Electrolytes Flashcards
Electrolytes Imbalances you commonly see
Potassium Magnesium Phosphorous Calcium Sodium
Measured on chemistry panels. Often the nurse is the first on to notice abnormalities that require treatment. fishbone diagram
Potassium
Essential for transmission of nerve impulses, maintaining acid-base balance and contraction of smooth, skeletal and cardiac muscle
Normal values 3.5-5.0 mEq/L
Too much or too little K+ can lead to fatal cardiac dysrhythmias
Hypokalemia is treated with oral or IV K+
Nursing Implications: Never IV push, burns when admin peripheral IV, slow infusion (at least over an hour)
Hyperkalemia treatment
Polystyrene sulfate (Kayexelate) given orally or rectally. Removes potassium be exchanging it with sodium in the intestine where it is excreted in the stool
“K Cocktail” is a combo of 2-4 IV meds given to quickly lower potassium (shifts K+ into the cells but effect is not permanent)
-10 units regular insulin IV
-50 mL of 50% dextrose IV
-1 gram Calcium IV (optional) - cardio protective effect
-50 mEq sodium bicarbonate IV (optional) - acid base balance
Calcium
Essential for bone formation, transmission of nerve impulses and skeletal and cardiac muscle contractility
NOrm Val 8.5-10 mg/dL
Most calcium binds to albumin- if albumin is low, serum calcium appears falsely low.
Hypercalcemia is treat with IV fluids and loop diuretics
Hypocalcemia is treated with PO or IV calcium.
IV CaCl delivered the most elemental Ca+ but should on lay be given via central line
IV Ca+ gluconate can be given via peripheral IV
Magnesium
- Essential for transmission of nerve impulses and muscle relaxation
- Normal values 1.5-2.5 mEq/L
- Often assoc. with hypokalemia
- Also administered in OB for eclampsia and to stop pre-term labor (IV to relax uterus)
- Hypomagnesemia is treated with PO or IV magnesium (IV can cause flushing and hypotension if given too fast)
Phosphorus
Essential for bon eformations
Norm Val 2.5-4.5 mg/dL
Hyperphosphatemia is assoc.. with symptoms of hypoclacemia (tetany, seizures) - treat with phosp binders
Hypophosphatemia leads to muscle weakness, treated with PO and IV phosphorous. IV phosp is administered over 4-6 hours
Sodium
Essential for regulating fluid volume and neuromuscular function
Normal values 135-145 mEq/L
HyPOonatremia can lead to lethargy and seizure - treat with PO or IV Na+ containing solution or fluid restriction
HyPERnatremia have altered mental status - treated with oral of IV free water replacement
Abnormal sodium levels must be corrected SLOWLY and require frequent monitoring of sodium levels (or may have irreversible or fatal neurological consequences)
