Electrolytes

Question 1

Hyponatremia < 136 mEq/L

SS

Answer 1

• VS: low temp, tachycardia, rapid thready pulse, HoTN, OH
• Apprehension
• personality changes
• HA
• confusion
• abdominal cramps, NVD
• muscle weakness, lethargy
• decreased LOC
• seizures,coma

Question 2

hypernatremia >145 mEq/L

Answer 2

• VS: high temp, tachycardia, OH, postural HoTN
• Extreme thirst, dry flushed skin, dry tongue and mucous membranes
• agitation, irritability, restless, confusion
• seizure, coma

Question 3

hypokalemia <3.5 mEq/L

Answer 3

• VS: increased temp, weak irregular pulse, HoTN, OH, respiratory distress
• EKG abnormalities: ventricular dysrhythmias, irregular pulse
• BILATERAL muscle weakness
• DECREASED deep tendon reflexes
• constipation, NV, intestinal distention, decreased bowel sounds

Question 4

hyperkalemia >5 mEq/L

Answer 4

• VS: slow irregular pulse, HoTN
• anxiety, muscle weakness
• parasthesias (numbness and tingling)
• dysrhythmias, cardiac arrest
• abdominal cramps, diarrhea

Question 5

hypocalcemia < 8.4 mg/dL

Answer 5

• positive Chvostek’s sign and Trousseau’s sign
• numbness/ tingling fingers and circumoral
• hyperactive reflexes
• muscle twitching -cramping
• seizures
• tetany

Question 6

hypercalcemia > 10.5 mg/dL

Answer 6

-anorexia
-NV, constipation
-fatigue
decreased LOC -personality changes=confusion
- flank pain from kidney stones
-ECG abnormalities: heart block
-X-rays shows osteoporosis

Question 7

hypomagnesemia

Answer 7

• positive Chvostek’s sign and Trousseau’s sign
• deep tendon reflexes (DTRs) hyperactive
• muscle cramps/twitching/seizures, grimacing

Question 8

hypermagnesemia

Answer 8

• lethargy, DTRs, hypoactive, flaccid, paralysis
• bradycardia, HoTN, cardiac dysrhythmias, cardiac arrest
• flushing, sensation of warmth
• rate and depth of respirations

Question 9

fluid volume deficit SS

Answer 9

• sudden weight loss (overnight)
• HoTN, postural HoTN
• tachycardia
• cold, clammy skin
• hypovolemic shock
• flat neck veins or collapsing with inhalation
• dark yellow urine, oliguria (<30 ml/hr)
• dry mucous membranes ~ loss of tears/sweat
• poor skin turgor
• furrowed tongue, thirst
• restless/ confusion

Question 10

fluid volume excess

Answer 10

• sudden weight gain
• edema
• distended neck veins when upright
• crackles in lung fields-may lead to pulmonary edema, “wet” lung sounds
• SOB
• HTN
• CVP