Electrolytes Flashcards
Hypokalemia Risk Factors?
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
Hypokalemia Symptoms?
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
What should nursing care for Hypokalemia look like?
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+.
What foods are rich in Potassium?
Avocados, Broccoli, Dairy Products, Bananas, Fruit Juices, Salt Substitutes, etc.
What should a pt with Hypokalemia be taught about?
What foods are rich in Potassium.
Avoid Diuretics and excessive Laxative use.
What complications can be caused by Hypokalemia?
Respiratory Failure
Cardiac Arrest
Risk factors of Hyperkalemia?
Overuse of salt substitutes + ACE Inhibitors + Potassium Sparring Diuretics + RBC Transfusions
Adrenal Insufficiency + Kidney Failure
Acidosis + Tissue Damage
Excessive Dietary Intake
Symptoms of Hyperkalemia?
Hypotension + Slow, Irregular Pulse
Restlessness + Irritability + Weakness
V-Fib + Premature Ventricular Contractions (PVC)
Peaked T Waves, Widened QRS
Diarrhea + Hyperactive Bowel Sounds + Oliguria
What should nursing care for Hyperkalemia look like?
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.
What should a pt with Hyperkalemia be taught about?
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
What complication can be caused by Hyperkalemia?
Cardiac Arrest
Hypocalcemia Risk Factors?
Acute Pancreatitis + Chronic Alcohol Use + Diarrhea + Vitamin D Deficiency + Renal Insufficiency + Loop Diuretics + Alkalosis
Hypomagnesemia + Hyperphosphatemia
Hypocalcemia Symptoms?
Hypotension + Fatigue / Weakness + Irritability.
Positive Chvostek Sign and Trousseau Sign.
Hyper Reflexes + Muscle Cramps + Numbness / Tingling of the Mouth + Seizures.
Prolonged QT Interval.
What should nursing care for Hypocalcemia look like?
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.
What should a pt with Hypocalcemia be taught about?
Diet Education about what foods are high in Calcium
Risk Factors of Hypercalcemia?
Hyperparathyroidism + Cancer with Bone Metastasis.
Excessive Dairy Intake + Thiazide Diuretic and Calcium Containing Antacids.
Paget Disease + Prolonged Immobilization + Acidosis.
Symptoms of Hypercalcemia?
Bone Pain / Fractures + HTN + Confusion + Fatigue/Lethargy + Depressed Reflexes + Kidney Stones.
N/V + Polyuria/Dehydration + Seizures.
Ventricular Dysrhythmias.
Short ST & QT Interval.
What should nursing care for Hypercalcemia look like?
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.
What should a pt with Hypercalcemia be taught about?
Do More Weight Bearing Activities + Diet Restrictions + Fluid Intake Requirements
Risk Factors for Hypophosphatemia?
Chronic Alcohol Use + Chronic Diarrhea + Diabetic Ketoacidosis + Malnutrition + Phosphate Binding Antacids + Respiratory Alkalosis + Hyperparathyroidism
Symptoms of Hypophosphatemia?
Confusion + Muscle Weakness (Including Respiratory Muscles) + Seizures + Rickets + Osteomalacia
HF + Dysrhythmias
What should nursing care for Hypophosphatemia look like?
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.
What should you teach a pt with Hypophosphatemia about?
High Phosphate Diet.
Report any increasing Bone Pain.
What complications can be caused by Hypophosphatemia?
Hypocalcemia + Hyperkalemia + Hypotension + Dysrhythmias
Risk Factors for Hyperphosphatemia?
Excessive Intake of Phosphate-Containing Laxatives
Hyperthermia + Hypoparathyroidism + Fleet Enema + Renal Failure + Sickle Cell Anemia
Symptoms of Hyperphosphatemia?
Hyper Reflexes + Hypocalcemia + Seizures + Numbness / Tingling in Extremities
What should nursing care for Hyperphosphatemia look like?
Restrict intake of high phosphate foods.
Administer Phosphate Binding Agents (Like Calcium Gluconate).
Dialysis if Severe.
What should a pt with Hyperphosphatemia be taught about?
Low Phosphate Diet
Risk Factors for Hypomagnesemia?
Acute Pancreatitis + Chronic Alcohol Use + GI Tract Loss + Hyperglycemia + Prolonged Malnutrition + Proton Pump Inhibitor Use + Increased Urine Output
Symptoms of Hypomagnesemia?
Positive Trousseau & Chvostek’s Sign.
Confusion + Hyperactive Deep Tendon Reflex + Muscle Cramps.
Tremors + Seizures + Vertigo.
Bounding Pulse + HTN.
What should nursing care for Hypomagnesemia look like?
Oral Supplements + Increase Dietary Intake.
IV Magnesium Sulfate if Severe OR if Hypocalcemia is present at the same time as Hypomagnesemia.
What things should a pt with Hypomagnesemia be taught about?
High Magnesium Diet
Risk Factors for Hypermagnesemia?
Adrenal Insufficiency + Hyperthyroidism + Metastatic Bone Cancer + Renal Failure.
IV Magnesium Administration + Antacid & Laxatives containing Magnesium.
Symptoms for Hypermagnesemia?
Decreased Deep Tendon Reflexes + Flushed Warm Skin + Lethargy / Drowsiness + N/V + Muscle Weakness.
Hypotension + Bradycardia + Urinary Retention.
What should nursing care for Hypermagnesemia look like?
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.
What things should a pt with Hypermagnesemia be taught about?
Dietary Restrictions
Foods high in Calcium?
Dairy Products + Kale + Broccoli + Oranges + Almonds + Sardines
What foods are high in Magnesium?
Spinach + Cashews + Avocado + Black Beans + Dark Chocolate + Bananas + Peanut Butter + Salmon
Hyponatremia Risk Factors?
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.
Hyponatremia Symptoms?
Hyperactive Bowel Sounds + Abdominal Cramping + Nausea.
Tachycardia + Diminished Pulses + Hypotension + Fatigue.
Decreased Deep Tendon Reflexes + Bounding Pulse + Headache.
Confusion + Muscle Weakness + Seizures + Dizziness.
What should nursing care for Hyponatremia look like?
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.
What should a pt with Hyponatremia be taught about?
Daily Weight
High Sodium Diet
Keep a Food Diary
Read Food Labels
What are the complications that can be caused by Hyponatremia?
Coma + Seizures + Respiratory Arrest
Risk Factors for Hypernatremia?
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.
Symptoms of Hypernatremia?
Thirst + Restlessness + Irritability + Dry Mouth + Nausea/Vomiting + Anorexia + Occasional Diarrhea.
Tachycardia + Hypotension.
Muscle Twitching + Decreased or Absent Deep Tendon Reflexes + Seizures + Coma.
What should nursing care for Hypernatremia look like?
Monitor LOC + Vitals + Lung Sounds + I&O + Potassium (If Diuretics are Administered).
Encourage Water Intake + Provide Oral Hygiene.
Give Seizure Precautions.
What should a pt with Hypernatremia be taught about?
Daily Weights (Notify Provider if 1-2 lb gain in 24 hrs).
Low Sodium Diet.
What complications can be caused by Hypernatremia?
Seizures, Convulsions, Death
What are some foods that are high in Sodium?
Broth, Tomato Juice, Canned Foods, etc.
What is the Trousseau Sign?
Hand / Finger Spasm caused by inflating a BP Cuff for a few minutes
What is the Chvostek Sign?
Contraction of the Facial Muscles in response to a light tap of the Facial Nerve in front of the Ear
