Electrolytes Flashcards

1
Q

Sodium (Na+) Levels

A

135 - 145 mEq/L

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2
Q

Sodium (Na+) Facts

A
  1. Most abundant electrolyte in the ECF
  2. Important in regulating neuromuscular impulses in the nerve & muscle fibers
  3. Attracts water
  4. Controlled by renal reabsorption & excretion
  5. Dietary sources are:
    a. Table salt
    b. processed/cured meat
    c. packaged food
    d. sea food
    e. cheese
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3
Q

Hyponatremia Levels

A
  1. Low Na+

2. < 135

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4
Q

Causes of Hyponatremia

A
  1. Diaphoresis
  2. Wound drainage
  3. Duiretic
  4. Dilutional states
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5
Q

Hyponatremia Manifestations

A
  1. Decreased urinary output
  2. Sleeplessness
  3. Spasm
  4. Muscle Weakness
  5. Decreased deep tendon reflex
  6. Coma
  7. N/V
  8. Anorexia
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6
Q

Hyponatremia Tx

A
  1. Tx cause
  2. Hypertonic IV fluid (Severe case)
  3. Isotonic IV fluid
  4. Oral Na+ supplement
  5. Restrict fluids
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7
Q

Hyponatremia RN Implication

A
  1. Monitor I & O
  2. DW
  3. Monitor labs
  4. Restrict fluids
  5. Increase dietary intake
  6. Monitor fluid status
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8
Q

Hypernatremia Levels

A
  1. High Na+

2. > 145

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9
Q

Causes of Hypernatremia

A
  1. Increase in Na+ intake
  2. Excess loss of water or inadequate intake of water
  3. Dehydration
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10
Q

Hypernatremia Manifestation

A
  1. Irritability
  2. Restlessness
  3. Aagitation
  4. Confusion
  5. Lathargy
  6. Muscle weakness
  7. Twitching or seizure
  8. Thirst**
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11
Q

Hypernatremia Tx

A
  1. Tx cause
  2. Correct fluid imbalance carefully
  3. IV fluids for dehydration (Isotonic & Hypertonic)
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12
Q

Hypernatremia RN Implication

A
  1. Monitor VS
  2. Monitor I & O
  3. DW
  4. Monitor edema
  5. Nutritional assessment
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13
Q

Potassium (K+) Levels

A

3.5 - 5 mEq/L

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14
Q

Potassium (K+) Facts

A
  1. Major cation in the ICF
  2. Important for nerve –> cell communication & the initiation of muscle contraction
  3. Controlled by kidneys
    a. Aldosterone(promotes excretion) & insulin (moves K+ into cell.
  4. Dietary sources:
    a. Bananas
    b. Cantaloupe
    c. Green leafy vegetables
    d. Potatoes
    e. Avocados
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15
Q

Hypokalemia Level

A

< 3.5 mEq/L

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16
Q

Causes of Hypokalemia

A
  1. Diuretics
  2. V/D
  3. Nasogastric suction
  4. Decreased intake
17
Q

Hypokalemia Manifestation

A
  1. Muscle weakness
  2. Fatigue*
  3. Decreased bowel motility*
  4. N/V/C
  5. Ileus (Obstruction)
  6. Cardiac arrhythmias
  7. Orthostatic Hypotension*
  8. Digoxin Sensativity
  9. Shallow/Innefective Resp.*
  10. Frequent Urination
18
Q

Hypokalemia Tx

A
  1. K+ supplements
    a. Take c fd to minimize GI upset
  2. IV K+
    a. Must be diluted
    b. Max rate of 10 mEq/hr
    c. Can cause burning sensation @ IV site
    d. Irritating to veins
19
Q

Hypokalemia RN Implication

A
  1. Cardiac Monitor
  2. Monitor Resp status
  3. Encourage dietary intake
  4. Monitor labs
  5. Do not crush or chew
20
Q

Hyperkalemia Level

A

> 5

21
Q

Hyperkalemia Causes

A
  1. Renal Failure
  2. K+ sparing diuretics
  3. K+ supplements or IV replacement
  4. Lack of insulin(diabetic ketoacidosis)
  5. Cell destruction(burns, trauma, infection)
  6. Hemolysis of cells with extended tourniquet application.
22
Q

Hypekalemia Manifestation

A
  1. Muscle cramps, weakness
  2. N/D
  3. Low BP
  4. Bradycardia
  5. Arrhythmias
  6. Numbness or Tingling of:
    a. Face
    b. Tongue
    c. Hands
    d. Feet
  7. Fatigue
  8. Drowsiness
  9. Confusion
23
Q

Hyperkalemia Tx

A
  1. Insulin moves K+ from ECF to ICF (Give dextrose if needed)
  2. Diuretics
  3. Na+ polystyrene sulfate, binds c K+ preventing absorption c fecal excretion
  4. Dialysis
  5. IV Ca++ to minimize cardiac toxicity
24
Q

Hyperkalemia RN Implication

A
  1. Monitor Renal Function
  2. Monitor intake - FD & Medication
  3. Cardiac Mmonitor
  4. Dialysis if needed
25
Q

Calcium (Ca++) Level

A

8.5 - 10.5 mg/dl

26
Q

Calcium (Ca++) Facts

A
  1. Most abundant mineral in body
  2. Provides mass & strength to bones & teeth
  3. Works closely c Phosphorus & Magnesium
    As Phos increases, Ca++ decreases**
    As Mg increases, Ca++ increases
  4. Necessary for transmission of nerve impulses, Normal muscle contraction, regulation of heart, hormone secretion & formation of blood clots.
  5. Controlled by vitamin D, Parathyroid hormone, Calcitonin & serum concentration:
    a. Intestinal absorption
    b. Renal reabsorption & excretion
    c. Bone breakdown & uptake
  6. Dietary sources:
    a. Milk
    b. Yogurt
    c. Cheese
    d. egg yolk
    e. Cauliflower
    f. Soybeans
    g. Green leafy vegetables
27
Q

Hypocalcemia Level

A

< 8.5

28
Q

Hypocalcemia Causes

A
  1. Renal failure
  2. Decreased intake or absorption
  3. Acute pancreatitis
  4. Hyperparathyroidism
  5. Vitamin D deficiency
  6. Low Mg level
  7. Low serum albumin
  8. Increased Phos
29
Q

Hypocalcemia Manifestation

A
  1. Skeletal muscle spasm, cramps, tetany
  2. Convulsions
  3. Parasthesias of lips & extremeties
  4. Chvostek’s sign
  5. Trousseau’s sign
  6. Cardiac arrhythmias
  7. Osteoporosis
30
Q

Hypocalcemia Tx

A
  1. Tx cause
  2. IV Ca++ gluconate - monitor IV for tissue necrosis
  3. Oral supplements c Vitamin D c fd.
31
Q

Hypocalcemia RN Implication

A
  1. Monitor electrolyte levels
  2. Cardiac monitor
  3. Monitor respiratory status
32
Q

Hypercalcemia Level

A

> 10.5

Greater than 12 mg/dl is life threatening!

33
Q

Hhypercalcemia Causes

A
  1. Excess intake or absorption
  2. Hyperparathyroidism
  3. Bone cancer cause breakdown of bone
  4. Multiple fractures
  5. Prolonged immobilization
  6. Prolonged use of aluminum-containing antacids
34
Q

Hypercalcemia Manifestation

A
  1. Anorexia, N/V/C
  2. Muscle weakness
  3. Decreased deep tendon reflex
  4. Lethargy
  5. Polydipsia, Polyuria, Dehydration
  6. Impaired concentration
  7. Confusion
  8. Blurred vision
  9. Bone pain
  10. Cardiac Arrhythmias
35
Q

Hypercalcemia Tx

A
  1. Diuretic**
  2. IV hydration c NS to increase renal blood flow & urinary excretion
  3. IV bisphophonates - obstruct Ca++ release from bone
  4. Calcitonin - inhibits release from bone & promotes renal excretion
36
Q

Hypercalcemia RN Implication

A
  1. Encourage oral fluids (3-4L/day)
  2. Monitor VS
  3. Cardiac monitor
  4. Monitor neuro status
  5. Encourage mobility
37
Q

Magnesium (Mg++) Level

A

1.8 - 2.5 mEq/dl

38
Q

Magnesium (Mg++) Facts

A
  1. 2nd most abundant cation in ICF
  2. Activating co-factor c more than 300 enzymes
  3. Necessary for formation & function of healthy bones
  4. Influences parathyroid hormone & Ca++ levels
  5. Important in blood clotting, DNA & RNA synthesis, Cardiovascular regulation
  6. Increased/Decreases c K+
  7. Dietary sources:
    a. Vegetables:
    Spinach
    Broccoli
    Avocado
    Potato
    Whole Grain
    Beef
    Chicken
    Tuna
    Milk
    Yogurt
    Raisins