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Nursing II Final Exam > Electrolytes > Flashcards

Electrolytes Flashcards

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1
Q

Sodium (Na+): General

A
  • Most abundant electrolyte in the ECF
  • Important in neuromuscular impulses in the nerve and muscle fibers
  • Attracts water; important in water distribution
  • Controlled by renal reabsorption and excretion (thirst mechanism, ADH, RAAS, ANF)
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2
Q

Sodium Diet Sources

A

Table salt, processed or cured meat, packaged foods, seafood, cheese, junk food

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3
Q

Hyponatremia Causes

A

Diaphoresis, wound drainage, diuretic use, dilutional states, SIADH (syndrome of inappropriate ADH secretion)

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4
Q

Hyponatremia Manifestations

A
  • Decreased urinary output
  • Sleepiness
  • Muscle weakness/spasm
  • Lethargy, confusion, seizures, coma
  • N/V, anorexia
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5
Q

Hyponatremia Tx

A
  • Treat cause
  • IV fluids: hypertonic or isotonic
  • Oral sodium supplements
  • Restrict fluids
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6
Q

Hyponatremia Nursing Interventions

A
  • Monitor I&O
  • Daily weight
  • Monitor labs
  • Fluid restriction
  • Increased dietary intake
  • Monitor fluid status
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7
Q

Hypernatremia Causes

A
  • Increase in sodium intake

- Excess loss of water or inadequate intake of water

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8
Q

Hypernatremia Manifestations

A
  • Irritability, restlessness, confusion, agitation
  • Lethargy, muscle weakness, twitching, or seizures
  • Thirst
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9
Q

Potassium (K+)

A
  • Major cation in the ICF
  • Important for nerve-cell communication and the initiation of muscle contraction
  • Controlled by kidneys (Aldosterone promotes excretion and insulin moves K+ into cells)
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10
Q

Potassium Dietary Sources

A

Bananas, cantaloupe, green leafy vegetables, potatoes, avocados

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11
Q

Hypokalemia Causes

A
  • Diuretics
  • Vomiting, diarrhea, NG suction
  • Decreased intake
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12
Q

Hypokalemia Manifestations

A
  • Muscle weakness, fatigue
  • Decreased bowel motility, N/V, constipation, ileus
  • Cardiac arrhythmias, ortho hypotension, digoxin sensitivity
  • Shallow, ineffective respirations
  • Decreased deep tendon reflexes, drowsiness, confusion
  • Frequent urination
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13
Q

Hypokalemia Tx

A
  • Potassium supplements: take with food to minimize GI side effects
  • IV potassium: must be diluted; max rate of 10mEq/hr (can cause burning at IV site, irritating to veins)
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14
Q

Hypokalemia Nursing Interventions

A
  • Cardiac monitor
  • Monitor resp. status
  • Encourage diet intake
  • Monitor labs
  • Do not crush or chew
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15
Q

Hyperkalemia Causes

A
  • Renal failure
  • K+-sparing diuretics
  • Potassium supplements or IV
  • Lack of insulin (diabetic ketoacidosis)
  • Cell destruction (burns, trauma, infection)
  • Hemolysis of cells with extended tourniquet application
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16
Q

Hyperkalemia Manifestations

A
  • Muscle cramps, weakness
  • Nausea, diarrhea
  • LOW BP, bradycardia, arrhythmias
  • Numbness or tingling of face, tongue, hands, feet
  • Fatigue, drowsiness, confusion
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17
Q

Hyperkalemia Tx

A
  • Insulin: moves K+ into cells
  • Diuretics
  • Sodium polysterene sulfate (Kayexalate) PO or via retention enema (binds with K+ preventing absorption with fecal excretion)
  • Dialysis
  • IV calcium to minimize cardiac toxicity
18
Q

Hyperkalemia Nursing Intervention

A

Cardiac monitor

19
Q

Calcium (Ca2+)

A
  • Most abundant mineral in the body
  • Provides mass and strength to the bones and teeth
  • Works closely with phosphorus and magnesium
  • Needed for transmission of nerve impulses, normal muscle contraction, regulation of the heart, hormone secretion, and formation of blood clots
  • Controlled by vitamin D, PTH, calcitonin, and serum concentration
20
Q

Calcium Dietary Intake

A

Milk, yogurt, cheese, egg yolk, cauliflower, soybeans, green leafy vegetables

21
Q

Hypocalcemia Causes

A
  • Renal failure
  • Decreased intake or absorption
  • Acute pancreatitis
  • Hypoparathyroidism
  • Vitamin D deficiency
  • Low magnesium level
  • Low serum albumin
  • Increased phosphorus
22
Q

Hypocalcemia Manifestations

A
  • Skeletal muscle spasm, cramps, tetany
  • Convulsions
  • Paresthesias of lips and extremities
  • Chvostek’s sign
  • Trousseau’s sign
  • Cardiac arrhythmias
  • Osteoporosis
23
Q

Hypocalcemia Tx

A
  • IV calcium gluconate (monitor IV for tissue necrosis)
  • Oral supplements with vitamin D with food
  • Cardiac monitor
24
Q

Hypercalcemia Causes

A
  • Excess intake/absorption
  • Hyperparathyroidism
  • Bone cancer causing breakdown of bone
  • Multiple fractures
  • Prolonged immobilization
  • Prolonged use of aluminum-containing antacids
25
Q

Hypercalcemia Manifestations

A
  • Anorexia, N/V, constipation
  • Muscle weakness, lethargy, decreased deep tendon reflexes
  • Polydipsia, polyuria, dehydration
  • Impaired concentration, confusion
  • Blurred vision
  • Bone pain
  • Cardiac arrhythmias
26
Q

Hypercalcemia Tx

A
  • Diuretics
  • IV hydration with NS to increase renal blood flow and urinary excretion
  • IV biphosphonates- obstruct calcium release from bone
  • Calcitonin (spray): inhibits release from bone and promotes renal excretion
  • Cardiac monitor
  • Encourage fluids (3-4L/day)
27
Q

Magnesium (Mg2+)

A
  • Second most abundant cation in ICF
  • An activating co-factor with more than 300 enzymes
  • Needed for formation and function of bones
  • Influences PTH and calcium levels
  • Important in blood clotting, DNA and RNA synthesis, cardiovascular regulation
  • Increases or decreases with K+
  • Increased intake of Ca2+ or P- decreases absorption of Mg2+ (vice versa)
28
Q

Magnesium dietary sources

A

Vegetables (spinach, broccoli), avocado, potato, whole grains, beef, chicken, tuna, milk, yogurt, raisins

29
Q

Hypomagnesemia Causes

A
  • Occurs in same conditions that lead to decreased K+ and Ca2+ levels
  • Inadequate intake
  • Alcoholism
  • Malabsorption
  • Hypothyroidism
  • Meds (diuretics, aminoglycoside antibiotics)
30
Q

Hypomagnesemia S/S

A
  • S/S not seen until less than 1 mEq/L
  • Cardiac arrhythmias
  • Neuromuscular irritability, twitches, tremors, leg and feet cramping
  • Restlessness, disorientation
  • Anorexia, N/V
31
Q

Hypomagnesemia Tx

A

Oral supplements, IV magnesium sulfate (max rate 150mg/min)

  • Cardiac monitor
  • Monitor neuro status
  • Monitor for digitalis toxicity
32
Q

Hypermagnesemia Causes

A

Renal dysfunction, chronic excessive use of laxatives (milk of magnesia, magnesium sulfate) or antacids (Mylanta)

33
Q

Hypermagnesemia S/S

A
  • Flushing, increase perspiration
  • Muscle weakness
  • Decreased deep tendon reflexes
  • N/V
  • Cardiac arrhythmias
  • Decreased BP
  • Lethargy, CNS depression
34
Q

Hypermagnesemia Tx

A
  • IV fluids increases excretion
  • Cardiac monitor
  • Monitor renal status and resp. status
  • Dialysis if needed
35
Q

Phosphorus (P-) or Phosphate (PO4-)

A
  • Most abundant anion in ICF
  • Metabolism of protein, calcium, and glucose
  • Muscle contractions
  • Maintaining acid-base balance
  • Found in ATP
  • Needs vitamin D for absorption
  • When Ca2+ is increased, P- is decreased (vice versa)
  • Controlled by PTH hormones: stimulates kidney to excrete P-
36
Q

Phosphorus dietary source

A

Milk, cheese, egg yolk, meat, nuts

37
Q

Hypophosphatemia Causes

A
  • Hyperventilation (sepsis, anxiety, pain, heatstroke, DKA, alcohol withdrawal)
  • Hyperparathyroidism
  • Decreased absorption (vomiting, diarrhea, vitamin D deficiency)
  • Diuretic use
  • Hyperglycemia
38
Q

Hypophosphatemia S/S

A
  • Numbness and tingling (parethesia)
  • Staggering gait (ataxia), tremor, weakness
  • Disorientation, confusion, seizures, difficulty speaking and swallowing
  • Unequal eye movements
  • Bruising, GI bleeding
39
Q

Hypophosphatemia Tx

A
  • Oral supplements

- IV potassium phosphate or sodium phosphate (must dilute; max rate 1-mEq/L)

40
Q

Hyperphosphatemia Causes

A
  • Renal failure
  • Increased intake and excess use of laxatives or enemas
  • Cell breakdown or injury (rhabdomyolysis, trauma, burns, exhaustive exercise, heat-related illness, severe infection)
  • Hypoparathyroidism
41
Q

Hyperphosphatemia S/S

A
  • Usually asymptomatic
  • Tetany
  • S/S are related to hypocalcemia (lethargy, fatigue, bone or joint pain, sudden seizure, cramps, numbness, tremors, N/V, abdom. distention, constipation, dysrhythmias)
42
Q

Hyperphosphatemia Tx

A
  • Aluminum-based antacids bind with P- in GI tract
  • Diuretics
  • Glucose and insulin moves P- into ICF
  • Correct hypocalcemia
  • Dialysis if needed

Nursing II Final Exam (3 decks)

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