Electrolytes Flashcards
Mg and Ca act like what?**
sedatives
Hypermagnesium causes:
renal failure
antacids
with Mg and Ca think what first?
muscles
S/S hypermagnesium
flushing warmth vasodilation decreased DTRs Muscle tone is weak and flaccid possible arrhythmias decreased LOC decreased pulse decreased respirations
Mg given to PIH pt why
to decrease bp and prevent seizures (because acts like sedative)
hypermagnesium treatment
ventilator - if respirations less than 12
dialysis - because kidneys not working
calcium gluconate - antidote for mg toxicity
safety precautions because sedated
hypercalcium s/s
brittle bones kidney stones decreased DTRs Muscle tone is weak and flaccid possible arrhythmias decreased LOC decreased pulse decreased respirations
phosphorous and what have inverse relationship
calcium
hypercalcemia causes
too much PTH (parathormone) - increases Ca
thiazides- retains calcium
immobilization - have to bear weight to keep ca in bones
hypercalcemia treatment
Moving
fluids to prevent kidney stones
sodium phosphate (phosphosoda and fleet) - have phosphorus - inverse relationship with ca
steroids - decrease ca by excreting it through the GI tract
add phosphorus to diet (anything with protein)
safety precautions because sedated
vitamin D to use Ca
calcitonin - decreases ca
hypomagnesmia and hypocalcemia means
not enough sedative
hypomagnesmia causes
diarrhea - lots of mg in intestines
alcoholism - not eating so no mg coming in and diuresising because alcohol suppresses ADH and it’s hypertonic
hypomagnesmia s/s
muscle tone rigid and tight
possible seizure
stridor/larngospasm - airway smooth muscle
chvosteks and trousseaus
arrhythmia’s - heart is muscle
increased DTR
mind changes - might be psychotic or depressed
swallowing problems - esophagus smooth muscle - risk for aspiration
hypomagnesmia treatment
give some Mg - check renal function before giving IV mg
seizure precations
eat magnesium
hypocalcemia s/s
muscle tone rigid and tight
possible seizure
stridor/larngospasm - airway smooth muscle
chvosteks and trousseaus
arrhythmia’s - heart is muscle
increased DTR
mind changes - might be psychotic or depressed
swallowing problems - esophagus smooth muscle - risk for aspiration
what do you do if your pt reports flushing and sweating when you start IV mg?
STOP IT!
Mg will decrease respirations
foods high in mg:
spinach, mustard greens, summer squash, broccoli, hailbut, turnip greens, pumpkin seeds, peppermint, cucumber, green beans, celery, kale, sunflower seeds, sesame seeds and flax seeds
hypocalcemia causes
hypoarathyroidism
radical neck
thyroidectomy
(all have not enough PTH so decreases serum Ca)
hypocalcemia treatment
Vitamin D - to help utilize Ca
Phosphate binders (sevelamer hydocholoride (renagel) and calcium acetate (phoslo) - bind to phos and decrease it to increase ca
IV calcium - give slowly
Your Na level is totally dependent on what
how much water is in your body
hypernatremia =
dehydration
too much Na, not enough water
hypernatremia causes
hyperventilation - lose water when exhale
heat stroke
DI
V/D
hypernatremia s/s
dry mouth
thirsty
swollen tongue
the brain doesn’t like it when what electrolyte is messed up
sodium so think neuro changes*
hypernatremia treatment
restrict sodium
dilute pt with fluids - diluting makes Na go down
daily weights and I&O - if Na problem then fluid problem
Lab work
Feeding tube pts tend to get
dehydrated = hypernatremia
important to check serum sodium
ask MD if can give more water with feeding
hyponatremia =
dilution
too much water, not enough Na
hyponatremia causes
drinking water for fluid replacement - only replaces water and dilutes the blood
Psychogenic polydipsia - loves to drink water
D5W (sugar and water)
SIADH - retaining water
hyponatremia s/s
H/A
Seizures
Coma
hyponatremia treatment
pt needs Na and doesn’t need water
If having neuro problems needs hypertonic saline - packed with particles - 3% NS or 5% NS - worry about FVE because pulling fluid into vascular space - give slowly
Potassium excreted by
the kidneys, so if kidneys not working well potassium will go up
Hyperkalemia causes
kidney trouble
spirnolactone (aldactone) - makes you retiain potassium
Hyperkalemia s/s
begins with muscle twitching then proceeds to weakness then flaccid paralysis
also life threatening arrhythmias
Hyperkalemia treatment
dialysis - kidneys aren’t working
calcium gluconate - decreases arrhythmia’s
insulin to carry glucose and potassium into the cell
sodium polystyrene sulfonate (kayexalate) - Na and K have inverse relationship
Hyperkalemia ECG changes
bradycardia, tall and peaked T waves, prolonged PR intervals, flat or absent P waves, widened QRS, conduction blocks, v fib
Hypokalemia causes
vomiting
NG suction (lots of K in stomach)
Diuretics
Not eating
Hypokalemia s/s
muscle cramps
weakness
life threatening arrhythmias
Hypokalemia ECG changes
U waves, PVCs, V tachy
Hypokalemia treatment
give potassium
spironolactone (aldactone) - makes them retain potassium
eat more potassium
major problem with PO K+
GI upset - so give with food
what to assess prior to giving IV K+ **
urine output
if it drops will cause them to retain potassium and can kill them
Never give IV K+
push - lethal injection - has to be diluted
Does K+ burn during infusion?
yes, K can eat up peripheral veins
Foods high in potassium
spinach, kale, mustard greens, brussel sprouts, broccoli, eggplant, cantaloupe, parsley, cucumber, bell pepper, apricots, ginger root, strawberries, avocado, banana, tuna, cauliflower, kiwi, oranges, lima beans, potatoes, and cabbage
electrolyte imbalance with burns
hyperkalemia - potassium is inside the cells and with burns they lyse open and K is released into the blood
hyperparathyriodism =
hypercalcium = hypophosphatemia
pt will be sedated
TX: partial parathyroidectomy
hypoparathyroidism =
hypocalcium = hyperphosphatemia
pt not sedated
TX: IV calcium (give slow causes bradycardia), phosphate binding drugs (Renagel, PhosLo)
electrolytes lost when detoxing
mg and k - when drink diuresis and then lose them
