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341 Exam 2 > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

Sodium levels

A

136-145

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2
Q

Potassium levels

A

3.5-5.0

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3
Q

Calcium levels

A

9.0-10.5

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4
Q

Phosphate levels

A

3.0-4.5

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5
Q

Magnesium levels

A

1.3-2.1

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6
Q

Maintaining normal nerve and muscle function, regulation of acid-base balance

A

Sodium Role

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7
Q

Imbalances for sodium

A

Hypernatremia

Hyopnatremia

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8
Q

a. Increased free water loss or increased sodium gain
b. Causes hyperosmolality (shifts out of cell) leading to cellular dehydration
c. Body’s protection – thirst!

A

Hypernatremia

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9
Q

a. Clinical Manifestations; hypernatremia

A

i. Excessive thirst
ii. Cognitive dysfunction
iii. Signs of volume depletion if there is volume deficit

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10
Q

Nursing interventions/treatment: hypernatremia

A

i. Monitor VS, assessments, fluid status
ii. Treat the underlying cause!
1. Free water loss - IV Fluids (hypotonic or isotonic)
2. Abnormal sodium gain – Sodium-free IVF + diuretic
iii. Monitor sodium levels and response to treatment

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11
Q

a. Results from excess water intake or abnormal sodium/water loss
b. Can be an isolated event or occur secondary to other illnesses

A

Hyponatremia Na <136

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12
Q

Clinical manifestations: Hyponatremia

A

i. Mild to severe neurological symptoms

ii. Headache, irritability, confusion, lethargy, seizures, coma

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13
Q

Treatment: hyponatremia
if excess water:
if abnormal fluid loss is cause;

A

i. Euvolemic - fluid restriction
ii. If excess water is cause – diuretics
iii. If abnormal fluid loss is cause – administer isotonic fluids, encourage fluid intake

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14
Q

Excess water:

A

i. Fluid restriction may be only treatment
ii. Loop diuretics and demeclocycline
iii. Severe symptoms (seizures)
iv. Give small amount of IV hypertonic saline solution (3% NaCl)

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15
Q

Abnormal fluid loss

A

i. Fluid replacement with isotonic sodium-containing solution
ii. Encouraging oral intake
iii. Withholding diuretics

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16
Q

i. Promotes normal function of nerve and muscle cells, maintains normal electricity of the heart, aids in movement of nutrients and waste products, cellular growth, acid-base balance

A

Potassium

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17
Q

Clinical manifestations: Hyperkalemia

A

i. Cardiac arrhythmias
ii. Fatigue, confusion
iii. Muscle cramps (tetany)
iv. Weak or paralyzed skeletal muscles
v. Abdominal cramping, diarrhea

18
Q

Meds for K excretion

A

diuretics, dialysis, Veltessa and/or Kayexalate (in stool)

calcium gluconate

19
Q

a. Results from increased loss of K+ via the kidneys or GI tract
i. Secondary to being overdiuresed or diarrhea/vomiting

A

Hypokalemia

20
Q

Manifestations: hypokalemia

A

i. Cardiac most serious
1. Cardiac arrythmias
ii. Skeletal and smoothe muscle weakness
iii. Decreased GI motility
iv. Hyperglycemia

21
Q

Administer KCl through

A

PO or IV NEVER PUSHING OR BOLUS

22
Q

i. Formation of teeth and bone
ii. Blood clotting
iii. Transmission of nerve impulses
iv. Myocardial contractions
v. Muscle contractions

A

Calcium

23
Q

Increases calcium deposition into bone, increases renal calcium excretion, and decreases GI absorption

A

Calcitonin

24
Q

Calcium balance controlled by:

A

Parathyroid hormone

25
Q

a. High levels of serum calcium caused by

i. Hyperparathyroidism (two-thirds of cases)

A

Hypercalcemia

26
Q

Manifestations; Hypercalcemia

A

i. Fatigue, lethargy, weakness, confusion
ii. Hallucinations, seizures, coma
iii. Dysrhythmias
iv. Bone pain, fractures, nephrolithiasis (kidney stones)
v. Polyuria, dehydration

27
Q

Implementation; hypercalcemia

A
  1. Low calcium diet
  2. Increased weight-bearing activity
  3. Increased fluid intake (3k-4k L)
  4. Hydration with isotonic saline infusion
  5. Bisphosphonates—gold standard
  6. Calcitonin
    a. Immediate effect
28
Q

a. Low serum Ca levels caused by
i. Decreased production of PTH (parathyroid hormone)
ii. Multiple blood transfusions
iii. Alkalosis
iv. Increased calcium loss

A

Hyopcalcemia

29
Q

Manifestations hypocalcemia

A

i. Positive Trousseau’s or Chvostek’s sign
1. Trousseau’s: BP on cuff, inflate for a few minutes-will have carpal spasms
2. Chvostek’s: Tap on facial nerve, facial twitching
ii. Laryngeal stridor
1. Noisy respirations
iii. Dysphagia
iv. Numbness and tingling around the mouth or in the extremities
v. Dysrhythmias

30
Q

treatment of hypocalcemia

A

i. Treat cause
ii. Calcium and Vitamin D supplements
iii. IV calcium gluconate
iv. Rebreathe into paper bag
v. Treat pain and anxiety to prevent hyperventilation-induced respiratory alkalosis

31
Q

b. Essential to function of muscle, red blood cells, and nervous system
d. Serum levels controlled by parathyroid hormone
e. Maintenance requires adequate renal functioning

A

Phosphate (anion) in ICF

32
Q

Hyperphosphatemia Phos caused by:

A

i. Acute kidney injury or chronic kidney disease
ii. Excess intake of phosphate or vitamin D
iii. Hypoparathyroidism

33
Q

Hyperphosphatemia manifestations

A

i. Tetany, muscle cramps, paresthesias, hypotension, dysrhythmias, seizures (hypocalcemia)
ii. Calcified deposition in soft tissue such as joints, arteries, skin, kidneys, and corneas (cause organ dysfunction)

34
Q

V. Hyperphosphatemia management

A

i. Identify and treat underlying cause
ii. Restrict intake of foods and fluids containing phosphorus
1. Milk, beans
iii. Oral phosphate-binding agents
1. Calcium carbonate
iv. Hemodialysis
v. Volume expansion and forced diuresis
vi. Correct any hypocalcemia

35
Q

a. Cofactor in enzyme for metabolism of carbohydrates
b. Required for DNA and protein synthesis
c. Blood glucose control
d. BP regulation

A

Magnesium

36
Q

i. Increased intake of products containing magnesium when renal insufficiency or failure is present
ii. Excess IV magnesium administration

A

hypermagnesmia

37
Q

hypermagnesmia manifestations

A

i. Hypotension, facial flushing
ii. Lethargy
iii. Nausea and vomiting
iv. Impaired deep tendon reflexes
v. Muscle paralysis
vi. Respiratory and cardiac arrest—can lead to coma

38
Q

i. Prolonged fasting or starvation
ii. Chronic alcoholism
iii. Fluid loss from GI tract
iv. Prolonged parenteral nutrition without supplementation
v. Diuretics, proton-pump inhibitors
vi. Hyperglycemic osmotic diuresis

A

Hypomagnesemia

39
Q

Manifestations; hyopmagnesemia

A

i. Resembles hypocalcemia
1. Muscle cramps, tremors
2. Hyperactive deep tendon reflexes
3. Chvostek’s and Trousseau’s signs
4. Confusion, vertigo, seizures

40
Q

Hypophosphatemia causes

A

Malnurishment/malabsorption
diarrhea
use of phosphate-binding antacids
inadequate replacement during parenteral nutrition

41
Q

Hypophosphatemia Manifestations

A

CNS depression
Muscle weakness/p!
Rickets (bow legged) & osteomalacia (softening of bones)

341 Exam 2 (17 decks)

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