits
lowest in eggs, bread, cereals
salt substitutes may be KCL

Question 21

Controlling K+ levels

Answer 21

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

Question 22

Hypokalemia

Answer 22

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

Question 23

Causes of Hypokalemia

Actual K+ Deficits

Answer 23

Inappropriate or excess use of drugs 
increased aldosterone 
cushings syndrome
Diarrhea Vomiting
Prolonged NGT Sx
Heat induced diaphoresis
Renal Disease
NPO
wound drainage

Question 24

Causes of Hypokalemia

relative K+ deficits

Answer 24

Alkalosis 
Hyperinsulinism
Hyperalimentation
TPN
Water Intoxication
IVF with K= poor solutions

Question 25

Assessment for Hypokalemia

Answer 25

Age 
Drugs 
Acute or chronic disease
Respiratory changes 
Musculoskeletal changes 
Cardiovascular changes
Neurological changes 
Intestinal changes