Fluid And Electrolytes Flashcards
What is the normal Sodium range
135-145
What is hyponatremia?
Too much water, not enough sodium
What are the causes of hyponatremia
-Drinking water for fluid replacement (need electrolytes)
-SIADH: likes to drink water
-Adrenal Insufficiency: (decreased aldosterone, decreased sodium)
Signs and Symptoms of Hyponatremia
-Headache
- Confusion/Lethargy
-Seizure
-Coma
Treatments for hyponatremia
-Give sodium, hold H2O
-IVF: LR, Isotonic Saline
-if Severe hyponatremia: hypertonic saline- pulls fluid volume into the vascular space can be dangerous and cause fluid overload
What is hypernatremia
Cell dehydration, too much sodium, not enough water
Causes of hypernatremia
Hyperventilation ( you lose H2O with exhalation)
DI
Vomiting/diarrhea
Signs and Symptoms of hypernatremia
Dry Mouth
Increased Thirst
Lethargy, weakness, seizures, coma
Treatment for hypernatremia
Restrict sodium (give fluids)
Dilute with fluids
Daily weight, I&O, labs
Monitor feeding tube clients (ensure they are getting H2O supplements)
Normal Potassium Range
3.5-5.0
Causes of Hypokalemia
Diuretics
Vomiting
NG suction
Poor PO intake
Increased colostomy output
Increased insulin (insulin carries potassium into the cell)
Signs and Symptoms of hypokalemia
Muscle cramps
Muscle weakness
Arrhythmias: PVCs, small T waves
Treatments for hypokalemia
Give potassium
Spironolactone
Eat more Potassium
Causes of hyperkalemia (hyperkalmeia is DANGEROUS)
Kidneys not working well
Spironolactone
Cell injury ( trauma, K moves out of the cell into the ECF)
Signs/Symptoms of hyperkalemia
Muscle twitching
Arrhythmias: tall, peaked T waves, widened QRS
Treatment for hyperkalemia
Dialysis: if kidneys are not working
Calcium gluconate treats arrhythmias not potassium
Glucose/Insulin: insulin carries glucose and K into the cell
Kayexelate: pulls K out through feces
Normal Calcium range
8.5-10.5
Regulates calcium
Parathyroid hormone
Causes of hypocalcemia
Hypoparathyroidism (PTH regulates calcium)
Thyroidectomy
Malabsorption: diarrhea/laxatives
Signs/Symptoms of hypocalcemia
Tetany
Muscle Spasm
Convulsions
Finger/mouth tingling
Positive trousseau (inflate BP cuff, look for carpal spasm)
Positive chvostek ( tap ācā cheek)
Mental status changes
Treatments for hypocalcemia
Vitamin D: helps with absorption of calcium
IV Calcium: give slowly and monitor the heart (widens QRS and can cause cardiac arrest), can cause cellulitis/necrosis
