Electrolytes

Question 1

Hypocalcemia - amount, s/s

Answer 1

< 8.5
“CRAMP”
Convulsions
Reflexes hyperactive
Arrythmias (prolonged QT intervals)
Muscle spasms in calves or feet (tetany)
Positive Trousseau and Chvostek signs

Question 2

Trousseau sign

Answer 2

BP cuff inflated to number higher than SBP and hold in place for 3 minutes to stop blood flow. If positive, hand will contract to duck shape

Question 3

Chvostek sign

Answer 3

tap cranial nerve VII (CNVII) (in front of the ear).
positive sign will show a twitching (ipsilateral facial spasm) often in the nose, lips, and eyebrows

Question 4

Normal chloride levels and why is it important?

Answer 4

95-105mEq/L

• acid-base balance, digestion, and balances fluids with sodium

Question 5

What is the relationship between chloride and sodium?

Answer 5

same - both increase or decrease

Question 6

What is the relationship between chloride and bicarb?

Answer 6

inverse relationship

Question 7

Causes of Hypernatremia

Answer 7

HIGH SALT
-Hypercortisolism (Cushing’s) and hyperventiliation
-Increased sodium intake
-GI feeding w/o adequate water supplement
-Hypertonic solutions
-Sodium excretion decreased (corticosteroids)
-Aldosterone problems (increased reabsorption of sodium)
-Loss of fluids (dehydration, fever, sweating)
-Thirst impairment

Question 8

s/s of hypernatremia

Answer 8

FRIED
- Fever, Flushed
- Restless, Really agitated
- Increased fluid retention
- Edema, Extremely confused (cerebral edema)
- Decreased urine output, dry mouth/skin

Question 9

Name the types of hyponatremia

Answer 9

Euvolemic, hypovolemic, hypervolemic

Question 10

Describe euvolemic hyponatremia and causes

Answer 10

water in body increases but sodium stays the same, no edema
- caused by SIADH, diabetes insipidus, adrenal insufficiency, Addison’s disease

Question 11

Describe hypovolemic hyponatremia and causes

Answer 11

loss of blood volume, decreased sodium and water
- caused by vomiting, diarrhea, burns, excessive sweating, NG suction, diuretics,

Question 12

Describe hypervolemic hyponatremia and causes

Answer 12

water and sodium in body increases, edema present
- caused by CHF, kidney failure, liver failure, excessive saline infusion

Question 13

Describe hyperkalemia causes

Answer 13

CARED
Cellular movement of K from intracellular to extracellular (burns and tissue damage acidosis)
Adrenal insufficiency (Addison’s disease)
Renal failure
Excessive K intake
Drugs (K sparing like ACE inhibitors, NSAIDS, Aldactone)

Question 14

Describe hyperkalemia s/s

Answer 14

MURDER
Muscle weakness
Urine production low or absent
Respiratory failure (muscle weakness/seizures)
Decreased cardiac contractibility (weak pulse and low BP)
Early signs of muscle twitching, cramps (late signs profound weakness, flaccid)
Rhythm changes (tall peaked T waves, flat or absent P waves, wide QRS, prolonged PR interval

Question 15

Describe hypokalemia causes

Answer 15

DITCH
Drugs (laxatives, diuretics, corticosteroids)
Inadequate K intake (NPO, anorexia, nausea)
Too much water intake
Cushing’s syndrome (increased aldosterone secretion)
Heavy fluid loss (NG suction, vomiting, diarrhea, wound drainage, sweating)
**high insulin levels/hypoglycemia

Question 16

Describe hypokalemia s/s

Answer 16

Slow and Low
weak pulse, orthostatic hypotension, decreased bowel sounds, flaccid, paralysis, confusion, weak, dimished breath sounds, shallow respirations

ECG changes - depressed ST segment, flat or inverted T waves, prominent U wave