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Principles of Nursing > Electrolytes > Flashcards

Electrolytes Flashcards

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1
Q

Serum sodium level

A

135-145 mEq/L

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2
Q

Function of sodium

A

Influences water distribution
Maintain acid-base balance
Affects serum osmolality, help nerve and muscles interact

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3
Q

Location of sodium

A

Outside of the cell, ECF

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4
Q

Body mechanisms for regulating Na

A

Sodium-potassium pump
Renin-angiotensin-aldosterone system
Dietary intake of Na & H2O
Atrial natriuretic peptide: Na+ excretion

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5
Q

Causes of hyponatremia

A

< Na+ or water gain, HF, cirrhosis, renal failure, intake, SIADH: causes excessive release of ADH = > water retention.
Renal loss, diuretics/antidepressants, GI suction or vomit, sweat

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6
Q

S&S of hyponatremia

A

115-120
N/V & anorexia, headache, irritability, altered mental status, weakness

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7
Q

S&S of severe hyponatremia

A

< 110
Stupor, delirium, psychosis, ataxia, inelastic skin turgor, dry mucous membranes, weak, rapid pulse, orthostatic hypotension, cellular swelling
Progress to stupor, delirium, seizures, coma

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8
Q

Treatment of hyponatremia

A

Na loss = oral NaCl or IV 0.9 NS
> H20 = restrict fluids

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9
Q

Treatment of severe hyponatremia

A

Small volume hypertonic IV and loop diuretics`

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10
Q

Who is most likely to get hypernatremia

A

H2O deficit in elderly most common

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11
Q

What causes sensation of thirst

A

High serum osmolality = stimulate hypothalamus = > sensation of thirst

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12
Q

Causes of hypernatremia: H2O loss

A

DI, watery diarrhea, loss from heat, fever, pulmonary infection, trach, burns

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13
Q

Causes of hypernatremia: Excess intake of Na

A

medical error, tube feeding or near drowning in sea water

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14
Q

S&S of hypernatremia

A

Cell shrinkage
Lethargy
Weakness
Irritability–>twitching, seizures, coma
Hyperreflexia
Intense thirst
Bounding pulse
Dyspnea
Dry mucous membranes, orthostatic hypotension

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15
Q

Treatment of hypernatremia

A

IV fluid replacement
Salt free solutions/1/2 normal saline solutions
< Na intake & diuretic

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16
Q

Treatment of DI

A

Vasopressin, hypotonic I.V. fluids, thiazide diuretics

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17
Q

Interventions of sodium

A

VS
fluid delivery & response
I&O
Assess skin, mucous membranes & S&S of breakdown
Assist with oral hygiene
Safe environment
Changing diet

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18
Q

Serum potassium level

A

3.5-5 mEq/L

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19
Q

Function of potassium

A

Cell excitability
Nerve and muscle
Resting membrane potential
Myocardial membrane responsiveness
intracellular osmolality
Acid base balance
Skeletal and cardiac muscle contraction
Electrical conductivity

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20
Q

Location of potassium

A

intracellular

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21
Q

Body mechanism for regulating K

A

Excreted
Sodium potassium pump
Aldosterone
pH level
Cell destruction

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22
Q

Hypokalemia causes

A

Inadequate K+ intake, suction, lavage, prolonged vomiting, diarrhea, fistulas, severe diaphoresis, > urine glucose levels, renal tubular acidosis, magnesium depletion,

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23
Q

Disease that cause hypokalemia

A

cushing’s syndrome and period of high stress, Hepatic disease, hyperaldosteronism, acute alcoholism, heart failure, malabsorption syndrome, nephritis, bartter syndrome, acute leukemias

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24
Q

Drugs that cause hypokalemia

A

Diuretics, corticosteroids, > secretion of insulin = K+ moves into cells, adrenergics move K+ into cells

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25
S&S of hypokalemia
Skeletal muscle weakness, parasthesia, absent/decreased DTR, tachycardic & tachypnea, rhabdomyolysis, weak and irregular pulse, orthostatic hypotension, palpitations, flattened or inverted t wave, u wave presence
26
Treatment of hypokalemia
> K+, low Na+ diet, oral K+ supplement = K+ salts, IV K+ therapy, K+ sparing diuretic
27
Hyperkalemia causes
Cell injury, donated blood near expiration Burns, severe infection, trauma, crash injury
28
Drugs that cause hyperkalemia
K+ sparing diuretics, NSAIDs
29
S&S of hyperkalemia
< HR, irregular pulse, < cardiac output, hypotension. Tall tented t wave Skeletal muscle weakness < DTR
30
Treatment of hyperkalemia
> Excretion Diuretic, hemodialysis IV sodium bicarbonate Regular IV insulin with hypertonic dextrose D10-D50
31
Nursing interventions of hypokalemia
VS Digoxin toxicity ECG trainings Signs of constipation Serum levels
32
Nursing interventions of hyperkalemia
Serum levels Hypoglycemia Bowel sounds Digoxin level Antidiarrheals Education of foods Fresh blood
33
Guidelines for I.V. K+ administration
IV infusion concentration shouldn't > 40mEq
34
dietary sources of potassium
Chocolate, dried fruits, nuts and seeds, oranges, bananas, avocados, apricots, cantaloupe, meats, beans, potatoes, yogurt
35
Serum magnesium level
1.5-2.5
36
Function of magnesium
Catalyst for enzyme reactions Produce and use ATP for energy DNA&protein synthesis Vasodilation Irritability and contractility of cardiac muscles, neurotransmitter & hormone receptor binding, production of parathyroid hormone, helps Na+ & K+ across cell membrane
37
Location of magnesium
Intracellular
38
Body mechanism of magnesium
Serum < GI tract absorbs > Mg & kidneys conserve. Serum > GI excretes > feces & kidneys excrete Mg. Binding to albumin
39
Causes of hypomagnesemia
Poor dietary intake/malnutrition Poor GI absorption > Mg loss in GI Chronic alcoholics Critically ill ETOH
40
S&S of hypomagnesemia
Tremors, twitching, tetany + Chvostek's sign and Trosseau's sign, cardiac arrhythmias, severe hyperactive DTR, rapid HR
41
Treatment of hypomagnesemia
Diet, oral supplement, IV: magnesium sulfate. > K, < Na
42
Causes of hypermagnesemia
< excretion > Mg intake TPN solutions Addison's disease Adrenocorticol insufficiency Renal failure DKA
43
S&S of hypermagnesemia
< muscle and nerve activity Hypotension Bradycardia and respiratory paralysis Hypoactive DTR Facial paresthesia
44
Treatment of hypermagnesemia
> fluid intake, > urine output, > excretion of Mg, diuretic
45
Nursing interventions of hypomagnesemia
Diet change Assess dysphagia VS Q 15 min I&O Serum Mg level Seizure precaution Fall precaution
46
Nursing interventions of hypermagnesemia
VS Lab tests I&O Dialysis Administer resuscitation drugs Provide mechanical ventilation Provide fluids < dietary Mg intake Avoid giving medications w Mg
47
Serum level of chloride
9.8-10.8
48
Function of chloride
Maintain osmotic pressure Affect body pH Maintains acid-base balance Produce hydrochloride acid CSF fluid and attract water
49
Location of chloride
ECF, outside of the cell
50
Body mechanisms for regulating chloride
Dietary, kidney excretion and reabsorption, Na changes, GI
51
Causes of hypochloremia
> vomitting, diarrhea, burns, addison's disease, gastric surgery, NG suctioning, drugs, Na/K+ deficiency, metabolic alkalosis
52
S&S of hypochloremia
Slow RR, hyperactive DTRs, & muscle hypertonicity, muscle cramps, arrhythmias, seizures, coma, and respiratory arrest
53
Treatment of hypochloremia
Salty broth, IV 0.9 NaCl or KCL IV, changing drugs/drug therapy
54
Hyperchloremia causes
Dehydration, DI, renal failure, < H2O intake. Drugs that contain chloride Associated with hypernatremia
55
Hyperchloremia S&S
Tachypnea, dehydration, hypotension, deep, rapid RR, arrhythmia, diminished cognitive ability
56
Treatment of hyperchloremia
Restore fluid and acid base balance Sodium & chloride restricted Severe: Sodium bicarbonate IV Lactated Ringer's solution
57
Nursing interventions of hypochloremia
RR & BP LOC offer foods > Cl Normal saline solution I&O Safe environment
58
Nursing interventions of hyperchloremia
RR reorient Evaluate muscle strength & adjust pt activity level restrict fluid I&O ABG
59
Serum calcium level
8.9-10.1
60
Function of calcium
Formation and structure of bone and teeth Cell membrane permeability Contraction of cardiac muscle Smooth muscle & skeletal muscle Blood clotting process Release of hormones
61
Locations of calcium
ECF and ICF
62
Calcium body mechanism regulation
Need Vit D, parathyroid hormone, calcitonin, absorbed in small intestine & excreted in urine and feces
63
Causes of hypocalcemia
Inadequate intake, alcoholics, < exposure to Vit D, malabsorption, > loss in Ca, anticonvulsants, < PTH, low Mg, > caffeine intake, severe burns and infections, diuretics/renal failure
64
S&S of hypocalcemia
+ trousseau & chvostek, paresthesia, easy fractures, brittle nails, dry skin or hair, hyperactive DTR, hypotension, < myocardial contractility
65
Treatment of hypocalcemia
IV calcium gluconate or IV calcium chloride and mag replacement, adjust diet
66
Causes of hypercalcemia
Hyperparathyroidism, cancer, multiple fractures, lack of weight bearing, hypophosphatemia
67
Medication causes of hypercalcemia
> antacids, calcium, Vit D, lithium/thiazide diuretics, milk-alkali syndrome, Vit A overdose
68
S&S of hypercalcemia
Personality changes, hyporeflexia, ataxia, < muscle tone, HTN, digoxin tox, bone pain, abdominal pain, altered mental status, constipation
69
Treatment of hypercalcemia
Hydrate, loop diuretics, hemodialysis, perineal dialysis, corticosteroids, < GI absorption
70
Hypocalcemia nursing interventions
VS Administer IV calcium replacement Serum lab values Calcium Sup & vit D
71
Hypercalcemia nursing interventions
< intake of Ca, > excretion of calcium, hydrating pt, normal saline solutions, loop diuretics, hemodialysis, oral corticosteroids, I&O, serum electrolyte, > liquid intake, strain urine for calculi, get pt up and moving
72
Serum Phosphorus levels
2.5-4.5
73
Function of phosphorus
Cell membrane integrity Muscle function Metabolism of carbs, fats, and protein O2 delivery compound in RBC Buffer acids and bases Energy transfer to cells WBC phagocytosis Platelet function healthy bones and teeth
74
Location of phosphorus
ICF
75
Phosphorus body regulation
Vitamin D = > phos PTH = > excretion Insulin Alkalosis Dietary intake Kidney excretion
76
Hypophosphatemia causes
Hyperventilation, refeeding syndrome, pt recovering from hypothermia, malabsorption syndrome, malnourishment, hyperglycemia, < Vit D, < dietary intake, diuretic use, DKA, > PTH, extensive burns
77
S&S of hypophosphatemia
Muscle weakness, diplopia, malaise, weakened hand grasp, slurred speech, dysphagia, myalgia, respiratory failure, bone pain, fractures, paresethesia, < cardiac contractility
78
Treatment of hypophosphatemia
> phos rich foods, PO phos supplements, I.V phos replacement
79
Causes of hyperphosphatemia
Damaged cells. Renal insufficiency, hypoparathyroidism. > intake
80
S&S of hyperphosphatemia
Hypocalcemia, parasthesia, severe muscle spasms, cramps, pain, and weakness, hyperreflexia, + Chvostek and Troussea sign, tetany, < mental status, delirium, seizures, hypotension, heart failure, calcification, impaired vision
81
Treatment of hyperphosphatemia
Therapy- Aluminum, Mg, calcium gel, phosphate-binding antacids Calcium salts Severe: hemodialysis/peritoneal dialysis < phos intake Eliminating use of phos-based laxatives and enemas 0.9 NS
82
Nursing interventions of hypophosphatemia
Serum phos levels VS LOC Rate and depth of RR HF Temp Q4h Phos supplements Orient ADL assist
83
Nursing interventions of hyperphosphatemia
VS I&O Serum electrolyte Admin prescribed meds Dialysis Consult dietitian

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