Electrolytes Flashcards
Mg - Magnesium (normal blood value)
1.6-2.6 mg/dL
Na - Sodium (normal blood value)
135-145 mEq/L
K - Potassium (normal blood value)
3.5-5.0 mEq/L
Ca - Calcium (normal blood value)
8.6-10 mEq/L
Phosphorus (normal blood value)
2.7-4.5 mEq/L
Hypokalemia causes what changes to ECG
- ST Depression
- Shallow, flat, or inverted T Wave
- Prominent U Wave
Foods High in Potassium Include
- Avocado
- Banana
- Cantaloupe
- Carrots
- Fish
- Mushrooms
- Oranges
- Potatoes
- Pork
- Beef
- Veal
- Raisins
- Spinach
- Strawberries
- Tomatoes
Signs of Hypocalcemia
- decreased heart rate
- hypotension
- diminished peripheral pulses
- hyperactive deep tendon reflexes
- increased gastric motility
- hyperactive bowel sounds
- Twitching
- Muscle spasm
- Numbness
- Hyperactive Reflexes
- Positive Trousseaus & Chvostek signs
- Anxiety & irritability
What type of patients are at high risk for fluid loss?
- elderly
- patients with an ileostomy or colostomy
Hyperkalemia and burns
Patients with wounds or substantial burns are at greater risk of hyperkalemia due to cellular fluid shifting during trauma. Also can be caused by sepsis or respiratory acidosis.
Administration of potassium
Potassium is administered by infusion solution. It is never given IM, subcut or bolus.
Should be diluted to 1 mEq/10ml.
Administration rate is 5-10 mEq per hour, NEVER to exceed 20 mEq per hour.
Renal function should assessed prior to administration & fluid balance should be monitored during administration.
Potassium infusion can cause phlebitis.
Hypocalcemia & Changes to the ECG
- Prolonged ST segment
2. Prolonged QT interval
Hypercalcemia & Changes to the ECG
- Shortened ST segment
2. Widened T wave
Hypokalemia & Changes to the ECG
- ST depression
- Shallow, flat or inverted T Wave
- Prominent U wave
Hypomagnesemia & Changes to the ECG
- Tall T Waves
2. Depressed ST segment
Hypermagnesemia & Changes to the ECG
- Prolonged PR interval
2. Widened QRS Complexes
Chvostek’s Sign
Contraction of the facial muscles in response to a light tap over the facial nerve in front of the ear.
Trousseau’s Sign
Carpal spasm induced by inflating a blood pressure cuff . The thumb and forefinger come together and contract inward toward the wrist.
Signs of Hypercalcemia
- increased heart rate
- increased BP
- bounding peripheral pulses
- ineffective respiratory movement
- profound muscle weakness
- diminished or absent deep tendon reflexes
- disorientation, lethargy, coma
- formation of renal calculi, flank pain
- decreased gastric motility & hypoactive bowel sounds
- anorexia, nausea, abdominal distention, constipation
Common sources of Magnesium
- almonds
- avocado
- canned white tuna
- cauliflower
- green leafy vegetables
- milk
- oatmeal
- peanut butter
- peas
- pork
- beef
- chicken
- soy beans
- potatoes
- raisins
- yogurt
Signs of Hypomagnesemia
- tachycardia
- hypertension
- shallow respirations
- twitching
- trousseaus & chvosteks signs
- hyperreflexia
- seizures
- irritability
- confusion
Signs of Hypermagnesemia
- bradycardia
- hypotension
- respiratory inssufficiency
- diminished deep tendon reflexes
- drowsiness, lethargy, coma
Common Sources of Phosphorus
Fish Pumpkin, squash Nuts Pork, beef, chicken & organ meats Whole Grain breads & Cereals Dairy Products
Cardiac changes in hypokalemia
Includes:
- impaired depolarization resulting in flattening of the T wave and eventually emergence of a U wave.
- potentially lethal dysrhythmias is increased
-
Signs of Hyponatremia
- pulse can be rapid, thready, weak, bounding or normal depending on whether the patient is normovolemic, hypovolemic or hypervolemic.
- shallow ineffective respiration
- generalized muscle weakness
- diminished deep tendon reflexes
- headache
- personality changes
- confusion
- seizures
- coma
- increased gastric motility and hyperactive bowel sounds
- nausea
- abdominal cramping
- dry mucous membranes
Signs of Hypernatremia
- heart rate and BP respond to vascular volume status
- pulmonary edema if hypervolemia is present
- early: muscle twitching & irregular contractions
- late: muscle weakness, diminished deep tendon reflexes
- altered mental function
- normo or hypovolemia - agitation, confusion, seizures
- hypervolemia - lethargy, stupor, coma
- extreme thirst
- decreased urinary output
- dry flushed skin
- dry sticky tongue & mucous membranes
- edema depending on fluid volume changes