Fluid and Electrolytes Flashcards
1
Q
What are the three adaptive mechanisms for acid base imbalance?
A
- Chemical Buffer System
- Respiratory System
- Renal system
2
Q
What is the primary regulator of acid base imbalance?
A
chemical buffer system
3
Q
How fast is the chemical buffer system?
A
immediate actions
4
Q
How does the chemical buffer system work?
A
chemicals that combine with acids and bases to minimize pH change
5
Q
What is this?
A
Acidosis
6
Q
What is this?
A
Alkalosis
7
Q
What is the secondary system for acid base imbalance?
A
respirarory system
8
Q
How long does the respiratory system take to respond?
A
minutes
9
Q
What is the action of the respiratory system on acid base imbalance?
A
elimination or retention of carbon dioxide
10
Q
What is the other secondary system for acid base imbalance?
A
renal system
11
Q
How long does the renal system take to respond to acid base imbalance?
A
2-3 days
12
Q
What is the renal system’s response to acid/base imbalance?
A
secretion or reabsorption of hydrogen and bicarbonate
13
Q
How do you determine acid base imbalance?
A
arterial blood gas analysis
14
Q
What does arterial blood gas assess?
A
- Acid/Base Balance
- Need for oxygen therapy
- Change in oxygen therapy
15
Q
pH
A
7.35-7.45
16
Q
paCo2
A
35-45mm Hg
17
Q
HCO3
A
24-30mEq/L
18
Q
paO2
A
75-100mm Hg
19
Q
O2 sat
A
92-100%
20
Q
What should you remember to indicate with ABG sample?
A
the use of O2
21
Q
What should you avoid changing 20 minutes prior to obtaining ABG sample?
A
O2 therapy
22
Q
What syringe should you use for ABG sample?
A
heparinized syringe
23
Q
Why is it especially important to expel air bubbles with an ABG sample?
A
air bubbles contain gases that can mess with the results of test
24
Q
What should be done after ABG sample has been taken?
A
put sample on ice and/or transfer immediately to lab
25
What should you apply after ABG sample?
pressure to artery for 5 minutes
26
Step One of Three Step Method
Look at pH
If \>7.45 alkalosis
If \<7.35 acidosis
27
Step Two in Three Step Method
Look at the pCO2
Respiratory conditions will have a change in the paCo2
Metabolic conditions - no change
Respiratory conditions - opposite pattern
28
ROME
Respiratory Opposite Metabolic Equal
29
pH UP PCO2 DOWN
Respiratory Alkalosis
30
pH DOWN PCO2 UP
Respiratory Alkalosis
31
pH UP HCO3 UP
Metabolic Alkalosis
32
pH DOWN HCO3 DOWN
Metabolic Acidosis
33
Step Three in Three Step Method
Look at the HCO3
Metabolic conditions will have a change in HCO3
34
Respiratory Acidosis
* Shallow Respirations
* Pain
* Narcotics
* Atelectasis
* Pneumonia
* COPD
* Asthma
35
Respiratory Acidosis Assessment
* Shallow Respirations
* Hypoxia
* Mental Changes
* Disorientation
* Drowsiness
* Dizziness
* Flushed, Warm Skin
* Weakness
36
Respiratory Acidosis Nur Dx
* Impaired Gas Exchange
* Disturbed Thought Processes
* Activity Intolerance
* Risk for injury
37
Respiratory Acidosis Interventions
* Assess
* Treat cause of shallow respirations
* TCDB
* Ambulate
* Treat Pain
* Reduce narcotic dose
* O2
* Protect from injury
38
Respiratory Acidosis
* Fast Respirations
* Anxiety
* Fever
* Respiratory Infections
* Pain
39
Respiratory Alkalosis Assessment
* Lightheadedness
* Confusion
* Teachycardia
* Numbness in extremities
* SOB
* Anxiety
40
Respiratory Alkalosis Nur Dx
* Ineffective Breathing Pattern
* Disturbed Thought Processes
* Risk for Injury
41
Respiratory Alkalosis Interventions
* Assess
* Treat underlying cause of hyperventilation
* Encourgae slow breathing
* Breathing into a paper bag
* Sedatives
* Protect from injury
42
Below Waist?
Loss of Base (poop)
43
Above waist?
Loss of acid (throw up)
44
Metabolic Acidosis
* Loss of intestinal contents
* Diarrhea
* Diabetes
* Renal Failure
45
Metabolic Acidosis Asessment
* Kussmaul Respirations
* Weakness
* Nausea and Vomiting
* Abdominal pain
* CNS symptoms
* Headache
* Confusion
* Drowsiness
46
Nursing Dx Metabolic Acidosis
* Deficient Fluid Volume
* Risk for Injury
47
Metabolic Acidosis Interventions
* Assessment
* Treat underlying cause
* Give IV sodium bicarbonate
* Protect from injury
48
Metabolic Alkalosis
* Loss of gastric acid contents
* Vomiting
* NG suction
* Diuretics
49
Metabolic Alkalosis Assessment
* CNS Symptoms
* Dizziness
* Confusion
* Irritability
* Tetany
* Tingling in extremities
* Tachycardia
* Hypoventilation
50
Metabolic Alkalosis Nur Dx
* Deficient Fluid Volume
* Risk for Injury
51
Metabolic Alkalosis Interventions
* Assessment
* Treat underlying cause
* IV fluid replacement
* Protect from injury
52
What % of the body is water?
50-60%
53
Older adult water %
45-55%
54
Infant water %
70-80%
55
Who is at a higher risk for fluid problems?
elderly people and infants
56
How much body water is located within the cells (intracellular fluid)
2/3
57
What does water do in the body?
regulates body temperaturre, lubricates joints and membranes and is a medium for food digestion
58
How much does one liter of water weigh?
2.2 lb or 1 kg
59
Fluid spacing
distribution of water
60
First Spacing
describes the normal distribution of fluid in the ICF and ECF compartments
61
Second Spacing
an abnormal accumulation of interstitial fluid, edema
62
Third Spacing
Occurs when fluid accumulates in a portion of the body (trancellular fluid) from which it is not easily exhanged with the rest of the ECF. Third spaced fluid is trapped and unavailable for functional use
63
Why are perioperative patients at risk for the development of fluid and electrolyte imbalances?
because of restriction of oral intake, GI prep, blood volume loss, fluid shifts
64
Hypovolemia is
ECF deficient
65
Hypervolemia is
ECF excess
66
Dehydration
the loss of pure water alone without corresponding loss of sodium
67
Why might fluid volume excess occur?
excessive intake of fluids, abnormal retention of fluids, or a shift of fluid from interstitial fluid into plasma fluid
68
What might be forms of therapy for fluid volume excess?
diuretics and fluid restriction
69
ECF volume excess signs and symptoms
full, bounding pulse, distended neck veins, increased blood pressure
70
Mild to moderate fluid volume deficit
sympathetic nervous system stimulation of the heart and peripheral vasoconstriction. orthostatic hypotension
71
Severe fluid volume deficit signs and symptoms
weak, thready, pulse that is easily obliterated as well as flattened neck veins, shock
72
ECF excess respiratory changes
pulmonary congestion and pulmonary edema as increased hydrostatic pressure in the pumonary vessels forces fluid into the alveoli
73
ECF excess resp. symptoms
SOB, irritative cough, moist crackles
74
ECF deficit resp. changes
increased resp. rate due to decreased tissue perfusion and resultant hypoxia
75
ECF excess neurologic changes
cerebral edema
76
ECF deficit neurologic changes
alteration in sensorium secondary to reduced cerebral tissue perfusion
77
Why does edemous skin feel cool?
because of the fluid accumulation and a decrease in blood flow secondary to the pressure of the fluid
78
Why should the patient with nasogastric suction not be allowed to drink water?
It will increase the loss of electrolytes. Water causes diffusion of electrolytes into the gastric lumen from mucosal cells; the electrolytes are then suctioned away.
79
What is the main cation of the ECF?
sodium
80
What does sodium do?
plays a major role in maintaining the concentration and volume of the ECF
81
What is the primary determinant of ECF osmolality?
sodium. sodium imbalances are typically associated with parallel changes in osmolality
82
What besides ECF osmolality does sodium do?
generation and transmission of nerve impulses and the regulation of acid-base balance
83
What absorbs sodium?
GI tract from foods
84
How does sodium leave the body?
urine, sweat, feces
85
What is the primary regulator of sodium balance?
kidneys
86
How do the kidneys regulate the ECF concentration of sodium?
excreting or retaining water under the influence of ADH
87
Hypernatremia occurs with
water loss OR sodium gain
88
Hypernatremia causes hyper...
osmolality. ECF hyperosmolality causes a shift of water out of the cells, which leads to cellular dehydration
89
Primary protection against the development of hyperosmolality
thirst
90
What clinical states can produce water loss and hypernatremia?
* a deficiency in the synthesis or release of ADH from the posterior pituitary gland
* decrease in kidney responsiveness to ADH
* administration of concentrated hyperosmolar tube feedings and osmotic diuretics
* hyperglycemia associated with uncontrolled diabetes mellitus
* excessive sweating
* increased sensible loss from high fever
91
Symptoms of hypernatremia
* intense thirst
* lethargy
* agitation
* seizures
* coma
* postural hypotension
* weakness
* decreased skin turgor
92
Hyponatremia results from
loss of sodium-containing fluids, from water excess, or a combination of both
93
Common cause of hyponatremia from water excess
inappropriate use of sodium-free or hypotonic IV fluids. This may occur in patients after surgery or major trauma, during admistration of fluids in patients with renal failure, or in patients with psychiatric disorders addociated with excessive water intake
94
Symptoms of hyponatremia
* cellular swelling
* excess water lowers plasma osmolality, shifting fluid into brain cells
* irritability
* apprehension
* confusion
* seizures
* coma
95
What is the major ICF cation?
potassium
96
What is potassium's role in the body?
* neuromuscular and cardiac functions
* regulates intracellular osmolality
* promotes cellular growth
* acid-base balance
97
Factors that cause potassium to move from the ICF to the ECF
* acidosis
* trauma to cells
* exercise
98
What is the most common cause of hyperkalemia?
renal failure
99
Metabolic acidosis is associated with K+ moving...
from the ICF to the ECF as hydrogen ions move into the cell
100
Hyperkalemia symptoms
* increased excitability of the cells
* cramping leg pain
* weakness
* paralysis of skeletal muscles
* ventricular filbrillation
* cardiac standstill
* abdominal cramping
* diarrhea
101
Treatment of hyperkalemia
* Eliminate oral and parenteral potassium intake
* Increase elimination of potassium VIA diuretics, dialysis, and use of ion exhange resins such as sodium polystyrene sulfonate, increase fluid intake
* Force K from ECF to ICF by administrating insulin + glucose or IV sodium bicarbonate
* calcium gluconate IV to reverse the membrane excitability
102
Most common causes of hypokalemia
* diuresis
* elevated aldosterone levels
* magnesium deficiency
* diarrhea
* laxative abuse
* vomiting
* ileostomy drainage
103
Hypokalemia is associated with which acid base imbalance?
metabolic alkalosis. causes a shift of potassium into the cells in exchange for hydrogen, lowering the potassium in the ECF
104
Hypokalemia symptoms
* reduced excitability of the cells
* ventricular dysrhythmias
* skeletal muscle weakness
* paralysis
* weakness or paralysis of respiratory muscles
* shallow respirations and resp. arrest
* decreased GI motility
* decreased airway responsiveness
* impaired regulation of arteriolar blood flow
* release of insulin impaired leading to hyperglycemia
105
Can potassium be given IV push?
no
106
Calcium balance is controlled by which part of the body?
parathyroid (parathyroid hormone, calcitonin and vitamin D)
107
What does PTH do?
increases bone resorption (movement of calcium out of bones), increases GI absorption of calcium and increases renal tubule reabsorption of calcium
108
What does calcitonin do?
opposes the action of PTH (opposite reactions)
109
What can cause hypocalcemia?
any condition that casuses a decrease in the production of PTH (surgical removal or f a portion of or injury to the parathyroid glands during thyroid or neck surgery), acute pancreatitis, multiple blood transfusions, diet low in calcium, increased loss of clacium due to laxative abuse and malabsorption syndromes
110
Trousseu's sign
carpal spasms induced by inflating a blood pressure cuff on arm. The blood pressure cuff is inflated above the systolic pressure. Carpal spasms become evident within 3 minutes if hypocalcemia is present.
111
Chvostek's sign
a contraction of facial muscles in response to a tap over the facial nerve in front of the ear
112
What is the second most abundent IC cation?
magnesium
113
How is magnesium regulated?
GI absorption and renal excretion
114
What happens with hypomagnesium?
neuromuscular and CNS hyperirritatbility
115
What happens with hypermagnesium?
depresses neuromuscular and CNS functions
116
When does hypermagnesium usually occur?
with an increase in magnesium intake accompanied by renal insufficiency or failure.
117
Major cause of hypomagnesemia
prolonged fasting or starvation, chronic alcholism
118
What foods are high in magnesium?
green vegetables, nuts, bananas, oranges, peanut butter, chocolate
119
Why do infants and growing children have much greater fluid turnover than adults?
high metabolic rate increases fluid loss. infants lose more fluid through the kidneys because immature kidneys are less able to conserve water than adult kidneys. infants' respiratory rate is much higher than that of adults and their body surface area is proportionately greater than that of adults, increasing insensible loss
120
How much water do fat cells contain?
little or no water
121
How much water do lean muscle tissue contain?
high water content
122
How much % water women
52% adult women's weight
123
how much % water men
60% adult man's weight
124
Obsese person's % water
30-40% person's weight
125
Two types of fluid imbalance
`isotonic and osmolar
126
Isotonic Imbalances
water and electolytes are lost or gained in equal proportions, so that the osmolality of the body fluids remains constant
127
Osmolar Imbalances
involve the loss or gain of only water, so that the osmolality of the serum is altered
128
Isotonic Fluid Volume Deficient
the body loses both water and electolytes
129
Hypovolemia
fluid initially lost from the intravascular compartment
130
Why does fluid volume deficit occur?
* abnormal losses through the skin, GI tract, or kidney
* decreased intake of fluid
* bleeding
* movement of fluid into a third space
131
Third Space Syndrome
fluid shifts from the vascular space into an area where it is not readily accessible as extracellular fluid
132
Fluid Volume Excess
occurs when the body retains water and sodium in similar proportions to normal ECF
133
Hypervolemia
increased blood volume
134
Causes of fluid volume excess
* excessive intake of sodium chloride
* administering sodium-containing infusions too rapidly, particularly to clients with impaired regulatory mechanisms such as heart failure, renal failure, cirrhosis of the liver and cushing's syndrome
135
Edema
excess interstitial fluid
136
Dehydration
hyperosmolar fluid imbalance. occurs when water is lost from the body, leaving the client with excess sodium
137
Overhydration
hypoosmolar fluid imbalance, occurs when water is gained in excess of electrolytes, resulting in low serum osmolality and low serum sodium levels
138
1 g of wet diaper weight = how much urine?
1mL urine
139
140
This electrolyte imbalance is most commonly associated with malignancy, hyperparathyroidism, and immoblization
hypercalcemia
141
This electrolyte imbalance may result from an injury or removal of the parathyroid gland
hypocalcemia
142
This electrolyte imbalance is commonly associated with renal failure and metabolic acidosis
hyperkalemia
143
This electolyte can be lost by GI (D/V/NG suction) and renal losses due to diuretics. A decifit of this electrolyte leads to reduced excitability of tissues, especially cardiac tissues
hypokalemia
144
A loss of this electrolyte causes a shift of water intracellular due to a low osmolality
hyponatremia
145
Clinical manifestation of excess of this electrolyte can lead to cellular dehydration which causes neurological symptoms
hypernatremia
146
This electrolyte imbalance would occur in a client with renal failure who ingests maalox
hypermagnesemia
147
This electrolyte imbalance is commonly associated with prolonged fasting or starvation but may also be cause by fluid loss from the GI tract, diuretics, or high glucose levels in uncontrolled diabetes mellitus
hypomagnesemia
148
3 day old infant fluid requirement
250-300mL/24 hours
149
1 year old fluid requirement
1150-1300 mL/24 hours
150
2 year old fluid requirement
1350-1500mL/24 hours
151
Adult fluid requirement
2500mL/24 hours
152
examples of 3rd spacing
blister, ascites (fluid in peritoneal cavity), pleural effusion (fluid between the lining of the lungs)
153
Causes Fluid Volume Deficit
* abnormal losses through skin, GI tract or kidneys
* Decreased fluid intake
* Bleeding
* Movement of fluid into a third space
154
Clinical manifestations fluid volume deficit
* dry mucous membranes
* weight loss
* increased respiratory rate
* decreased skin turgor
* flattened neck veins
* increased HR, decreased BP
* orthostatic hypotension
* restlessness, lethargy, convulsions
155
TNI fluid volume deficit
* monitor VS
* measure I/O
* monitor daily weight
* assess LOC
* provide fluid replacement
* encourage PO intake
* safety precautions
156
Fluid Volume Excess causes
1. Excessive sodium intake
2. Administering Na-containing infusions too rapidly
3. Congestive heart failure
4. Renal Failure
157
Clinical manifestations of fluid volume excess
* Pulmonary edema - moist crackles
* Weight gain
* Neck vein distention
* Full bounding pulse
* increased BP
* peripheral edema
* HA, confusion, lethargy
158
TNIs Fluid volume excess
* Monitor VS
* Measure I/O
* Monitor for changes in LOC
* Decrease intake of H2O and NA
* Assess Resp. Status/lung sounds
* Monitor electrolytes
* Elevate HOB
* Monitor Weight Daily
* Safety Precautions
159
Sodium normal range
135-145 mEq
160
Sodium Facts
* Major cation in the extracellular fluid
* Regulation of fluid distribution in the body. Water follows sodium.
* Maintenance of body fluid osmolarity
* Transmission of nerve and muscle impulses
* Regulation of acid-base balance
161
Hyponatremia Etiology
* V/D/Drainage from suction
* Excessive Sweating
* Diuretics, excessive urinary output, other renal losses
* Water gains - hypotonic tube feedings, excessive hypotonic IV, excessive fluid intake
162
Hyponatremia Clinical Manifestations
* Irritability
* Feelings of impending doom
* Confusion
* Exhaustion
* Seizures
* Coma
* Anorexia
* N/V
* Abdominal Cramps
* Muscle weakness and spasms
* Dry mucous membranes
* Pale, dry skin
* Rapid, thready pulse
* Postural hypotension
163
TNI Hyponatremia
* Correct deficiency slowly
* Monitor neurological sstatus
* Restrict or replace fluids as indicated
* Sodium replacement as indicated
* Safe environment for client with neuromuscular symptoms
* Seizure precautions as indicated
164
Hypernatremia Etiology
* Excessive parenteral administration of saline solutions
* Hypertonic tube feeding with inadequate H2O supplements
* Excessive intake of salt
* Excessive insensible H2O loss
* Hyperventilation
* High Fever
* Heat Stoke
* Decreased H2O intake
165
SALT
HYPERNATREMIA
Skin flushed
Agitation
Low-grade fever
Thirst
166
Clinical Manifestations of hypernatremia
* Intense thirst
* Dry swollen tongue
* dry, sticky mucous membranes
* Flushed skin
* Elevated T
* Restlessness, agitation, twitching
* Disorientation
* Seizure
* Coma
167
TNIs Hypernatremia
* Fluid replacement as indicated
* Meticulous oral care prn
* Restrict foods high in Na as ordered
* Maintain a safe environment for clients with neuromuscular symptoms
* Seizure precautions prn
* 5 and 20 rule
168
Physiological Role of Potassium
* Major cation in the intracellular fluid
* Regulation of fluid volume within the cell
* Promotion of nerve impulse transmission
* Contraction of skeletal, smooth and cardiac muscles
169
Potassium Normal Range
3.5-5.0
170
Hypokalemia Etiology
* Diarrhea
* Laxative overuse
* Prolonged gastric suctioning
* Vomiting
* Prolonged starvation or fasting
* Potassium wasting diuretics
* Inadequate intake of potassium
* K shift into tissue cells from plasma
* increase insulin
* alkalosis
171
Hypokalemia Clinical Manifestations
* Weak, thready pulse
* Dysrhythmias
* Enhanced digitalis effect
* Bradycardia
* Fatigue
* Muscle weakness, leg cramps
* Diminished deep tendon reflexes
* Soft, flabby muscles
* Paresthesia
* Confusion, lethargy, can progress to coma
* Hypoactive BS
* anorexia, N/V
* Ileus
172
A Sick Walt
Hypokalemia
* Alkalosis
* Soft, flabby muscles
* Ileus
* Confusion
* K-replace cautiously
* Weakness
* Arrhythmias
* Lethargy
* Thready Pulse
173
TNI Hypokalemia
* Careful VS and ECG monitoring
* Protect client from injury due to weakness
* Potassium replacement
* Salt substitues can be used as a supplement
* IV potassium replacement (high alert med)
* Monitor clients receiving digitalis closely
174
Liquid, soluble granule, soluble powder or soluble tablet form of potassium replacement
This medicine must be completely dissolved in at least one half glass of cold water or juice to reduce gastric irritation
175
IV Potassium Replacement
* High Alert Med
* Never IV PUSH
* Periperal line acess rate should not exceed 10mEq/50-100mL infuses over one hour
* central line access rate 20mEq 50-100 mL with EID over 1 hour
* Dilution should never exceed 40mEq/L
* Always use EID
176
Peripheral Line Access Potassium
10mEq/50-100 mL over one hour
177
Central Line Acess Potassium
20mEq/50-100 mL over 1 hour
178
Hyperkalemia Etiology
* Excessive or rapid parenteral administration
* K containing drugs
* K containing salt substitutes
* Decreased K excretion (renal failure)
* K shift out of tissue cells into plasma
* massive cell damage
* burns
* acidosis
179
Mad Red
Hyperkalemia
* Muscle Weakness
* Acidosis
* Dysrhythmias
* Renal Failure
* EKG changes
* Diarrhea
180
Clinical Manifestations of Hyperkalemia
* Tachycardia leading to bradycardia
* Dysrhymias
* Cardiac arrest
* EKG changes
* Muscle twitching
* Muscle Cramps
* Weakness
* Flaccid paralysis
* Abd cramping
* hypermotility with hyperactive BS
* Diarrhea
181
TNI Hyperkalemia
* Protect client from injury
* Monitor ECG/VS
* Diuretics
* Sodium polysyrene sulfonate
* exchanges sodium for potassium in GI tract leading to increased elimination of K
* slow onset
* may be given orally or rectally
* Glucose and insulin
* Sodium bicarbonate
* Dialysis
* Calcium gluconate
182
Normal Level Calcium
9-11 mg/dl
183
Physiological Role of Calcium
* Maintaining skeletal elements
* Regulating neuromuscular activity
* 99% of body's calcium reside in bones and teeth
* Parathyroid hormone regulates calcium levels
184
Etiology Hypocalcemia
* Inadequate secretion of parathyroid hormone
* Surgical removal of parathyroid gland
* Vitamin D decifiency
185
CATS
Hypocalcemia
* Chvostek's Sign
* Arrhythmias
* +Trousseau's Sign, Tetany
* Spasm (laryngeal)
186
Clinical Manifestations of Hypocalcemia
* Numbness and tingling of extremities and around mouth
* Muscle Cramps
* Hyperactive deep tendon reflexes
* Postive Trousseau's sign
* Postive Chvostek's Sign
* Tetany
* Seizures
* Confusion
* Laryngeal Spasm
* Decreased BP
* Dysrhythmias
* Reduction in prothrombin time
* Blood doesn't clot normally
187
TNI Hypocalcemia
* Monitor resp status
* Monitor ECG
* Administer calcium supplements as directed
* Oral calcium carbonate , IV calcium Gluconate
* Protect client from injury
* Close monitoring of thyroid or neck surgery clients in immediate postoperative period
*
188
Etiology Hypercalcemia
* Muscle Weakness
* Incoordination
* Lethargy
* Bone Pain
* Pathological fractures
* Depressed reflexes
* Confusion
* Dysrhymias
* Anorexia
* Constipation
* N/V
* Flank Pain due to calcium stones in the kidney
189
FAR
Hypercalcemia
* Fractures
* Anorexia
* Renal Colic, Reflexes depressed
190
TNI Hypercalcemia
* Encourage weight bearing exercises
* Promote Ca excretion
* Diuretics
* 3000-4000mL fluid per day
* Handle client gently to prevent fractures
* Administer calcitonin as ordered
191
Normal Magnesium
1.5-2.5mEq/L
192
Physiological Role of Magnesium
* Second most abundant intracellular cation
* Regulation of neuromuscular activity
* Regulation of electrolyte imbalance, facilitates transport of Na and K across cell membrane, influence utilication of calcium and potassium
* Regulated by GI absorption and renal excretion
193
Clinical Manifestations Hypomagnesemia
* Hyperactive reflexes
* Tremors
* Confusion
* Seixures
* Dysrhythmias
* Increased potential for digitalis toxicity
194
RAT
Hypomagnesemia
* Reflexes hyperactive
* Arrhythmias
* Tremors
195
TNIs Hypomagnesemia
* Monitor for digitalis toxicity
* Oral - magnesium citrate
* IV- magnesium sulfate
* Monitor reflexes. Absent or knee jerk reflex is a sign of Mg toxcitiy
196
Etiology Hypermagnesemia
* Decreased urinary output
* Renal Failure
* Overuse of Magnesium containing antacids or laxatives
197
Clinical Manifestations Hypermagnesemia
* Hypoactive deep tendon reflexes
* lethargy
* drowsiness
* hypotension
* dysrhythmias
* cardiac and respiratory arrest
198
TNI hypermagnesemia
* IV fluids to increase urinary output
* diuretics for mg excretion
* creased mg intake
* emergency treatment administer calcium gluconate, provide myocardial protection against effects of hypermagnesemia
*
199
Etiology Hypomagnesemia
* Prolonged fasting
* Starvation
* Chronic Alcoholism
* NG suction
* Prolonged Diarrhea
* Ileostomy
* Diuretics
* Osmotic diuresis secondary to uncontrolled diabetes
200
