Electrolytes Flashcards
Name the causes for Hyponatremia.
Increased sodium excretion
(N/D/V, diuretics, wound drainage, kidney disease, or decreased secretion of aldosterone)
Inadequate sodium intake
Dilution of serum sodium
(Excessive hypotonic fluids, kidney disease, freshwater drowning, hyperglycemia, or Heart Failure)
Normal Range for serum sodium?
135-145mEq/L
Name the causes for Hypernatremia.
Decreased sodium excretion
(Cushings, corticosteroids, kidney disease, hyperaldosteroism)
Increased sodium intake
Decreased water intake
Increased water loss
Name common food sources for Sodium.
Bacon Butter Canned food Cheese Ketchup and Mustard Lunch meat Milk Processed foods Soy sauce Table salt White and whole wheat bread
Hyponatremia signs and symptoms
*think Neurological
Skeletal muscle weakness
Increased urinary output and GI motility
Mental Changes
Hypernatremia signs and symptoms
*think neurological
Extreme thirst
Decreased urinary output
Muscle twitching and/or weakness
Interventions for Hyponatremia
Monitor electrolytes
IV sodium chloride infusion (if both fluid & sodium are decreased)
Osmotic diuretic administered (if sodium is low and fluid volume is high)
Increase oral sodium intake
Monitor closely if taking Lithium (Hyponatremia can cause lithium toxicity)
Interventions for Hypernatremia
Monitor electrolytes
Prepare to administer IV infusions if the cause is fluid loss
If caused by inadequate renal excretion than administer diuretics that promote sodium loss
Restrict sodium & fluid intake as prescribed
Normal range for serum Potassium
3.5-5.0
Name the causes for Hypokalemia
Excessive potassium intake
Decreased potassium excretion
(Kidney disease, potassium retaining diuretics, or adrenal insufficiency like Addisons)
Potassium shifting from intercellular fluid to extracellular fluid
(Tissue damage, acidosis, hyperuricemia, or hypercatabloism)
Name Common Foods rich in Potassium
Avocado Bananas Cantaloupe Carrots Fish Mushrooms Oranges Potatoes Pork, beef, veal Raisins Spinach Strawberries Tomatoes
Name the signs & symptoms of Hypokalemia
*think Cardiac
Thready, weak irregular heart rate
Muscle cramps
Arrhythmias that can be life threatening
Name the signs & symptoms of Hyperkalemia
*think Cardiac
Slow, weak irregular heart rate
Muscle twitching initially then followed by flaccid paralysis
Arrhythmias that can be life threatening
Aldosterone increases when……..
Blood Volume goes down
Where is aldosterone found?
Name the diseases the result from too much aldosterone being secreted and too little being secreted.
Aldosterone is found in the adrenal glands
Too Much: cushings and hyperaldosteroism
Too Little: Addisons
Where is ANP found and what is it’s function?
ANP is found in the atria of the heart and is a hormone that works on the kidneys to reduce blood volume.
Where is ADH found and what is its function?
What are some common causes?
ADH is found in the pituitary and makes your body retain water.
Causes can include Increased ICP, head injury, craniotomy, or transphenoidal hypophysectomy.
Name the disease caused by too much ADH and some common signs and symptoms.
SIADH (makes you go into FVE)
Urine decreases and is concentrated
Blood is diluted (low electrolyte levels)
S/S of FVE
Name the disease caused by not enough ADH and common sign and symptoms.
Diabetes Insipidus (which causes FVD)
Urine is diluted and blood is concentrated (high electrolyte levels)
Watch for shock!
Has NOTHING to do with blood sugar!
The Removal of the pituitary gland through the sinuses is called:
Transphenoidal Hypophysectomy
Treatment for FVE:
Low Na diet/restrict fluids as ordered
Weights daily
Bed rest
Physical assessments
Diuretics
Name the treatments for FVD:
Prevent further fluid loss
Replace fluid loss by PO and/or IV fluids
Monitor for fluid overload
At higher risk for falls r/t vitals and LOC
Isotonic solutions and contradiction uses:
Normal Saline (0.9%)
LR
d5W
D5 1/2 NS
Contradiction w/clients with HTN, cardiac disease, or renal disease because these solutions can cause FVE
Name examples of hypotonic solutions and contradictions.
D2.5W, 1/2NS. 0.33%NS
*rehydrates cells but does not cause HTN
Contradictions: watch for cellular edema and FVD, which would cause decreased B/P
Name hypertonic solutions and contradictions:
D10W, 3%NS, 5%NS, D5LR, D5 1/2NS, TPN, and Albumin
Used for patients who have developed 3rd spacing, severe edema, burns, and/or ascites.
*watch for FVE!
Normal lab value for Calcium
8.6-10.5mg/dl
Name 3 causes of Hypercalcemia
6 Signs & Symptoms
6 Treatments
Hyperparathyroidism, thiazides, immobilization
S/S: brittle bones, kidney stones, ^b/p, muscle weakness, decreased DTRs, and decreased pulse
Tx: bear weight(move!), push fluids as ordered (prevent kidney stones), Pospho Soda Fleet Enema, Steroids, add phosphorus diet, and/or Calcitonin
Normal Lab Value for Magnesium
1.2-2.6mg/dl
Name 3 causes for HyperMagnesium
Identify 6 Signs & Symptoms
Name 4 Treatments
Causes: Renal Failure, Antacids, Overdose of Mg
S/S: flushing~warmth, vasodilation, decreased DTRs, decreased LOC, muscle weakness, and drowsiness
Tx: Ventilator (if RR<12rpm)
Dialysis (if kidneys not working properly)
Calcium Gluconate IV slowly (antidote to Mg toxicity)
Safety Precautions
Name 3 causes of HypoCalcemia
Name 6 signs & symptoms
Name 3 treatments
Causes: Hypoparathyroidism, Radical Neck, and Thyroidectomy
S/S: Mind changes, rigid/tight muscle tone, possible seizures, +chovstek’s(cheek tap), +Trousseau’s( b/p cuff, increased DTRs, & swallowing problems
Tx: Vitamin D
Phosphate Binders
IV Ca (given slowly) w/heart monitor
Name 3 causes for HypoMagnesia
Name 6 signs & symptoms
Name 4 Treatments
Causes: Diarrhea, Alcoholism, Starvation or Drinking
S/S: mind changes, tight/rigid muscle tone, increased DTRs, +Chovstek’s, +Trousseau’s, and possible seizures.
Tx: IV Mg
Check kidney function
Seizure Precautions
Eat Magnesium
Name the Causes of Respiratory Acidosis
Name the S/S
List some treatments
Causes: pneumonia, narcotics, sleeping pills, collapsed lung, or mid abd incision
S/S: H/A, confusion, sleepy
Restlessness & Tachycardia
Tx: treat the cause
Post-Op: turn, cough, and deep breathe
Name causes for Respiratory Alkalosis
Name S/S
List Treatments
Causes: Hyperventilating, Hysteria, Acute Aspirin Overdose
S/S: light headed, numbness/tingling in fingers and toes, Peri-oral numbness
Tx: breathe into bag
Calm client
Treat the cause
Monitor ABGs
Name 5 foods that contain high amounts of Calcium
Milk and Soy Milk Cheese Collard Greens Yogurt Tofu
Nam 5 foods that contain high amount of Magnesium:
Avocados Green leafy vegetables Oatmeal Pork, beef,chicken, and soy beans Peanut Butter
Name 5 foods with high amounts of Phosphorus:
Fish Nuts Pork, beef, chicken, organ meats Dairy products Whole grain breads and cereals
Name the causes of Metabolic Acidosis
Signs & Symptoms
Treatments
Causes: DKA, Starvation, Renal Failure, Severe Diarrhea, High fat diet, Excessive ASA ingestion
S/S: depends on cause, Hyperkalemia, increased RR
(Kussmaul Respirations)
Tx: treat the cause (like insulin for DKA)
Monitor Respiratory, I&Os, LOC, Safety/seizure precautions
Watch K+ levels (tx may cause Hypokalemia)
IV sodium bicarb push as ordered
Name the Causes of Metabolic Alkalosis
Signs & Symptoms
Treatments
Causes: loss of GI contents(like excessive suctioning or vomiting), diuretics,too many Antacids, and too much bicarb
S/S: depends on cause
K+ goes down (watch LOC, cramping, arrhythmias)
Tx: fix the cause
Replace K+
Prepare to administer meds to promote excretion of bicarb through kidneys
Normal HCO3 level
22-27mEq/L
Normal pCO2 level
35-45mm Hg
Normal Po2 level
80-100mmHg
