F/E Diseases Flashcards
Hyponatremia:
Serum Na+ <135mEq/L
Results from excess of water or loss of Na+
Water shifts from ECF into cells
S/S: abd cramps, confusion, N/V
Tx: Diet/IV therapy/fluid restrictions
What are some medical conditions that may cause a dilution hyponatremia?
CHF
Renal Failure
SIADH ( Cancer, pituitary trauma )
Addisons Disease (hypoaldosteronism & Na loss )
What are some conditions that might cause actual loss of sodium from the body?
GI losses – nasogastric suctioning, vomiting, diarrhea
Certain diuretic therapies
Permanent neurological damage can occur when serum Na levels fall below 110 mEq/L. Why?
Hypotonic environment swells cells, increasing ICP – brain damage
Hypernatremia:
Serum Na+> 145mEq/L
Results from Na+ gained in excess of H2O OR Water is lost in excess of Na+
Water shifts from cells to ECF
S/S: thirst, dry mucous membranes & lips, oliguria, increased temp & pulse, flushed skin, confusion
Tx: IV therapy/diet
What are some medical conditions that may cause elevated serum Na?
Renal failure
Diabetes Insipidus
Diabetes Mellitus ( hyperglycemic dehydration)
Cushings syndrome (hyperaldosteronism)
What are some other patient populations at risk for hypernatremia?
Elderly ( decreased thirst mechanism )
Patient’s receiving:
- tube feedings
- corticosteroid drugs
- certain diuretic therapies- Sprinolactone
Seizures, coma, death my result if hypernatremia is left untreated. Why?
Cells lose fluid into the ECF causing irreversible cell damage
For the client experiencing FVE & hyponatremia d/t excessive intake of water, which IV solution would you expect the physician to order?
D5NS
NS
D5W
½ NS
D5NS
For the client experiencing FVD and hypernatremia d/t excessive water loss, which IV solution would you expect the physician to order?
D5 ½ NS
D5RL
D5W
½ NS
1/2 NS
Hypokalemia serum level
<3.5mEq/L
Hypokalemia results from
decreased intake
loss via GI/Renal & potassium depleting diuretics
Hypokalemia signs and symptoms:
muscle weakness & leg cramps
decreased GI motility
cardiac arrhythmias
Hypokalemia treatment
diet
supplements
IV therapy
What are some medical conditions that may cause hypokalemia?
Renal disease/CHF
metabolic alkalosis
Cushing’s disease (Na retention leads to K loss)
What are some conditions that might cause actual loss of potassium from the body?
GI losses- nasogastric suctioning, vomiting, diarrhea
Certain diuretic therapies- lassie
Inadequate intake- (body cannot conserve K, need PO take)
Cardiac arrest may occur when serum K levels fall below 2.5 mEq/L. Why?
Increased cardiac muscle irritability leads to PACs and PVCs, then AF
Hypocalcemia:
Serum Ca < 4.3mEQ/l
results from:
- low intake
- loop diuretics
- parathyroid disorders
- renal failure
Hypocalcemia signs and symptoms:
osteomalacia
ekg changes
numbness/tingling in fingers
muscle cramps/tetany
seizures
Chovstek/Triysseau Sign
What are some other conditions that might cause elevated Ca?
Excessive intake of Ca OR vitamin D
Excessive intake of OTC antacids
If hypercalcemia is uncorrected, AV block and cardiac arrest may occur
Hypomagnesemia:
Common in critically ill patients
associated with high mortality rates
increases cardiac irritability and ventricular dysrhythmias- especially in patients with recent MI- tornado De Pointes
Maintenance of adequate serum Mg has been shown to reduce mortality rates post MI
Hypermagnesemia
Serum > 2.5mEq/L
Results from renal failure, increased intake
Signs and symptoms of hypermagnesemia
flushing, lethargy, cardiac changes (decreased HR)
decreased resp
loss of deep tendon reflexes
Treatment: restrict intake, diuretic rx
