Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 1245 > Electrolytes II > Flashcards

Electrolytes II Flashcards

1
Q

Na+ range

A

135 - 145

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

K+ range

A

3.5 - 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ca+
Total

Ionized

A

Total 8.5 - 10.5 mg/ dL

Ionized 4 - 6mg / dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mg+ range

A

1.3 - 2.1mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cl- range

A

95 - 105 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PO4- phosphate
Range

A

2.5 - 4.5 mg/ dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Electrolyte Relationships

Sodium / Potassium
(Similar / Inverse)

High Na = ___K

A

Inverse

High Na =Low K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Electrolyte Relationships

Calcium /Phosphorus

High Calcium = ___ Phosphorus

A

Inverse

High Ca = Low Phos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Electrolyte Relationships

Calcium / Vitamin D

Similar or Inverse

A

Similar

High Ca = high Vit D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Electrolyte Relationships

Magnesium/ Calcium

Similar or Inverse

Low Mg = ____ Ca

A

Similar

Low Mg = Low Ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Electrolyte Relationships

Magnesium/ Potassium

Similar or Inverse

If there is high Mg there will be ___ K

A

Similar

High Mg = high K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Electrolyte Relationships

Magnesium/ Phosphorus

Similar or Inverse

Low Mg = ___ Phos

A

Inverse

Low Mg = High Phos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Besties with H²O

A

Sodium NA+ 135 - 145mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fluid distribution and elimination (BP)

A

Sodium NA+ 135 - 145mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Transmits impulses in nerve and muscle fibers

A

Sodium NA+ 135 - 145mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many weeks vacation do RNs get per year

A

2 atleast to start

Plus 2.5x pay for holidays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Maintained by ADH & Assisted by Aldostrone

A

Sodium NA+ 135 - 145mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Neurological symptoms are most likly due to this electrolyte

A

Sodium NA+ 135 - 145mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Labs for Diagnostic for Hyponatremia

Serium osmolality Less than….

Serum Sodium level Less than….

Urine specific gravity less than…. (unless SIADH)

What happens to the Hemocrit and plasma protein

A

Labs for Diagnostic for Hyponatremia

Serium osmolality (280 mOsm/kg) Less than 280

Serum Sodium level Less than 135

Urine specific gravity less than 1.010 (unless SIADH)

Hemocrit & plasma proteins elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Sodium levels may appear low bc too much fluid is in the body?

A

Isovolemic hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

This type of hyponatremia

S/S

Maybe no signs
Thrist in SIADH (High Concentration Urine, increased ADH)
Primary polydipsia
NEURO/PSYCH

A

Isovolemic Hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

This type of Hyponatremia

Causes

Glucocortidicoid deficiency (causing inadequate fluid filtration by kidneys)

Hypothyroidism (limited water excretion)

Renal failure (increased H2O levels)

Medication: Psych / Lithium

Tramatic Brain Injury

Adrenal Insufficiency

SIADH (too much ADH causes, increased thrist, H2O retention, increased NA+ excretion)

A

Isovolemic Hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Interventions for this type Hyponatremia

Oral urea (extreme cases)
Fluid restrictions
1L q day
Increases Serum osmolality/ stabilizes ADH

High Na+ Diet
Daily weight
I & Os
NEURO CHECKS

SODIUM CHLORIDE TABS

A

Isovolemic hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diagnostics

Low urine sodium <25
Low urine osmolality <100

A

Hypovolemic hyponatremia

low urine sodium and low urine osmolality in the context of hyponatremia suggests a situation where the body is conserving sodium and attempting to retain water, likely due to a loss of both sodium and water (hypovolemia).

Result from conditions such as vomiting, diarrhea, excessive sweating, or the use of diuretics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Both sodium and water are decreased in extracellular area, sodium loss is greater than water loss

A

Hypovolemic hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Renal causes

Salt-losing nephritis adrenal insufficiency

Diuretic use, loop, thiazide (volume depletion, thirst and H²O retention)

Osmotic diuresis (Inhibiting Na+ reabsorbs)

A

Hypovolemic Hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

S/ S

Mental confusion, headache

Altered LOC

hyperirritability, anxiety

Tremors, seizures

Hyperreflexia, muscle weakness, twitching

Nausea, Vomiting, abdominal cramps

Edema and weight gain

A

Hypovolemic Hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Non-renal Causes

Vomiting

Diarrhea

Fistulas

Sweating excess

Burns

Continuous NG suction

A

Hypovolemic Hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Interventions

High Na+ Diet

Daily weight / I & O

Neuro checks

Sodium Chloride tabs

ISOTONIC IV FLUIDS (NO D5W)

A

Hypovolemia hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Diagnostics

Low urine sodium

GI loss (diarrhea)

Renal loss due to diuretics (after diauretics stopped)

Third spacing

A

Hypovolemia hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

High urine sodium

> 40 mEq/L

Metabolic alkalosis (Vomiting)
Renal Salt losses due to diuretics

Adrenal insufficiency, or cerebral salt wasting

A

Hypovolemia hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Both sodium and water are INCREASED in the EXTRACELLULAR area, but water gain is more than sodium gain (Aldosterone)

A

Hypervolemic Hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

S /S
Edema / Third Spacing
Hypertension
Weight gain
Rapid / Bounding pulse

Causes

Heart Failure
Renal failure
Liver failure
Nephrotic syndrome
EXCESSIVE ADMINISTRATION OF HYPOTONIC IV
HYPERALDOSTRONE

A

Hypervolemic hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Interventions

High Na+ diet
Daily weight/ I & O
Neuro checks
Sodium chloride tabs

ISOTONIC IV FLUIDS (NO D5W)

Maybe given dose of Lasix while receiving hypertonic solutions

A

Hypervolemic hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

The normal serum osmolality is _____ mOsm/kg.

Lower significa….

Higher…

A

285–295

Lower: less solutes in water Over hydration

Higher: more solutes in water Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Addisons adreal insufficiency
SIADH

Fluid Overload: CHF, Liver failure

Renal problems, NG

This electrolyte problem

A

Hyponatremia

<135

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Assessment for Hyponatremia

SALT LOSS

S = Seizures
A = ____ cramps
L =
T= tendon reflex

L = loss ____
O =
S = ____ Respiration
S = ____ of muscles

A

Seizures & Stupor
Abdominal cramping & Attitude
Lethargic
Tendon Reflexes Diminished

Loss Urine/ Appetite
Orthostatic Hypotension/ Overactive bowle sounds
Shallow respiration (late Dev- muscle weakness)
Spasms of muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

S/S

Restlessness
Fever / Flushed Skin
Nause / Vomiting
Lethargy/ Confused
Seizures/ Coma
TWITCHING/ HYPERREFLEXIA
ATAXIA

Causes:

Hypothalamus lesion
Elderly / Confused
Infants

May appear hypervolemic

Elevated BP
Bounding pulse
Dyspnea

A

Hypernatremia > 145

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Causes (electrolyte imbalance)

Cushing’s syndrome & hyperventilating

GI feeding out H2O

Corticosteroids, failed compensatory

Aldosterone (too much)

Thirst impairment

A

Hypernatremia >145

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Hypernatremia

No FRIED foods for you

F = (2)
R = Relaxed or Restlessness
I = increased (2)
E = (2)
D = Describe Skin

A

Fever & Flushed Skin
Restlessness
Increased fluid retention/ increased deep tendon reflexes
Edema, extremely confused
Dry skin, decreased tugor, dry mucous
Decreased urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

For Hypernatremia >145 use this IV bag

A

D5 / .45% or

D5W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Why do you use

D5 / .45% or

D5W

To treat Hypernatremia >145

A

Gradual reduction to prevent cerebal edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Hypernatremia Vs Hyponatremia

Agitation
Confusion
Flushed Skin / low fever
Thrist
Restlessness
Weakness

Hypernatremia Vs Hyponatremia

Decreased Reflexes
Ab cramps
Leathargy /Confused
Headache
Muscle twitching
Nausea / Vomiting
Anorexia

A

Hypernatremia

Agitation
Confusion
Flushed Skin / low fever
Thrist
Restlessness
Weakness

Hyponatremia

Decreased Reflexes
Ab cramps
Leathargy /Confused
Headache
Muscle twitching
Nausea / Vomiting
Anorexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Assist in skeletal and heart muscle contraction

Aids in transmission of nerve impulse

Acid base balance

A

Potassium

Hydrogen- potassium exchange

When there is an increase in extracellular acidity (low pH), cells may take up more hydrogen ions in exchange for releasing potassium ions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How is the most K+ lost

A

Urine 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

______ stimulates Na+ reabsorption and K+ excretion

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

(Low / High) pH in ECF can cause H+ to be substituted for K+ to maintain ICF neutrality

A

Low (Acidic)

<7.35

Norm

7.35 to 7.45.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Cellular Excitability:

The sodium-potassium pump helps establish and maintain the resting membrane potential of cells, which is critical for electrical excitability and nerve impulse transmission.

Osmotic Balance:

By regulating the concentration of sodium and potassium ions, the pump helps control osmotic balance, preventing cells from swelling or shrinking excessively.

Energy Conservation:

The pump consumes energy (in the form of ATP) to move ions against their gradients. This constant energy expenditure contributes to overall cellular metabolism.

Secondary Active Transport:

The sodium-potassium pump creates a sodium concentration gradient that indirectly drives the cotransport of other substances, such as glucose and amino acids, into cells.

All describe the action of which ACTIVE TRANSPORT mechanism

A

Sodium Potassium Pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Cushings syndrome
Decreased Magnesium
Hyperaldostronism
Hepatic disease
Hyperglycemia
Lasix, steroids, laxatives
Respiratory alkalosis

A

Hypokalemia <3.5

Severe <2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Your body threw K+ in the DITCH

D = drugs (name them)
I = inadequate intake K+
T = too much _____
C = ______ syndrome
H = heavy fluid loss

(Hypokalemia)

A

Hypokalemia

Drugs (laxatives, diuretics, corticosteroids)
Inadequate intake of K+
Too much water
Cushings syndrome
Heavy fluid loss (NG suction, N&V, wound drainage, Profuse sweat)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Assessment finding

Hypokalemia

Cardiac

Neurovascular

GI motility

Deep tendon reflexes

A

Cardiac

Weak irregular Pulse, Palpation, Orthostatic hypotension

Neurovascular

Weakness, cramps, paresthesia, fatigue

GI motility

Decreased/ Constipation

Deep tendon reflexes

Decreased

52
Q

Hypokalemia

If its low its slow

7 L’s

A

Lethargic
Low shallow respiration
Lethal cardiac Dysthymia
Loss urine
Leg cramps
Limp muscles
Low BP & HR

53
Q

SUCTION

describes symptoms for which electrolyte imbalance

A

Hypokalemia

Skeletal muscle weakness / decreased reflexes
U-wave (ECG changes)
Constipation
Toxic effects of Digoxin
Irregular, weak pulse (low bp)
Orthostatic hypotension
Numbness (Paresthesia)

54
Q

You will be able to work as much as you want when your an RN

A

And get raises and promotions

55
Q

Hypokalemia

ECG changes

______ ST segment
______ T-wave
______ U- wave

A

Depressed ST segment
Flat T-wave
Prominet U- wave

56
Q

IV replacement for Hypokalemia

Never give….

Max….

Replace ____ first

A

Never give IV push or Bolus, FATAL

Max 10mEg/hr

Replace Mg first, inverse

57
Q

Assess

VS
HR & Rhythm
Labs
Digoxin level
I & O

A

Hypokalemia

Both hypokalemia and digoxin can affect the electrical activity of the heart, and when combined, there is an increased risk of adverse effects.

58
Q

Causes of this electrolyte problem

Tissue injury
Drugs (ACE, NSAID, ARBs, certain diuretics)
Renal failure
Blood transfusion
Elevated pH (H+)
Salt substitutes

A

Hyperkalemia >5

59
Q

The body “CARED” too much for K+

Hyperkalemia

C = Cells what happens to the cells
A = This disease
R = _____ FAILURE
E = Excessive _____
D = Drugs (3)

A

Hyperkalemia

Cellular movement from Intra - Extracellular space. (Burns, tissue damage, acidosis, cell destruction)

Addisons (Adrenal Insufficiency)
Renal failure
Excessive K+ / Salt Substitutes
Infection, extensive surgery, hemolysis

Drugs (Aldactone, ACE inhibitor, NSAIDS)

Hemorrhage

60
Q

Hyperkalemia Assessment

Cardiac

Neuromuscular

GI / GU

A

Cardiac

Bradycardia
Irregular pulse
Hypotension
Rhythm changes

Neuromuscular

Paresthesia
Muscle weakness
Paralysis
Hyperreflexia
Respitory Distress

GI / GU

Ab cramps
Nausea
Decrease urine output

61
Q

Hyperkalemia will MURDER you

M = muscle _____
U = Urine level
Respitory failure
D = Decreased
E = Early Sign
R = Rhythm Changes

A

Hyperkalemia

Muscle weakness
Urine low
Respitory failure
Decreased cardiac contraction
Early signs / Twitching/ Cramps
Rhythm changes in heart
VFIB / VTACH

62
Q

Labs

K >5 , sever >7
Decreased pH Acidosis
H+ levels

Tall peaked T-wave
Flat or absent P-wave
Wide QRS complexes (Cardiac Arrest)
Prolonged PR interval

VFIB or VTACH

A

Hyperkalemia

63
Q

Hyperkalemia

Labs

K level, K level sever

pH level

H+ level

A

K >5 , severe >7

pH <7.35 Decreased

H+ levels INCREASED

64
Q

Interventions for ______

Eliminate from body

(This_Type) Diuretic

Dialysis

Sodium polystyrene sulfonate

NaHCO³ (Stablizes acidosis)

Dextrose & insulin

Albuterol

Admin CaCl or Ca gluconate …. Why

A

Hyperkalemia

Loop diuretic

Combat myocardial effects

65
Q

Magnesium range

A

1.3 - 2.1

66
Q

This electrolyte

Maintains electric activities in nerves and muscles

Vasodilation and irritability

Contraction of cardiac muscles

Skeletal muscle contraction

Carb metabolism, ATP formation, vitamin activation, cell growth

A

Magnesium+ 1.3 - 2.1

67
Q

Causes of this electrolyte imbalance

Hypocalcemia
Cirrhosis
Sepsis
Loss from GI / urine
DM / DKA (w/ insulin)
Alcohol

Medications

Insulins
Diuretics
PPI / Prilosec
Laxatives
(TPN) is when the IV administered nutrition is the only source of nutrition the patient is receiving

A

Hypomagnesemia

68
Q

LOW MAG anagram

L = limited intake
O = other electrolytes issues ___ & ___
W = ___ via kidneys

M = Malabsorption
A = _____
G = ____ Issue

A

Limited intake
Other electrolyte issue (Hypocalcemia & Hypokalemia)
Wasting via Kidneys
Malabsorption
Alcohol
Glucemic issue (DKA)

69
Q

Assessment for Hypomagnesemia

TWITCHING

A

Trousseau’s sign (related to Hypocalcemia) uncontrolled muscle spasm / Chvostek (Hypocalcemia) facial twitching

Weak respiration

Irritability / confusion

Torsade de pointes (ECG Arythmia, Fatal, alcohol abuse)

Cardiac changes

Hypotension

Involuntray movement, muscle cramps, seizures

Nausea

GI issues (Decreased bowel sounds and motility)

70
Q

In low magnesium <1.3 how is

Chvostek sign tested

Trousseau’s sign

A

Chvostek sign tested

Tap on face.
Positive = uncontrolled muscle spasms

Trousseau’s sign

Blood pressure cuff inflated to just above systolic

Positive: Carpuel tunnel flailing of hands or wrist

71
Q

Diagnostic Lab

Mg < 1.3 (1.5)

May see LOWER this electrolyte

ECG changes

PR & QT _____

QRS ______

A

Hypomagnesemia

Lower K+

ECG

PR & QT PROLONGED

QRS WIDE

72
Q

Chocolate, dry beans, peas, green leafy veg, meats, nuts, seafood, whole grains

High in ….

A

Mg

73
Q

Causes

Addisons Disease
DKA
Cell Damage
Hypothyroidism
Hyperparathyroidism
Antacids

A

Hypermagnesemia >2.1

74
Q

Assessment Findings Hypermagnesemia

LETHARGIC

L =
E =EKG
T = tendon reflexes
H = ____ tension / Diaphoresis
A=
R= Respitory _____
G =
I = _____breathing
C = Cardiac ___

A

Lethargy,weakness, confusion, dprsd

EKG changes, PR & QT Wide, QRS Prolonged

Tendon reflexes diminished

Hypotension/ Diaphoresis

Arrhythmia, Bradycardia / weak pulse

Respiratory arrest (Sudden)

GI issues (N&V)

Impaired breathing

Cardiac Arrest

75
Q

Mg 2.9

ECG

Wide PR & QT
Prolonged QRS complex

Indicative of…

A

Hypermagnesemia >2.5

76
Q

Interventions

Dialysis
Fluids
Loop diuretics
CALCIUM GLUCONATE

A

Hypermagnesemia

77
Q

Role:

Maintains cell membrane structure and impulses

Required for blood clotting

Structure for bones and teeth

A

Calcium

78
Q

Activación of this electrolyte requires vitamin D

A

Calcium

79
Q

When more calcium is needed ______ is released

Excess calcium is present, the thyroid gland secrets ______

A

Parathyroid hormone

Thyrocalcitonin

80
Q

Hypocalcemia

LOW CALCIUM

Low (this hormone)
Oral intake, Problems
Wound drainage an issue?

C = This disease
A = Acute ______
L = Low this vitamin
C = Chronic __ diseae
I = increased ____ level
U = Using these meds
M = These types of issues

A

Low parathyroid hormone
Oral intake lacks (alcoholism, bulimia)
Wound drainage

Celiacs disease
Acute pancreatitis
Low vitamin-D (needed 4 absorption)
Chronic Kidney disease
Increased Phosphorus levels
Using meds (lax, loop diuretics)
Mobility issues (bones)

81
Q

Assessment Hypocalcemia
CRAMPS

A

Confusion
Reflexes
Arrythmia
Muscle Spams & Seizures
Positive Trousseau’s (BP cuff,hand contracts)
Sing of Chvostek (Facial nerve hyperexcitable)

82
Q

(Ionized /Serum) calcium is the total amount of calcium in the blood, including both free calcium (in Blood stream) and calcium bound to proteins (mainly albumin).

What is free calcium floating in the blood stream called____

A

Serum

Ionized

83
Q

Hypoglycemia

Serum Ca <_____

Ionized Ca<_____

ECG

______ QT & ST intervals

A

Serum <8.5

Ionized <4.5

Prolonged QT & ST intervals

84
Q

Hypocalcemia Intervention

Calcium Chloride (Describe)
Calcium gluconate (Describe)

Give more (Mg or Phosphate)
Give less (Mg or Phosphate)

Vitamin D Supp

A

Calcium Chloride (faster 3x stronger)
Calcium gluconate (commonly used)

Give more Mg
Give less Phosphate

85
Q

VS
Respuratory Stridor
ECG
PROLONGED QT & ST
Chvostek’s & Trousseau

A

Hypocalcemia <8.5

86
Q

Hypercalcemia
Menomic HIGH CAL

A

Hyperparathyroidism Too much Ca released in the blood

Increased intake of Ca+
Glucocorticoids
Hyperthyroidism
Calcium excretion decreased (thiazide diuretics, renal failure, bone cancer)
Addisons Adrenal Insufficiency
Lithium Use (Affects parathyroid and decreases phosphorus)

87
Q

Assessment fir Hypercalcemia

WEAK

W = Weak ….
E= EKG
A = Absent …
A= Abdominal…

A

Weakness of muscle
EKG changes Shortened QT & Prolonged ST
Absent reflexes & Abdominal distention

88
Q

Total (Serum) Calcium 11.1
Ionized 5.9

ECG changes
_____ QT interval
_____ ST interval

A

Hypercalcemia

Total Ca >10.5
Ionized >5.1

Shortened QT
Prolonged ST

89
Q

Interventions

Increase Excretion
Hydration, diuretics, hemodialysis

Strain urine

A

Hypercalcemia

90
Q

PO⁴

Name & Normal level

A

Phosphate / Phosphorus

2.5 - 4.5

91
Q

Role

Nerve & Muscle function
Works with Ca for Bone Structure
WBC phagocytosis & platelet function
Activates vitamins and enzymes; assists in cell growth

A

Phosphate/ Phosphorus / PO⁴
2.5 - 4.5

92
Q

Causes:

Malnutrition/ absorption
Hyperglycemia
Alcoholism

S/S
Weakness, Confused
Hypercalcemia
Po⁴ less than 2.5 mg
Hypercalcemia
Bone fractures

Treatment:

Increase oral intake
Oral / IV supplements
Safety/Teaching/ monitoring

A

Hypophosphatemia

<2.5

93
Q

Causes

Hypoparathyroidism
Cell destruction
Enemas

S/S
Calcification hypocalcemia (bones & teeth)
Hyperactive Deep tendon reflexes

A

Hyperphosohatemia

94
Q

Chloride
CL-

NORMAL RANGE

A

96 - 106

95
Q

Travels with Na+ to maintain serum osmolality

Acid/base balance
Secreted by gastric mucosa (HCI)

SAME S/S as ….

A

Chloride

Same S/S as Na

96
Q

Electrolyte associated with

Mental Status

A

Na

97
Q

Electrolyte associated with

Cardiac and muscles

A

K potassium

98
Q

Electrolyte associated with

Reflexes and muscles

A

Mg

99
Q

Addisons disease causes this electrolyte imbalance.

Why

A

Hyponatremia and hyperkalemia

Adrenal insufficiency.

Hyponatremia is mainly due to the increased release of antidiuretic hormone

100
Q

With Cushings syndrome these electrolytes are impaired how?

A

Low potassium &
High sodium, and high bicarbonate levels

Oppsite of Addisons

Addison’s lack Cortisol (and Aldosterone),

Cushing’s too much cortisol (hypercortisolism)

101
Q

To treat hypovolemic,hyponatremia give isotonic IV.

However, do not give this IV type

A

D5W.

It is hypo in the body system

102
Q

Interventions

Hypervolemia/ hyponatremia

Isotonic IV given no D5W

Hypertonic IV can be given in ICU slowly (Risk Brain damage) if sodium is under

A

120

103
Q

Insufficiently low levels of _______ result in low sodium levels (hyponatremia), elevated potassium levels (hyperkalemia

A

aldosterone

104
Q

Which number value is more likely to complain of

Agitation, Increased Reflexes, Low-grade fever, Weakness

From Na issues

A

Hypernatremia

> 145

105
Q

Which value range is more likely

Lethargy, Abdominal cramping, Nausea, Vomiting, Anorexia

Due to Na issues

A

Hyponatremia

<135

106
Q

Which group is more likely to experience

Headache, Muscle Twitching, Lethargy, and GI issues

From Na issues

A

Hyponatremia

<135

107
Q

Which group is more likely to experience

Falls, Flushed Skin / Fever, Thirst, increased reflexs and confusion

From Na issues

A

Hypernatremia

> 145

108
Q

Interventions

Hyponatremia/ Hypernatremia

Isotonic IV fluids (No D5W)

Hypertonic (if under 120 given in ICU slow, “Brain Damage Risk”) -

Lasix maybe given when receiving Hypertonic Solutions

Hyponatremia/ Hypernatremia

Salt free fluids (No Gatorade)

Use Hypotonic IV (D5 / .45% or D5W)

Diuretics and water

A

Hyponatremia

Isotonic IV fluids (No D5W)

Hypertonic (if under 120 given in ICU slow, “Brain Damage Risk”) -

Lasix maybe given when receiving Hypertonic Solutions

Hypernatremia

Salt free fluids (No Gatorade)

Use Hypotonic IV (D5 / .45% or D5W)

Diuretics and water

109
Q

Aldosterone will raise this number _____ and lower this numer

A

Lower K+ potassium

Raise Na sodium

110
Q

Cushings syndrome has which effect on electrolytes

A

Lowers K potassium

Raises Na sodium

111
Q

Causes

Hypokalemia/ Hyperkalemia

Drugs (ACE, NSAID, ARBS, Certain Diuretics)

Blood transfusions

Elevated pH

Salt substitutes

Hypokalemia/ Hyperkalemia

Decreased Mg

Hyperaldosteronism

Respitory Alkalosis

Insulin therapy

Cushings

A

Hyperkalemia >5 mEq/L

Drugs (ACE, NSAID, ARBS, Certain Diuretics)

Blood transfusions

Elevated pH

Salt substitutes

Hypokalemia <3.5 - Sever <2.5
Decreased Mg

Hyperaldosteronism

Respitory Alkalosis

Insulin therapy

Cushings

112
Q

Assessment Findings

Hypokalemia/ Hyperkalemia

Weak, Irregular Pulse
Orthostatic hypotension
WEAK legs,cramps, paresthesia
Fatugue
Respitory Weakness
Constipation
Decreased Deep Tendon Reflexes

Hypokalemia/ Hyperkalemia

Bradycardia
Hypotension
Rhythm changes
Tall - T
Flat - P
Wide - QRS

A

Hypokalemia

Weak, Irregular Pulse
Orthostatic hypotension
WEAK legs,cramps, paresthesia
Fatugue
Respitory Weakness
Constipation
Decreased Deep Tendon Reflexes

Hyperkalemia

Bradycardia
Hypotension
Rhythm changes
Tall - T
Flat - P
Wide - QRS

113
Q

Dont give IV rate of Potassium greater than _____ MMOL / HR

LEATHAL!!!!

A

10

114
Q

Interventions

Hypokalemia / Hyperkalemia

Dont use Loop Diuretics
Ass Digoxin Level
Replace Mg First
Never Give IV bolus or Push.
Max 10 mEq/hr
ALWAYS USE PUMP

Hypokalemia/ Hyperkalemia

Use Loop diuretics
Dialysis
Sodium polystyrene sulfonate
NaHCO³ Sodium Bicarbonate
Dextrose & Insulin
Albuterol
CaCl or Ca gluconate (combat myocardial effects)

A

Hypokalemia

Ass Digoxin Level
Replace Mg First
Never Give IV bolus or Push.
Max 10 mEq/hr
ALWAYS USE PUMP

Hyperkalemia

Use Loop diuretics
Dialysis
Sodium polystyrene sulfonate
NaHCO³ Sodium Bicarbonate
Dextrose & Insulin
Albuterol
CaCl or Ca gluconate (combat myocardial effects)

Sodium bicarbonate NaHCO³
Shift potassium ions into cells temporarily, which can be beneficial in addressing hyperkalemia, especially when associated with acidosis.

115
Q

Diagnostics

Hypokalemia/ Hyperkalemia
K > 5 (severe >7)
Decreased pH (Acidosis)
H+ level High

Hypokalemia/Hyperkalemia

K+ <3.5 (<2.5 is severe)
Lower Mg <1.3
Elevated pH and Bicarb levels
Elevated Glucose
Elevated Digoxin

A

Hyperkalemia

K > 5 (severe >7)
Decreased pH (Acidosis)
H+ level High

Hypokalemia

K+ <3.5 (<2.5 is severe)
Lower Mg <1.3
Elevated pH and Bicarb levels
Elevated Glucose
Elevated Digoxin

116
Q

Hypomagnesemia/ Hypermagnesemia

Sepsis
Cirrhosis
Hypocalcemia
DM / DKA
Elderly Increased Risk
TPN (total parenteral nutrition)
Alcohol

Hypomagnesemia/ Hypermagnesemia

Cell damage
Hypothyroid
Hyperparathyroidism
Antacids (Certain types)
Addisons

A

Hypomagnesemia

Sepsis
Cirrhosis
Hypocalcemia
DM / DKA
Elderly Increased Risk
TPN (total parenteral nutrition)
Alcohol

Hypermagnesemia

Cell damage
Hypothyroid
Hyperparathyroidism
Antacids (Certain types)
Addisons

117
Q

Hypomagnesemia/ Hypermagnesemia

Trousseau’s sign (Flailing Arm) - Related to Hypocalcemia

Chvostek sign (twitching face) -
Related to Hypocalcemia

Weak respiration
Irritability / Confusion
Torsade de pointes
Cardiac changes
Hypotension (Vasodilation)

Hypomagnesemia/ Hypermagnesemia

Lethary, weak, confusion, depression
Diminished Tendon Reflexes
Diaphoresis
Bradycardia/weak pulse
Respitory / Cardiac Arrest

A

Hypomagnesemia

Trousseau’s sign (Flailing Arm) - Related to Hypocalcemia

Chvostek sign (twitching face) -
Related to Hypocalcemia

Weak respiration
Irritability / Confusion
Torsade de pointes
Cardiac changes
Hypotension (Vasodilation)

Hypermagnesemia

Lethary, weak, confusion, depression
Diminished Tendon Reflexes
Diaphoresis
Bradycardia/weak pulse
Respitory / Cardiac Arrest

118
Q

Hypomagnesemia/ Hypermagnesemia

ECG

Wide PR & QT
Prolonged QRS

Mg 2.9 (exp)

Hypomagnesemia/ Hypermagnesemia

ECG

Prolonged PR & QT
Wide QRS
Increased T wave

Mg 1.1 (exp)
May see Low K

A

Hypermagnesemia

Wide PR & QT
Prolonged QRS

Mg > 2.5

Hypomagnesemia

Prolonged PR & QT
Wide QRS
Increased T wave

Mg < 1.3
May see Low K

119
Q

Interventions (Name Electrolyte too)

Hypo / Hyper

Give Foods such as: Chocolate, dry beans, peas, leafy vegs, meats nuts

Hypo/ hper
Dialysis
Loop diuretics
Calcium Gluconate IV

A

Hypomagnesemia

Give Foods such as: Chocolate, dry beans, peas, leafy vegs, meats nuts

Hypermagnesemia

Dialysis
Loop diuretics
Calcium Gluconate IV

120
Q

Hypocalcemia/ Hypercalcemia

Hyperparathyroidism
Glucocorticoid
Hyperthyroidism
Addisons (Adrenal Insufficiency)
Lithium Use

Hypocalcemia/ Hypercalcemia

Low parathyroid hormone
Alcohol/ Bulimia
Celiacs Disease
Acute Pancreatitis
Increased Phosphorus
Medication (Magnesium & Laxatives)
Mobility Issues

A

Hypercalcemia

Hyperparathyroidism
Glucocorticoid
Hyperthyroidism
Addisons (Adrenal Insufficiency)
Lithium Use

Hypocalcemia

Low parathyroid hormone
Alcohol/ Bulimia
Celiacs Disease
Acute Pancreatitis
Increased Phosphorus
Medication (Magnesium & Laxatives)
Mobility Issues

121
Q

Hypocalcemia/ Hypercalcemia

Assessment

Weakness of Muscles (very profound)
EKG: Shortened QT interval and prolonged ST interval

Reflexes absent

Abdominal Distention

Hypoglycemia/ Hypercalcemia

Confusion

Hyperactive reflexes

Arrhythmia (Prolonged QT & ST interval)

Muscle spams & Seizures

Positive Trousseau (BP cuff / hand contracting)

Positive Chvostek (facial nerve hyper)

A

Hypercalcemia

Weakness of Muscles (very profound)
EKG: Shortened QT interval and prolonged ST interval

Reflexes absent

Abdominal Distention

Hypocalcemia
Confusion
Hyperactive reflexes
Arrhythmia (Prolonged QT & ST interval)
Muscle spams & Seizures
Positive Trousseau (BP cuff / hand contracting)
Positive Chvostek (facial nerve hyper)

122
Q

Hypocalcemia/ Hypercalcemia

ECG:
Prolonged QT & ST interval

Serum < 8.5
Ionized < 4.5

Hypocalcemia/ Hypercalcemia

ECG:
QT shortened
ST Prolonged

Serum > 10.5
Ionized > 5.1

A

Hypocalcemia

ECG:
Prolonged QT & ST interval

Serum < 8.5
Ionized < 4.5

Hypercalcemia

ECG:
QT shortened
ST Prolonged

Serum > 10.5
Ionized > 5.1

123
Q

Hypophosphatemia / Hyperphosphatemia

Causes

Kidney Disease

Hypoparathyroidism

Cell destruction

Enemas

Hypophosphatemia / Hyperphosphatemia

Magnesium based drugs
Hyperglycemia
Alcoholism

A

Hyperphosphatemia

Kidney Disease

Hypoparathyroidism

Cell destruction

Enemas

Hypophosphatemia

Magnesium based drugs
Hyperglycemia
Alcoholism

124
Q

What does Aldosterone do to Na and K levels.

A

The more Aldosterone Higher Na & Lower K

125
Q

Hyperkalemia >5

Two ECG waves associated

A

VFIB & VTACH

126
Q

Steroids have this affect in

Na

K

Ca

A

Na >145 hyper

K <3.5 hypo

Ca > 10.5 hyper

NURS 1245 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions