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NURS 1245 > Electrolytes II > Flashcards

Electrolytes II Flashcards

1
Q

Na+ range

A

135 - 145

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2
Q

K+ range

A

3.5 - 5

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3
Q

Ca+
Total

Ionized

A

Total 8.5 - 10.5 mg/ dL

Ionized 4 - 6mg / dL

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4
Q

Mg+ range

A

1.3 - 2.1mEq/L

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5
Q

Cl- range

A

95 - 105 mEq/L

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6
Q

PO4- phosphate
Range

A

2.5 - 4.5 mg/ dl

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7
Q

Electrolyte Relationships

Sodium / Potassium
(Similar / Inverse)

High Na = ___K

A

Inverse

High Na =Low K

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8
Q

Electrolyte Relationships

Calcium /Phosphorus

High Calcium = ___ Phosphorus

A

Inverse

High Ca = Low Phos

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9
Q

Electrolyte Relationships

Calcium / Vitamin D

Similar or Inverse

A

Similar

High Ca = high Vit D

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10
Q

Electrolyte Relationships

Magnesium/ Calcium

Similar or Inverse

Low Mg = ____ Ca

A

Similar

Low Mg = Low Ca

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11
Q

Electrolyte Relationships

Magnesium/ Potassium

Similar or Inverse

If there is high Mg there will be ___ K

A

Similar

High Mg = high K

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12
Q

Electrolyte Relationships

Magnesium/ Phosphorus

Similar or Inverse

Low Mg = ___ Phos

A

Inverse

Low Mg = High Phos

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13
Q

Besties with H²O

A

Sodium NA+ 135 - 145mEq/L

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14
Q

Fluid distribution and elimination (BP)

A

Sodium NA+ 135 - 145mEq/L

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15
Q

Transmits impulses in nerve and muscle fibers

A

Sodium NA+ 135 - 145mEq/L

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16
Q

How many weeks vacation do RNs get per year

A

2 atleast to start

Plus 2.5x pay for holidays

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17
Q

Maintained by ADH & Assisted by Aldostrone

A

Sodium NA+ 135 - 145mEq/L

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18
Q

Neurological symptoms are most likly due to this electrolyte

A

Sodium NA+ 135 - 145mEq/L

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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

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20
Q

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

A

Isovolemic hyponatremia

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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

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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

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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

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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.

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25
Both sodium and water are decreased in extracellular area, sodium loss is greater than water loss
Hypovolemic hyponatremia
26
Renal causes Salt-losing nephritis adrenal insufficiency Diuretic use, loop, thiazide (volume depletion, thirst and H²O retention) Osmotic diuresis (Inhibiting Na+ reabsorbs)
Hypovolemic Hyponatremia
27
S/ S Mental confusion, headache Altered LOC hyperirritability, anxiety Tremors, seizures Hyperreflexia, muscle weakness, twitching Nausea, Vomiting, abdominal cramps Edema and weight gain
Hypovolemic Hyponatremia
28
Non-renal Causes Vomiting Diarrhea Fistulas Sweating excess Burns Continuous NG suction
Hypovolemic Hyponatremia
29
Interventions High Na+ Diet Daily weight / I & O Neuro checks Sodium Chloride tabs ISOTONIC IV FLUIDS (NO D5W)
Hypovolemia hyponatremia
30
Diagnostics Low urine sodium GI loss (diarrhea) Renal loss due to diuretics (after diauretics stopped) Third spacing
Hypovolemia hyponatremia
31
High urine sodium >40 mEq/L Metabolic alkalosis (Vomiting) Renal Salt losses due to diuretics Adrenal insufficiency, or cerebral salt wasting
Hypovolemia hyponatremia
32
Both sodium and water are INCREASED in the EXTRACELLULAR area, but water gain is more than sodium gain (Aldosterone)
Hypervolemic Hyponatremia
33
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
Hypervolemic hyponatremia
34
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
Hypervolemic hyponatremia
35
The normal serum osmolality is _____ mOsm/kg. Lower significa.... Higher...
285–295 Lower: less solutes in water Over hydration Higher: more solutes in water Dehydration
36
Addisons adreal insufficiency SIADH Fluid Overload: CHF, Liver failure Renal problems, NG This electrolyte problem
Hyponatremia <135
37
Assessment for Hyponatremia SALT LOSS S = Seizures A = ____ cramps L = T= tendon reflex L = loss ____ O = S = ____ Respiration S = ____ of muscles
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
38
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
Hypernatremia > 145
39
Causes (electrolyte imbalance) Cushing's syndrome & hyperventilating GI feeding out H2O Corticosteroids, failed compensatory Aldosterone (too much) Thirst impairment
Hypernatremia >145
40
Hypernatremia No FRIED foods for you F = (2) R = Relaxed or Restlessness I = increased (2) E = (2) D = Describe Skin
Fever & Flushed Skin Restlessness Increased fluid retention/ increased deep tendon reflexes Edema, extremely confused Dry skin, decreased tugor, dry mucous Decreased urine output
41
For Hypernatremia >145 use this IV bag
D5 / .45% or D5W
42
Why do you use D5 / .45% or D5W To treat Hypernatremia >145
Gradual reduction to prevent cerebal edema
43
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
Hypernatremia Agitation Confusion Flushed Skin / low fever Thrist Restlessness Weakness Hyponatremia Decreased Reflexes Ab cramps Leathargy /Confused Headache Muscle twitching Nausea / Vomiting Anorexia
44
Assist in skeletal and heart muscle contraction Aids in transmission of nerve impulse Acid base balance
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.
45
How is the most K+ lost
Urine 80%
46
______ stimulates Na+ reabsorption and K+ excretion
Aldosterone
47
(Low / High) pH in ECF can cause H+ to be substituted for K+ to maintain ICF neutrality
Low (Acidic) <7.35 Norm 7.35 to 7.45.
48
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
Sodium Potassium Pump
49
Cushings syndrome Decreased Magnesium Hyperaldostronism Hepatic disease Hyperglycemia Lasix, steroids, laxatives Respiratory alkalosis
Hypokalemia <3.5 Severe <2.5
50
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)
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)
51
Assessment finding Hypokalemia Cardiac Neurovascular GI motility Deep tendon reflexes
Cardiac Weak irregular Pulse, Palpation, Orthostatic hypotension Neurovascular Weakness, cramps, paresthesia, fatigue GI motility Decreased/ Constipation Deep tendon reflexes Decreased
52
Hypokalemia If its low its slow 7 L's
Lethargic Low shallow respiration Lethal cardiac Dysthymia Loss urine Leg cramps Limp muscles Low BP & HR
53
SUCTION describes symptoms for which electrolyte imbalance
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
You will be able to work as much as you want when your an RN
And get raises and promotions
55
Hypokalemia ECG changes ______ ST segment ______ T-wave ______ U- wave
Depressed ST segment Flat T-wave Prominet U- wave
56
IV replacement for Hypokalemia Never give.... Max.... Replace ____ first
Never give IV push or Bolus, FATAL Max 10mEg/hr Replace Mg first, inverse
57
Assess VS HR & Rhythm Labs Digoxin level I & O
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
Causes of this electrolyte problem Tissue injury Drugs (ACE, NSAID, ARBs, certain diuretics) Renal failure Blood transfusion Elevated pH (H+) Salt substitutes
Hyperkalemia >5
59
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)
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
Hyperkalemia Assessment Cardiac Neuromuscular GI / GU
Cardiac Bradycardia Irregular pulse Hypotension Rhythm changes Neuromuscular Paresthesia Muscle weakness Paralysis Hyperreflexia Respitory Distress GI / GU Ab cramps Nausea Decrease urine output
61
Hyperkalemia will MURDER you M = muscle _____ U = Urine level Respitory failure D = Decreased E = Early Sign R = Rhythm Changes
Hyperkalemia Muscle weakness Urine low Respitory failure Decreased cardiac contraction Early signs / Twitching/ Cramps Rhythm changes in heart VFIB / VTACH
62
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
Hyperkalemia
63
Hyperkalemia Labs K level, K level sever pH level H+ level
K >5 , severe >7 pH <7.35 Decreased H+ levels INCREASED
64
Interventions for ______ Eliminate from body (This_Type) Diuretic Dialysis Sodium polystyrene sulfonate NaHCO³ (Stablizes acidosis) Dextrose & insulin Albuterol Admin CaCl or Ca gluconate .... Why
Hyperkalemia Loop diuretic Combat myocardial effects
65
Magnesium range
1.3 - 2.1
66
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
Magnesium+ 1.3 - 2.1
67
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
Hypomagnesemia
68
LOW MAG anagram L = limited intake O = other electrolytes issues ___ & ___ W = ___ via kidneys M = Malabsorption A = _____ G = ____ Issue
Limited intake Other electrolyte issue (Hypocalcemia & Hypokalemia) Wasting via Kidneys Malabsorption Alcohol Glucemic issue (DKA)
69
Assessment for Hypomagnesemia TWITCHING
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
In low magnesium <1.3 how is Chvostek sign tested Trousseau's sign
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
Diagnostic Lab Mg < 1.3 (1.5) May see LOWER this electrolyte ECG changes PR & QT _____ QRS ______
Hypomagnesemia Lower K+ ECG PR & QT PROLONGED QRS WIDE
72
Chocolate, dry beans, peas, green leafy veg, meats, nuts, seafood, whole grains High in ....
Mg
73
Causes Addisons Disease DKA Cell Damage Hypothyroidism Hyperparathyroidism Antacids
Hypermagnesemia >2.1
74
Assessment Findings Hypermagnesemia LETHARGIC L = E =EKG T = tendon reflexes H = ____ tension / Diaphoresis A= R= Respitory _____ G = I = _____breathing C = Cardiac ___
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
Mg 2.9 ECG Wide PR & QT Prolonged QRS complex Indicative of...
Hypermagnesemia >2.5
76
Interventions Dialysis Fluids Loop diuretics CALCIUM GLUCONATE
Hypermagnesemia
77
Role: Maintains cell membrane structure and impulses Required for blood clotting Structure for bones and teeth
Calcium
78
Activación of this electrolyte requires vitamin D
Calcium
79
When more calcium is needed ______ is released Excess calcium is present, the thyroid gland secrets ______
Parathyroid hormone Thyrocalcitonin
80
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
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
Assessment Hypocalcemia CRAMPS
Confusion Reflexes Arrythmia Muscle Spams & Seizures Positive Trousseau's (BP cuff,hand contracts) Sing of Chvostek (Facial nerve hyperexcitable)
82
(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____
Serum Ionized
83
Hypoglycemia Serum Ca <_____ Ionized Ca<_____ ECG ______ QT & ST intervals
Serum <8.5 Ionized <4.5 Prolonged QT & ST intervals
84
Hypocalcemia Intervention Calcium Chloride (Describe) Calcium gluconate (Describe) Give more (Mg or Phosphate) Give less (Mg or Phosphate) Vitamin D Supp
Calcium Chloride (faster 3x stronger) Calcium gluconate (commonly used) Give more Mg Give less Phosphate
85
VS Respuratory Stridor ECG PROLONGED QT & ST Chvostek's & Trousseau
Hypocalcemia <8.5
86
Hypercalcemia Menomic HIGH CAL
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
Assessment fir Hypercalcemia WEAK W = Weak .... E= EKG A = Absent ... A= Abdominal...
Weakness of muscle EKG changes Shortened QT & Prolonged ST Absent reflexes & Abdominal distention
88
Total (Serum) Calcium 11.1 Ionized 5.9 ECG changes _____ QT interval _____ ST interval
Hypercalcemia Total Ca >10.5 Ionized >5.1 Shortened QT Prolonged ST
89
Interventions Increase Excretion Hydration, diuretics, hemodialysis Strain urine
Hypercalcemia
90
PO⁴ Name & Normal level
Phosphate / Phosphorus 2.5 - 4.5
91
Role Nerve & Muscle function Works with Ca for Bone Structure WBC phagocytosis & platelet function Activates vitamins and enzymes; assists in cell growth
Phosphate/ Phosphorus / PO⁴ 2.5 - 4.5
92
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
Hypophosphatemia <2.5
93
Causes Hypoparathyroidism Cell destruction Enemas S/S Calcification hypocalcemia (bones & teeth) Hyperactive Deep tendon reflexes
Hyperphosohatemia
94
Chloride CL- NORMAL RANGE
96 - 106
95
Travels with Na+ to maintain serum osmolality Acid/base balance Secreted by gastric mucosa (HCI) SAME S/S as ....
Chloride Same S/S as Na
96
Electrolyte associated with Mental Status
Na
97
Electrolyte associated with Cardiac and muscles
K potassium
98
Electrolyte associated with Reflexes and muscles
Mg
99
Addisons disease causes this electrolyte imbalance. Why
Hyponatremia and hyperkalemia Adrenal insufficiency. Hyponatremia is mainly due to the increased release of antidiuretic hormone
100
With Cushings syndrome these electrolytes are impaired how?
Low potassium & High sodium, and high bicarbonate levels Oppsite of Addisons Addison's lack Cortisol (and Aldosterone), Cushing's too much cortisol (hypercortisolism)
101
To treat hypovolemic,hyponatremia give isotonic IV. However, do not give this IV type
D5W. It is hypo in the body system
102
Interventions Hypervolemia/ hyponatremia Isotonic IV given no D5W Hypertonic IV can be given in ICU slowly (Risk Brain damage) if sodium is under
120
103
Insufficiently low levels of _______ result in low sodium levels (hyponatremia), elevated potassium levels (hyperkalemia
aldosterone
104
Which number value is more likely to complain of Agitation, Increased Reflexes, Low-grade fever, Weakness From Na issues
Hypernatremia >145
105
Which value range is more likely Lethargy, Abdominal cramping, Nausea, Vomiting, Anorexia Due to Na issues
Hyponatremia <135
106
Which group is more likely to experience Headache, Muscle Twitching, Lethargy, and GI issues From Na issues
Hyponatremia <135
107
Which group is more likely to experience Falls, Flushed Skin / Fever, Thirst, increased reflexs and confusion From Na issues
Hypernatremia >145
108
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
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
Aldosterone will raise this number _____ and lower this numer
Lower K+ potassium Raise Na sodium
110
Cushings syndrome has which effect on electrolytes
Lowers K potassium Raises Na sodium
111
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
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
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
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
Dont give IV rate of Potassium greater than _____ MMOL / HR LEATHAL!!!!
10
114
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)
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
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
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
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
Hypomagnesemia Sepsis Cirrhosis Hypocalcemia DM / DKA Elderly Increased Risk TPN (total parenteral nutrition) Alcohol Hypermagnesemia Cell damage Hypothyroid Hyperparathyroidism Antacids (Certain types) Addisons
117
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
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
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
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
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
Hypomagnesemia Give Foods such as: Chocolate, dry beans, peas, leafy vegs, meats nuts Hypermagnesemia Dialysis Loop diuretics Calcium Gluconate IV
120
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
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
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)
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
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
Hypocalcemia ECG: Prolonged QT & ST interval Serum < 8.5 Ionized < 4.5 Hypercalcemia ECG: QT shortened ST Prolonged Serum > 10.5 Ionized > 5.1
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Hypophosphatemia / Hyperphosphatemia Causes Kidney Disease Hypoparathyroidism Cell destruction Enemas Hypophosphatemia / Hyperphosphatemia Magnesium based drugs Hyperglycemia Alcoholism
Hyperphosphatemia Kidney Disease Hypoparathyroidism Cell destruction Enemas Hypophosphatemia Magnesium based drugs Hyperglycemia Alcoholism
124
What does Aldosterone do to Na and K levels.
The more Aldosterone Higher Na & Lower K
125
Hyperkalemia >5 Two ECG waves associated
VFIB & VTACH
126
Steroids have this affect in Na K Ca
Na >145 hyper K <3.5 hypo Ca > 10.5 hyper

NURS 1245 (12 decks)

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