Fluid and Electrolytes II Flashcards
excessive sodium in the blood; water rushes out of the cell into the blood and the cell shrinks (dehydrates)
hypernatremia
135-145 mEq/L (blood test picks up on the amount of sodium outside of the cell)
normal sodium level
electrolyte that helps water move from inside the cell and outside the cell. ____ and water love each other. wherever ____ goes water follows
Sodium
causes of hypernatremia?
mnemonic device –> HIGH SALT
(HIGH) Hypercortisolism (hyper-ventilation), Increased sodium intake, GI feeding without adequate water supplement, Hypertonic solutions (ex: 3% solution)
(SALT) Sodium excretion decreased (ex: corticosteriods), Aldosterone problems (increased absorption of sodium), Loss of fluids, Thirst Impairment
"NO FRIED FOODS FOR YOU" F -fever flushed skin R - restless, really agitated I - increased fluid retention E - edema, extremely confused D - decreased urine output, dry mouth
signs and symptoms of hypernatremia
- restrict NA+ intake (bacon, butter, canned foods, cheese, hot dogs, lunch meat, processed foods, etc)
- Patient safety: confused and agitated (call light in reach, fall risk)
- MD may order a isotonic or hypotonic IV solution (0.45% saline) give slowly (causes a shift of the fluid within the cell so watch out for cerebral edema)
- educate the client on proper diet and signs and symptoms of increased sodium level
nursing intervetions for hypernatremia
low sodium in the blood ; the cell swells and could potentially burst. affects cells everywhere in the body and brain cells are particularly sensitive to this causing confusion for the patient.
hyponatremia
“NO NA+”
- Na+ excretion is increased, renal problems, NG suction, vomiting, diuretics, sweating, diabetes insipidus, aldosterone sections
- Overload of fluids
- NA+ intake low through low salt diet or NPO status
- anti-diuretic hormone over secreted (SIADH)
causes of hyponatremia
“SALT LOSS”
S - seizures and stupor
A - abdominal cramping and attitude changes (confusion)
L - lethargic
T - tendon reflexes diminshed, trouble concentrating
L - loss of urine and appetite
O - orthostatic hypotension, overactive bowel sounds
S - shallow respirations
S - spasms of the mucles
Signs and symptoms of hypnatremia
- watch cardiac, respiratory, renal and GI status
- hypovolemic: administer IV solution to restore fluids and sodium (3% saline hypertonic solution)
- restrict fluids, some cases order diuretics
- declomyocin (tetracylcine) don’t give with food especially dairy and antacids (affects absorption)
- instruct the patient to indulge in sodium rich foods
nursing interventions for hypnatremia
normal level is 3.5-5.1 anything over 7 is extremely dangerous
normal level of potassium
high potassium in the blood ; ________ is responsible for nerve impulses and muscle contractions (loves to live inside the cell so potassium in this situation has mainly gravitated toward the outside of the cell)
hyperkalemia ; potassium
“MURDER”
M - muscle weakness
U - urine production low or absent
R - respiratory failure
D - decreased cardiac contractility (weak pulse, low BP)
E - early signs of muscle twitching/cramps (late sign)
R - rhythm changes
signs and symptoms of hyperkalemia
- monitor patient cardiac, respiratory, nueromusclant, and GI status
- hold PO supplements if ordered, stop IV potassium infusion
- initiate K+ restrictive diet (no potatoes, pork, fish, spinach, strawberries, tomatoes, oranges, mushrooms, cantaloupe
- prepare for dialysis
- may order lasix (potassium wasting drug)
- may order hypertonic solution of glucose and insulin
nursing intervention for hyperkalemia
low potassium in the blood
hypokalemia
"everything is slow and low" 7 L's Lethargic Low and slow respirations Lethal cardiac S's Loss of urine Leg cramps Limp muscles Low B/P and HR
signs and symptoms of hypkalemia
never want to give ______ via IV push, subcutaneous injection or IM injection. Give slowly via IV
potassium
Hold Lasiz, thiazides, and diagcin
these are potassium diuretics so no need to waste more potassium
low calcium in the blood;
hypocalcemia
plays a huge role in bone and teeth health, muscle and nerve function, cell function, and blood clotting
role of calcium
normal 8.6-10.0 mg/dL
normal calcium level
calcium is absorbed in the GI system, stored in the bone, excreted in the kidneys, _____ helps play in this role (calcium and phosphorus affect each other in opposite ways)
Vitamin D
“CRAMPS”
C - confusion
R - reflexes hyperactive
A - Arrhythmias (prolonged QT interval & ST interval)
P- positive trousseaus’s sign (BP cuff upper arm inflate above stystolic and hold in place in 3 mins; patients hand open and closes (reflexes)
S- sign of onvastekis (masseter (lips or nose twitch toward jaw)
signs and symptoms of hypocalcemia
- make sure safety precautions are in place and watch out for laryngeal spams
- monitor heart rhythm and watch any infiltration or phlebitis
- best to give through central line (10% Calcium glucoside)
- administer Vitamin D
- may order medicine like TUMS to decrease phosphorus level
- increased calcium intake (spinach, sardines, collard greens, milk, rhubarb, yogurt, cheese)
nursing interventions for hypocalcemia
