Electrolytes Flashcards

1
Q

Hypokalemia Risk Factors?

A

Overuse of diuretics, digoxin, & corticosteroids + Cushing’s Syndrome + Increased Aldosterone

GI Tract Losses (vomiting, diarrhea, prolonged NG suctioning)

Tap Water Enema + NPO + Kidney Disease + Alkalosis + Total Parenteral Nutrition + Water Intoxication

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2
Q

Hypokalemia Symptoms?

A

Decreased BP + Hypoactive Bowel Sounds + Reduced Deep Tendon Reflex + Shallow Breathing

Weak Pulse + Altered LOC + Anxiety + Confusion + Coma + N/V + Abdominal Distention + Weakness

Flattened T-Wave, Prominent U-Wave, ST Depression, Prolonged PR Interval

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3
Q

What should nursing care for Hypokalemia look like?

A

Administer K+ Replacement.
(NEVER give via IM, IV Bolus, or SUBQ Routes).

Monitor Urine Output + Respirations (For Shallow or Ineffective Breathing) + EKG + LOC + O2 Sat.

Assess Muscle Weakness + Deep Tendon Reflexes.

Implement Strict Fall Precautions & Encourage Foods Rich in K+.

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4
Q

What foods are rich in Potassium?

A

Avocados, Broccoli, Dairy Products, Bananas, Fruit Juices, Salt Substitutes, etc.

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5
Q

What should a pt with Hypokalemia be taught about?

A

What foods are rich in Potassium.

Avoid Diuretics and excessive Laxative use.

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6
Q

What complications can be caused by Hypokalemia?

A

Respiratory Failure

Cardiac Arrest

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7
Q

Risk factors of Hyperkalemia?

A

Overuse of salt substitutes + ACE Inhibitors + Potassium Sparring Diuretics + RBC Transfusions

Adrenal Insufficiency + Kidney Failure

Acidosis + Tissue Damage

Excessive Dietary Intake

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8
Q

Symptoms of Hyperkalemia?

A

Hypotension + Slow, Irregular Pulse

Restlessness + Irritability + Weakness

V-Fib + Premature Ventricular Contractions (PVC)
Peaked T Waves, Widened QRS

Diarrhea + Hyperactive Bowel Sounds + Oliguria

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9
Q

What should nursing care for Hyperkalemia look like?

A

Monitor Cardiac Rhythm + I&O + GI Symptoms + Lab Values.

Assess for Muscle Weakness.

Avoid Potassium Supplements (Oral or IV) + Administering Whole Blood Products + Foods High in Potassium.

Administer IV Fluids with Dextrose and Regular Insulin + Loop Diuretics, Albuterol, IV Insulin, Glucose.

Treat Severe Hyperkalemia with Calcium Gluconate Administration.

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10
Q

What should a pt with Hyperkalemia be taught about?

A

Low Potassium Diet:

Beverages Low in Potassium = Coffee + Ginger Ale + Root Beer + Tea

Fruits & Juices Low in Potassium = Raw Apples + Cranberries + Grapes + Cranberry & Grape Juice + Lettuce + Cabbage + Cucumbers + Green Beans

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11
Q

What complication can be caused by Hyperkalemia?

A

Cardiac Arrest

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12
Q

Hypocalcemia Risk Factors?

A

Acute Pancreatitis + Chronic Alcohol Use + Diarrhea + Vitamin D Deficiency + Renal Insufficiency + Loop Diuretics + Alkalosis

Hypomagnesemia + Hyperphosphatemia

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13
Q

Hypocalcemia Symptoms?

A

Hypotension + Fatigue / Weakness + Irritability.

Positive Chvostek Sign and Trousseau Sign.

Hyper Reflexes + Muscle Cramps + Numbness / Tingling of the Mouth + Seizures.

Prolonged QT Interval.

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14
Q

What should nursing care for Hypocalcemia look like?

A

Diet rich in Calcium + Vitamin D Supplementation + IV Calcium Gluconate Administration.

Closely assess pt’s who’ve had a recent Neck or Thyroid Surgery in the immediate Post-Op Phase.

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15
Q

What should a pt with Hypocalcemia be taught about?

A

Diet Education about what foods are high in Calcium

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16
Q

Risk Factors of Hypercalcemia?

A

Hyperparathyroidism + Cancer with Bone Metastasis.

Excessive Dairy Intake + Thiazide Diuretic and Calcium Containing Antacids.

Paget Disease + Prolonged Immobilization + Acidosis.

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17
Q

Symptoms of Hypercalcemia?

A

Bone Pain / Fractures + HTN + Confusion + Fatigue/Lethargy + Depressed Reflexes + Kidney Stones.

N/V + Polyuria/Dehydration + Seizures.

Ventricular Dysrhythmias.
Short ST & QT Interval.

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18
Q

What should nursing care for Hypercalcemia look like?

A

Avoid any meds that increase Calcium.

Increase Weight Bearing Activity.

Maintain a Low Calcium Diet + Maintain Adequate Hydration (3,000-4,000 mL of Fluid Daily).

For Severe Hypercalcemia, administer IV Isotonic Saline & Calcitonin. Dialysis is for Life-Threatening Situations.

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19
Q

What should a pt with Hypercalcemia be taught about?

A

Do More Weight Bearing Activities + Diet Restrictions + Fluid Intake Requirements

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20
Q

Risk Factors for Hypophosphatemia?

A

Chronic Alcohol Use + Chronic Diarrhea + Diabetic Ketoacidosis + Malnutrition + Phosphate Binding Antacids + Respiratory Alkalosis + Hyperparathyroidism

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21
Q

Symptoms of Hypophosphatemia?

A

Confusion + Muscle Weakness (Including Respiratory Muscles) + Seizures + Rickets + Osteomalacia

HF + Dysrhythmias

22
Q

What should nursing care for Hypophosphatemia look like?

A

Increase Oral Intake of Phosphate (Dairy Products, Phosphate Supplements, etc.)

For Severe Hypophosphatemia, administer IV Sodium Phosphate or Potassium.

If giving IV replacement, monitor Phosphate Level every 6-12 hrs.

23
Q

What should you teach a pt with Hypophosphatemia about?

A

High Phosphate Diet.

Report any increasing Bone Pain.

24
Q

What complications can be caused by Hypophosphatemia?

A

Hypocalcemia + Hyperkalemia + Hypotension + Dysrhythmias

25
Q

Risk Factors for Hyperphosphatemia?

A

Excessive Intake of Phosphate-Containing Laxatives

Hyperthermia + Hypoparathyroidism + Fleet Enema + Renal Failure + Sickle Cell Anemia

26
Q

Symptoms of Hyperphosphatemia?

A

Hyper Reflexes + Hypocalcemia + Seizures + Numbness / Tingling in Extremities

27
Q

What should nursing care for Hyperphosphatemia look like?

A

Restrict intake of high phosphate foods.

Administer Phosphate Binding Agents (Like Calcium Gluconate).

Dialysis if Severe.

28
Q

What should a pt with Hyperphosphatemia be taught about?

A

Low Phosphate Diet

29
Q

Risk Factors for Hypomagnesemia?

A

Acute Pancreatitis + Chronic Alcohol Use + GI Tract Loss + Hyperglycemia + Prolonged Malnutrition + Proton Pump Inhibitor Use + Increased Urine Output

30
Q

Symptoms of Hypomagnesemia?

A

Positive Trousseau & Chvostek’s Sign.

Confusion + Hyperactive Deep Tendon Reflex + Muscle Cramps.

Tremors + Seizures + Vertigo.

Bounding Pulse + HTN.

31
Q

What should nursing care for Hypomagnesemia look like?

A

Oral Supplements + Increase Dietary Intake.

IV Magnesium Sulfate if Severe OR if Hypocalcemia is present at the same time as Hypomagnesemia.

32
Q

What things should a pt with Hypomagnesemia be taught about?

A

High Magnesium Diet

33
Q

Risk Factors for Hypermagnesemia?

A

Adrenal Insufficiency + Hyperthyroidism + Metastatic Bone Cancer + Renal Failure.

IV Magnesium Administration + Antacid & Laxatives containing Magnesium.

34
Q

Symptoms for Hypermagnesemia?

A

Decreased Deep Tendon Reflexes + Flushed Warm Skin + Lethargy / Drowsiness + N/V + Muscle Weakness.

Hypotension + Bradycardia + Urinary Retention.

35
Q

What should nursing care for Hypermagnesemia look like?

A

Stop Magnesium containing meds + Limit Dietary Intake + Increase Fluid Intake.

Always give IV Magnesium on an Infusion Pump, monitor Reflexes frequently.

Keep IV Calcium Gluconate on hand if giving an IV Magnesium Replacement.

36
Q

What things should a pt with Hypermagnesemia be taught about?

A

Dietary Restrictions

37
Q

Foods high in Calcium?

A

Dairy Products + Kale + Broccoli + Oranges + Almonds + Sardines

38
Q

What foods are high in Magnesium?

A

Spinach + Cashews + Avocado + Black Beans + Dark Chocolate + Bananas + Peanut Butter + Salmon

39
Q

Hyponatremia Risk Factors?

A

Excessive Sweating + Diuretics + Wound Drainage + NG Tube Suction + Kidney Disease.

NPO + Low Sodium Diet.

Cerebral Salt Wasting Syndrome + Hyperglycemia + Decreased production of Aldosterone.

Hypotonic IV Fluid.

40
Q

Hyponatremia Symptoms?

A

Hyperactive Bowel Sounds + Abdominal Cramping + Nausea.

Tachycardia + Diminished Pulses + Hypotension + Fatigue.

Decreased Deep Tendon Reflexes + Bounding Pulse + Headache.

Confusion + Muscle Weakness + Seizures + Dizziness.

41
Q

What should nursing care for Hyponatremia look like?

A

Promote a High Sodium Diet.

IV Fluids (Lactated Ringer’s, Normal Saline, Isotonic Solutions).

Restrict Water Intake as Prescribed.

Monitor I&O + Daily Weight + Vitals + LOC.

42
Q

What should a pt with Hyponatremia be taught about?

A

Daily Weight
High Sodium Diet
Keep a Food Diary
Read Food Labels

43
Q

What are the complications that can be caused by Hyponatremia?

A

Coma + Seizures + Respiratory Arrest

44
Q

Risk Factors for Hypernatremia?

A

Kidney Failure + Cushing’s Syndrome + Aldosteronism.

Excessive Intake of Sodium + Water Deprivation + Tube Feedings without adequate water supplement.

Diabetes Insipidus + Heatstroke + Burns + Watery Stools + Hyperventilation.

45
Q

Symptoms of Hypernatremia?

A

Thirst + Restlessness + Irritability + Dry Mouth + Nausea/Vomiting + Anorexia + Occasional Diarrhea.

Tachycardia + Hypotension.

Muscle Twitching + Decreased or Absent Deep Tendon Reflexes + Seizures + Coma.

46
Q

What should nursing care for Hypernatremia look like?

A

Monitor LOC + Vitals + Lung Sounds + I&O + Potassium (If Diuretics are Administered).

Encourage Water Intake + Provide Oral Hygiene.

Give Seizure Precautions.

47
Q

What should a pt with Hypernatremia be taught about?

A

Daily Weights (Notify Provider if 1-2 lb gain in 24 hrs).

Low Sodium Diet.

48
Q

What complications can be caused by Hypernatremia?

A

Seizures, Convulsions, Death

49
Q

What are some foods that are high in Sodium?

A

Broth, Tomato Juice, Canned Foods, etc.

50
Q

What is the Trousseau Sign?

A

Hand / Finger Spasm caused by inflating a BP Cuff for a few minutes

51
Q

What is the Chvostek Sign?

A

Contraction of the Facial Muscles in response to a light tap of the Facial Nerve in front of the Ear