Fluid and Electrolytes 2 Flashcards
Magnesium and Calcium act as _____
SEDATIVES
Magnesium is excreted by the ____ but it can be lost in other way such as ____/
kidneys
Gi tract
NORMAL magnesium lab values
1.3-2.1
NORMAL calcium lab values
9.0- 10.5
Calcium and _____ have inverse relationship!!
Phosphorus
If you want to get mg and ca questions right, think ____ FIRST
muscles
causes of hypermagnesemia
renal failure
antacids
S/S of hypermagnesemia
- flushing
- warmth
- makes you vasodilate
DTR- decrease Muscle tone- weak, flaccid arrhythmias- YES LOC- Decrease Pulse - Decrease respirations- Decrease
treatment for hypermagnesemia
- ventilator
- dialysis
- calcium gluconate (reverses resp. depression and arrthymias)
How is calcium gluconate administered?
IV push very slowly
max rate 1.5-2ml/min
causes for hypercalcemia
-hyperparathyroidism (TOO much PTH)
WHYYY?!?
When your serum calcium gets low, PTH kicks in and pulls CA from the BONE and puts it in the blood; therefore, the serum calcium goes UP.
-thiazides (retain calcium)
-immobilization (you have to bear weight to keep CA in the bone)
S/S of hypercalcemia
- bones are brittle
- kidney stones (majority is made of calcium)
Treatment for hypercalcemia
- MOVE
- Fluids to prevent kidney stones
- Sodium phosphate
- Steroids
- Add phosphorus to diet
- Must have Vitamin D to use Ca.
- Calcitonin DECREASES serum Ca
Causes of hypomagnesemia
- diarrhea (lots of Mg in intestines)
- alcoholism
- alcohol suppresses ADH & it hypertonic
- *not eating, drinking
Causes of hypocalcemia
-hypoparathyroidism
-radical neck
-thyroidectomy
(NOT ENOUGH PTH for all of these)
s/s of hypo calcemia and hypomagnesemia
- Muscle tone= rigid and tight
- pt could have seizures
- stridor/larynogospasm
- positive chvostek
- positive trousseau
- arrhythmias
- DTR= increase
- mind changes
- swallowing problems (esophagus is a smooth muscle)
what is the chvosteks sign?
tap check (C is for cheek)
what is trousseaus sign?
pump up BP cuff. the hand will hyperflex
if you get a tremor, NOT NORMAL!
treatment for hypomagnesemia?
- give some mg
- check kidney function (before and during IV mg)
- seizure precautions
- eat magnesium
treatment of hypocalcemia?
- vit. d
- phosphate binder (sevelamer hydrochloride [renagel], calcium acetate [PhosLo]) (makes phos go DOWN, ca go UP)
- IV ca
What is important to do with IV calcium?
GO SLOWLY
make sure patient is on heart monitor!
What do you do if your client reports flushing and sweating when you start IV Mg?
STOP THE INFUSION!
Why should you put a patient getting IV calcium on a heart monitor?
because it widens the QRS complex.
What are some foods that are high in magnesium?
spinach mustard green summer squash broccoli halibut turnip greens pumpkin seeds peppermint cucumber green beans celery kale sunflower seeds sesame seeds flax seeds
sodium think ____.
neuro changes
normal sodium lab values
135-145 meq/l
the sodium level in your blood is totally dependent on __.
how much WATER you have in your blood.
Hypernatremia =
DEHYDRATION
too much sodium; not enough water
causes of hypernatremia
hyperventilation
heat stroke
diabetes insipidous
s/s of hypernatremia
dry mouth
thirsty-already dehydrated by the time your thirsty
swollen tongue (when severe)
treatment for hypernatremia
- restrict sodium
- dilute client with fluids (diluting makes sodium go down)
- daily weight
- I & O
- lab work
hyponatremia =
DILUTION
too much water; not enough sodium
causes of hyponatremia
- drinking water for fluid replacement
- psychogenic polydipsia ( loves to drink water)
- D5W (sugar and water)
- SIADH (retaining water)
s/s of hyponatremia
headache
seizure
coma
treatment for hyponatremia
- client needs sodium
- client doesnt need water
- if having neuro problems, need HYPERTONIC(packed with particles) saline. (3%NS or 5%NS)
with patient taking 3%NS or 5% NS, _____.
They will be in an ICU setting!
Feeding tube patient tend to get ____.
Dehydrated!!
normal potassium lab value
3.5 - 5.0
potassium is excreted by ___
the kidneys
if the kidneys arent working well, the serum potassium level will go ____ .
UP
causes of hyperkalemia
- kidney trouble
- spironolactone (makes you retain potassium)
s/s of hyperkalemia
- begins with muscle twitching
- then proceeds to weakness
- then flaccid paralysis
treatment for hyperkalemia
- dialysis; kidneys arent working
- calcium gluconate (decreases arrhythmias)
- glucose and insulin (insulin carries glucose and potassium into the cell)
- sodium polystyrene sulfonate
Sodium and potassium are ____.
INVERSE
anytime you give IV insulin, worry about ____.
hypoglycemia and hypokalemia
causes of hypokalemia
- vomiting
- NG suction (we have lots of potassium in our stomach)
- Diuretics
- not eating
s/s of hypokalemia
muscle cramps
weakness
life-threatening arrhythmias can happen with __.
HYPO and HYPER kalemia
treatment for hypokalemia
- give potassium
- spironolactone (makes pt retain potassium)
- eat more potassium
major problem with oral potassium is?
GI UPSET
what should you assess before and during IV potassium?
urinary output
always put IV potassium on ___.
a pump
never give IV potassium ___.
PUSH.
Mix well!
does IV potassium burn during infusion?
YES
use large bore catheter.
foods high in potassium?
spinach, fennel, kale, mustard greens, brussels sprouts, broccoli, eggplant, cantaloupe, tomatoes, parsley, cucumber, bell pepper, apricots, ginger root, strawberries, avocado, banana, tuna, halibut, cauliflower, kiwi, oranges, lima beans, potatoes, cabbage.
