FE/AB Flashcards
Calcium Normal Levels
9-10.5
Calcium Function
Hint: Gates to CAlifornia
Bone and teeth formation, nerve and muscle function, clotting
- Gatekeeper for Na and action potentials
- Gates too low: AP going off
- Gates too high: AP cannot get through
Hypocalcemia
Causes? Muscles? VS?
S/s?
Care?
- Vit D deficiency, hypoparathyroidism
- Chvostek’s/Trousseau’s positive, muscle spasms, numbness/tingling in lips/fingers, GI upset, hypotension, decreased HR
- increase foods high in calcium and provide supplementation
Hypercalcemia
Causes?
S/s?
- hyperparathyroidism, long-term steroid use, bone cancer
- constipation, decreased DTRs, lethargy, kidney stones
Magnesium Normal Levels
1.3-2.1
Magnesium Function
nerve and muscle function, bone formation. critical for many biochemical processes in the body
Hypomagnesemia
Causes?
S/s? DTRs? GI? Muscles?
Care?
- GI losses, diuretics, malnutrition, ETOH abuse
- hyperactive DTRs, tetany, seizures, constipation/ileus
- increase foods high in mag, provide supplements (PO can cause diarrhea)
Hypermagnesemia
Causes?
S/s?
Care?
- kidney disease, laxatives containing mag
- hypotensions, muscle weakness, lethargy, and respiratory and cardiac arrest
Potassium Normal Level
3.5-5.0
Potassium Function
maintains ICF balance, nerve function, regulates muscle and heart contractions
Hypokalemia?
Causes?
S/s? Hint: Slow and low; cardiac? vs?
Care?
- GI losses, diuretics, skin losses, metabolic alkalosis
- dysrhythmias (flat T waves, U wave), muscle weakness/cramps, constipation/ileus, hypotension, weak pulse
- increase foods high in K+, administer supplements (PO/IV), cardiac monitoring. never push K+, administer via IV SLOW
Hyperkalemia
Causes?
S/s?
Care?
- DKA, metabolic acidosis, salt substitutes, kidney failure, potassium-sparing diuretics (aldactone)
- dysrhythmias (tall peaked T, short QT, ST depression), muscle weakness, numbness/tingling, diarrhea
- limit foods high in K+, administer loop diuretics, Kayexalate (sodium polystyrene), insulin with dextrose
Sodium Normal Level
135-145
Sodium Function
maintain body’s fluid balance, nerve and muscle function
Hyponatremia
Causes?
S/s?
Care?
- GI losses, diuretics, kidney disease, skin losses, SIADH, hyperglycemia, HF
- tachycardia, hypotension, confusion (elderly), fatigue, headache, N/V
- administer isotonic solution (0.9% NaCl), increase sodium intake. For acute hyponatremia, give hypertonic (3% NaCl) IV fluids SLOWLY
Hypernatremia
Causes?
S/s?
Care?
- water deprivation, excess Na intake, kidney failure, Cushing’s syndrome, DI, burns, excess sweating
- tachycardia, muscle twitching/weakness, GI upset
- administer 0.9% or 0.45% IVF, decrease Na intake, increase water intake
Fluid Volume Deficit
Causes? S/s? Labs? Care? Complications & what to do?
- GI losses, diuretics, hemorrhage, diaphoresis, DI, kidney disease, hyperventilation (insensible loss)
- tachycardia, tachypnea, hypotension, weak pulse, fatigue, weakness, thirst, dry MM, GI upset, oliguria, decreased skin turgor, decreased CRT, diaphoresis, flat neck veins
- increased Hct, serum osmolarity, urine specific gravity , BUN, serum sodium
- fluid replacement, monitor daily weights, I & Os, notify provider for urine output <= 30 ml/kg, implement fall precautions,
- hypovolemic shock (!)»_space; administer O2, colloids, crystalloids, vasoconstrictors
Fluid Volume Excess
Causes? S/s? Labs? Care? Complications?
- HF, steroid use, kidney dysfunction, cirrhosis, burns, excess Na intake
- tachycardia, tachypnea, HTN, bounding pulses, weight gain, edema, ascites, dyspnea, crackles, distended neck veins
- decreased Hct and Hgb, serum osmolarity, urine osmolarity, urine specific gravity, BUN
- semi or High-fowler’s, monitor daily weights, I & Os, fluid restriction, Na restriction, administer diuretics and O2 as ordered
- pulmonary edema (dyspnea, pink frothy sputum)
Fluid Volume Excess
Daily Weight: What weight gain do you need to report to the provider?
1-2 lbs in 1 day
OR
3 lbs in 1 week
Chemical/Protein Buffers
What are they?
What do they do?
- bicarb, phosphate, Hgb = first line of defense
- bind or release H+ ions to quickly change pH
Respiratory Buffers
second line of defense; chemoreceptors sense a change in CO2, send signal to the brain to adjust respirations
- increased CO2»_space; increased RR and RD (to blow off CO2)
- decreased CO2»_space; decrease RR and RD (to keep CO2)
Renal Buffers
third line of defense; slower to respond but has longest duration
- kidneys reabsorb and produce more bicarb in response to high levels of H+ ions
- kidneys excrete more bicarb in response to low levels of H+ ions
Respiratory Acidosis
Causes?
Labs?
S/s?
Care?
- respiratory depression, inadequate chest expansion, airway obstruction, PE, pulmonary edema (retention of CO2 or inappropriate gas exchange)
- PaCO2 (>45), pH < 7.35
- tachycardia, tachypnea, shallow breathing, pale/cyanotic skin, confusion
- administer O2, bronchodilators
Respiratory Alkalosis
Causes?
Labs?
S/s?
Care?
- hyperventilation (r/t fear, anxiety, salicylate toxicity)
- PaCO2 < 35, pH > 7,45
- tachypnea, deep and rapid breathing, anxiety, chest pain, dysrhythmias
- reduce anxiety
Metabolic Acidosis
Causes?
Labs?
S/s?
Care?
- DKA, kidney failure, diarrhea, pancreas/liver failure
- HCO3 < 22, pH < 7.35
- bradycardia, hypotension, weak pulses, dysrhythmias, Kussmaul respirations, warm/flushed skin
- administer insulin DKA, sodium bicarbonate
Metabolic Alkalosis
Causes?
Labs?
S/S?
Care?
- antacid overdose or baking soda overdose, GI losses (V, GI suction)
- HCO3 > 26, pH > 7.45
- tachycardia, dysrhythmias, muscle weakness
- administer antiemetics for vomiting
