Electrolytes Flashcards
Functions of Electrolytes
Promote neuromuscular irritability
Regulate acid & base balance
Regulate distribution of body fluids among body compartments
These electrolytes are most common in Intracellular fluid
Prevalent cation is K+
Prevalent anion is Phosphate
These electrolytes are the most common in extracellular fluid
Prevalent cation is Na+
Prevalent anion is Cl-
Functions of Sodium
Attracts fluid and helps preserve fluid volume
Combines with chloride and bicarbonate to regulate acid-base balance
Who am I: (blank increases) then - Increase thirst – increase ADH, kidneys retain water, dilutes blood and normalizes serum osmolality
Sodium
Who am I: (Blank Decreases)– ADH suppression, kidneys excrete more water to restore normal serum osmolality
Sodium
(BLANK) regulates ECF sodium balance via feedback loop – adrenal cortex secretes aldosterone, stimulates renal tubules to conserve water and sodium when serum sodium low – normalizes ECF sodium level.
Aldostereone
Untreated changes in (BLANK) levels can lead to serious cardiac and neuromuscular problems
Potassium
PH: (BLANK) –> hyperkalemia (K+ moves out of cells)
Acidosis
PH: (BLANK)–> hypokalemia (K+ moves into cells)
Alkalosis
S.U.C.T.I.O.N.
Skeletal muscle weakness U wave (EKG changes) Constipation, ileus Toxicity of digitalis glycosides Irregular, weak pulse Orthostatic hypotension Numbness (paresthesia)
S.U.C.T.I.O.N. reflects (blank)
Hypokalemia
S.A.L.T.
Skin flushed
Agitation
Low grade fever
Thirst
SALT reflects (BLANK)
Hypernatremia
More symptoms of Hypernatremia
Restlessness Dry, sticky mucous membranes, rough/dry tongue Tachycardia Lethargy Seizures/Coma Impaired LOC
Interventions for Hypernatremia
Correct underlying disorder Gradual fluid replacement Monitor for s/s of cerebral edema Monitor serum Na+ level Seizure precautions
Causes of Hypernatremia
May be caused by water deficit or over-ingestion of Na+
Also may result from diabetes insipidus
Renal Dysfunction
When high levels of (blank) occurs, fluid shifts outside the cells
Sodium
Nursing interventions for hyponatremia
Restrict fluid intake for hyper/isovolemic hyponatremia
IV fluids and/or increased po Na+ intake for hypovolemic hyponatremia
Nursing Interventions for severe hyponatremia
Infuse hypertonic NaCl solution (3% or 5% NaCl)
Furosemide to remove excess fluid
Monitor client in ICU
Can be caused by GI losses, diarrhea, insufficient intake, non-K+ sparing diuretics (thiazide, furosemide)
Hypokalemia
Hypokalemia Nursing Interventions
Increase dietary K+ Oral KCl supplements IV K+ replacement – Do not give IV push Change to K+-sparing diuretic Monitor EKG changes
Renal dysfunction is most common cause
Renal failure
Addison’s disease
Adrenocortical insufficiency
Hypermagnesemia
Role in cell membrane permeability
calcium
Affects cardiac muscle contraction
Participates in blood clotting
calcium
Signs and Symptoms of (Blank)
Decreased neuromuscular activity
Generalized weakness
Occasionally nausea/vomiting
Hypermagnesemia
Hypomagnesemia cardiovascular symptoms
Tachycardia
Hypertension
EKG changes
Hypomagnesemia GI symptoms
Dysphagia
Anorexia
Nausea/vomiting
Hypomagnesemia CNS/Neuromuscular symptoms
Altered LOC Confusion Hallucinations Muscle weakness Leg/foot cramps Tetany
Calcium Regulation
Affected by body stores of Ca++ and by dietary intake & Vitamin D intake
Parathyroid hormone draws Ca++ from bones increasing low serum levels (Parathyroid pulls)
With high Ca++ levels, calcitonin is released by the thyroid to inhibit calcium loss from bone (Calcitonin keeps)
Hyperkalemia: Nursing interventions for mild cases
Loop diuretics (Lasix) Dietary restriction
Hyperkalemia: (BLANK DRUG) is utilized for moderate cases
Kayexalate
*10 %Potassium only excreted by bowel, rest via kidneys
What is kayexalate?
Sodium polystyrene sulfonate (kayexalate) is not absorbed from the gastrointestinal tract. As the resin passes through the gastrointestinal tract, the resin removes the potassium ions by exchanging it for
sodium ions. Onset is 2-12hours…in severe cases of hyperkalemia kayexalate not utilized as wanting a faster/more reliable effect
Emergency Interventions for Hyperkalemia
10% calcium gluconate for cardiac effects
Sodium bicarbonate for acidosis
Why utilize calcium gluconate for hyperkalemia
The calcium gluconate is used as a protector for the cardiac cells. They are very fragile and we need to protect their electric conductivity. This has a short duration of action
Who am I:
Role in protein synthesis & carbohydrate metabolism
Helps cardiovascular system function (vasodilation)
Regulates muscle contractions
Magnesium
Who am I:
Helps produce ATP
Magnesium
Caused by poor dietary intake, poor GI absorption, excessive GI/urinary losses
Hypomagnesemia
High Risk Individuals for (blank) Chronic alcoholism Malabsorption GI/urinary system disorders Sepsis Burns Wounds needing debridement
Hypomagnesemia
Nursing Interventions for Hypermagnesemia
Increased fluids if renal function normal
Loop diuretic if no response to fluids
Calcium gluconate for toxicity
Mechanical ventilation for respiratory depression
Hemodialysis (Mg++-free dialysate)
Who am I:
99% in bones, 1% in serum and soft tissue
Works with phosphorus to form bones and teeth
Calcium
Symptoms of Hypocalcemia
Neuromuscular:
Anxiety, confusion, irritability, muscle twitching, paresthesia (mouth, fingers, toes), tetany
Fractures
Diarrhea
Diminished response to digoxin
EKG changes
Causes of Hypocalcemia
Caused by inadequate intake, malabsorption, pancreatitis, thyroid or parathyroid surgery, loop diuretics, low magnesium levels
Nursing Interventions for Hypocalcemia
Calcium gluconate for postop thyroid or parathyroid client
Cardiac monitoring
Oral or IV calcium replacement
Nursing Interventions for Hypomagnesemia
Use infusion pump
Monitor vital signs for hypotension and respiratory distress
Monitor serum Mg++ level q6h
Cardiac monitoring
Calcium gluconate as an antidote for overdosage
Two major causes of hypercalcemia
Cancer
Hyperparathyroidism
Signs and Symptoms of Hypercalcemia
Fatigue, confusion, lethargy, coma Muscle weakness, hyporeflexia Bradycardia cardiac arrest Anorexia, nausea/vomiting, decreased bowel sounds, constipation Polyuria, renal calculi, renal failure
Who am I: Nursing Interventions: If asymptomatic, treat underlying cause Hydrate the patient to encourage diuresis Loop diuretics Corticosteroids
Hypercalcemia
