F/E Diseases

Question 1

Hyponatremia:

Answer 1

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

Question 2

What are some medical conditions that may cause a dilution hyponatremia?

Answer 2

CHF

Renal Failure

SIADH ( Cancer, pituitary trauma )

Addisons Disease (hypoaldosteronism & Na loss )

Question 3

What are some conditions that might cause actual loss of sodium from the body?

Answer 3

GI losses – nasogastric suctioning, vomiting, diarrhea

Certain diuretic therapies

Question 4

Permanent neurological damage can occur when serum Na levels fall below 110 mEq/L. Why?

Answer 4

Hypotonic environment swells cells, increasing ICP – brain damage

Question 5

Hypernatremia:

Answer 5

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

Question 6

What are some medical conditions that may cause elevated serum Na?

Answer 6

Renal failure

Diabetes Insipidus

Diabetes Mellitus ( hyperglycemic dehydration)

Cushings syndrome (hyperaldosteronism)

Question 7

What are some other patient populations at risk for hypernatremia?

Answer 7

Elderly ( decreased thirst mechanism )

Patient’s receiving:

• tube feedings
• corticosteroid drugs
• certain diuretic therapies- Sprinolactone

Question 8

Seizures, coma, death my result if hypernatremia is left untreated. Why?

Answer 8

Cells lose fluid into the ECF causing irreversible cell damage

Question 9

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

Answer 9

D5NS

Question 10

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

Answer 10

1/2 NS

Question 11

Hypokalemia serum level

Answer 11

<3.5mEq/L

Question 12

Hypokalemia results from

Answer 12

decreased intake

loss via GI/Renal & potassium depleting diuretics

Question 13

Hypokalemia signs and symptoms:

Answer 13

muscle weakness & leg cramps

decreased GI motility

cardiac arrhythmias

Question 14

Hypokalemia treatment

Answer 14

diet

supplements

IV therapy

Question 15

What are some medical conditions that may cause hypokalemia?

Answer 15

Renal disease/CHF

metabolic alkalosis

Cushing’s disease (Na retention leads to K loss)

Question 16

What are some conditions that might cause actual loss of potassium from the body?

Answer 16

GI losses- nasogastric suctioning, vomiting, diarrhea

Certain diuretic therapies- lassie

Inadequate intake- (body cannot conserve K, need PO take)

Question 17

Cardiac arrest may occur when serum K levels fall below 2.5 mEq/L. Why?

Answer 17

Increased cardiac muscle irritability leads to PACs and PVCs, then AF

Question 18

Hypocalcemia:

Answer 18

Serum Ca < 4.3mEQ/l

results from:

• low intake
• loop diuretics
• parathyroid disorders
• renal failure

Question 19

Hypocalcemia signs and symptoms:

Answer 19

osteomalacia

ekg changes

numbness/tingling in fingers

muscle cramps/tetany

seizures

Chovstek/Triysseau Sign

Question 20

What are some other conditions that might cause elevated Ca?

Answer 20

Excessive intake of Ca OR vitamin D

Excessive intake of OTC antacids

If hypercalcemia is uncorrected, AV block and cardiac arrest may occur

Question 21

Hypomagnesemia:

Answer 21

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

Question 22

Hypermagnesemia

Answer 22

Serum > 2.5mEq/L

Results from renal failure, increased intake

Question 23

Signs and symptoms of hypermagnesemia

Answer 23

flushing, lethargy, cardiac changes (decreased HR)

decreased resp

loss of deep tendon reflexes

Treatment: restrict intake, diuretic rx