electrolytes - Sheet1

Question 1

What is the major extracellular fluid electrolyte?

Answer 1

Sodium.

Question 2

What is hypernatremia?

Answer 2

Serum sodium > 145 mEq/L, caused by kidney pathology or excessive intake.

Question 3

What is hyponatremia?

Answer 3

Serum sodium < 135 mEq/L, caused by plasma dilution or sodium loss; common in hospitalized patients.

Question 4

What is the classification of sodium chloride (NaCl)?

Answer 4

Therapeutic: Agent for hyponatremia; Pharmacologic: Electrolyte, sodium supplement.

Question 5

What are adverse effects of sodium chloride?

Answer 5

Hypernatremia, lethargy, confusion, muscle tremors/rigidity, hypotension, restlessness, pulmonary edema.

Question 6

What are contraindications for sodium chloride?

Answer 6

Hypernatremia, CHF, impaired renal function.

Question 7

What is the most abundant intracellular cation?

Answer 7

Potassium (K⁺).

Question 8

What is the normal extracellular potassium level?

Answer 8

3.5–5 mEq/L.

Question 9

What is hypokalemia?

Answer 9

Serum potassium < 3.5 mEq/L, caused by loop/thiazide diuretics, ↓ intake, alkalosis, ↑ insulin, vomiting, diarrhea, or laxative abuse.

Question 10

What are symptoms of hypokalemia?

Answer 10

Weakness, paralysis, risk for fatal dysrhythmias, intestinal dilation, and ileus.

Question 11

What is potassium chloride (KCl) used for?

Answer 11

Treating or preventing hypokalemia.

Question 12

What are adverse effects of oral KCl?

Answer 12

GI irritation (abdominal pain, nausea, vomiting, diarrhea), intestinal injury, hyperkalemia.

Question 13

What are the nursing considerations for oral KCl?

Answer 13

Take with meals or a full glass of water, remain upright during administration.

Question 14

What are the nursing considerations for IV KCl?

Answer 14

Must be diluted, infused slowly (≤ 10 mEq/h), never given as IV push, monitor serum K⁺, renal function, ECG, and I&O.

Question 15

What is hyperkalemia?

Answer 15

Serum potassium > 5 mEq/L, caused by severe tissue trauma, Addison’s disease, acute acidosis, misuse of K⁺-sparing diuretics, or K⁺ overdose.

Question 16

What are symptoms of mild hyperkalemia (5–7 mEq/L)?

Answer 16

T-wave heightening and PR interval prolongation.

Question 17

What are symptoms of severe hyperkalemia (8–9 mEq/L)?

Answer 17

Risk of cardiac arrest, confusion, anxiety, dyspnea, muscle weakness, numbness, and tingling.

Question 18

How is hyperkalemia treated?

Answer 18

Withhold K⁺-rich foods/meds, calcium salts (e.g., calcium gluconate) for cardiotoxicity, glucose + insulin infusion, sodium bicarbonate for acidosis, sodium polystyrene sulfonate (Kayexalate), or dialysis.

Question 19

What is magnesium’s role in the body?

Answer 19

It is the 2nd most abundant intracellular cation (~40 mEq/L), required for enzyme activity, binding of mRNA to ribosomes, and regulating neurochemical transmission and muscle excitability.

Question 20

What is the normal serum magnesium level?

Answer 20

1.8–3 mEq/L.

Question 21

What causes hypomagnesemia?

Answer 21

Diarrhea, hemodialysis, renal disease, prolonged IV feeding, chronic alcohol abuse, diabetes, and pancreatitis.

Question 22

What are the effects of hypomagnesemia on muscles and the CNS?

Answer 22

Increases acetylcholine release, leading to muscle excitability; also causes increased CNS neuron excitability, disorientation, psychoses, and seizures.

Question 23

What causes hypermagnesemia?

Answer 23

Renal insufficiency, especially with Mg-containing antacids or cathartics.

Question 24

What are the symptoms of mild hypermagnesemia?

Answer 24

Muscle weakness, hypotension, sedation, and ECG changes.

Question 25

What are the severe symptoms of hypermagnesemia?

Answer 25

Respiratory paralysis at 12–15 mEq/L and cardiac arrest at >25 mEq/L.

Question 26

What is magnesium sulfate (MgSO4) used for?

Answer 26

Oral prophylaxis of magnesium deficiency and IV/IM treatment of hypomagnesemia.

Question 27

What are the adverse effects of oral MgSO4?

Answer 27

Diarrhea.

Question 28

What are the administration guidelines for MgSO4 IM?

Answer 28

0.5–1 gm four times a day.

Question 29

What are the administration guidelines for MgSO4 IV?

Answer 29

10% solution at a rate of 1.5 mL/min or less.

Question 30

Why is injectable calcium important when administering MgSO4?

Answer 30

To counteract potential magnesium toxicity.

Question 31

What are nursing considerations for MgSO4 administration?

Answer 31

Assess vital signs every 10–15 minutes when giving IV, monitor serum magnesium levels, test patellar reflex before parenteral doses, assess for early signs of toxicity, and notify if respiratory rate falls below 12 breaths/min.

Question 32

When should MgSO4 administration be discontinued?

Answer 32

If urine output is less than 100 mL in the preceding 4 hours.