Fluid and Electrolytes (Part 2)

Question 1

What are normal sodium levels?

Answer 1

135-145 mEq/L

Question 2

Kidneys are the primary regulator of what?

Answer 2

-renin angiotensin aldosterone system
-ADH
-ANP

Question 3

What are risk factors for loss of sodium?

Answer 3

-GI losses
-renal loss: kidney disease, diuretics
-skin loss: excessive perspiration, burns
-inappropriate ADH

Question 4

What is inappropriate ADH a result of?

Answer 4

-head injury
-AIDS
-malignant tumor

Question 5

Hyponatremia Manifestations

Answer 5

-decreased serum osmolality

-muscle cramps, weakness

-headache

-anxiety

-lethargy

-anorexia, nausea, vomiting

-hypotension, shock

Question 6

Hypernatremia Manifestations

Answer 6

-increased serum osmolality

-increased thirst

-dry skin and mucous membranes

-headache

-seizures, coma

-tachycardia, hypotension

Question 7

How do you diagnosis hyponatremia?

Answer 7

-serum sodium
-serum osmolality
-24 hour urine specimen
-urine specific gravity <1.010

Question 8

What are priorities of care for a patient with hyponatremia?

Answer 8

-restoring sodium, water balance
-preventing cerebral edema (swelling)

Question 9

NANDAs for hyponatremia

Answer 9

-risk for fluid volume imbalance

Question 10

Pathophysiology of hypernatremia

Answer 10

-excessive water loss (diarrhea, fever, hyperventilation, poor intake)
-excessive sodium intake (tube feedings, IV)

Question 11

Manifestations- Hypernatremia

Answer 11

-thirst
-dry mucous membranes
-red, dry, swollen tongue
-urine specific gravity > 1.030
-can progress to seizures, coma, and death

Question 12

What medications should be given for hypernatremia?

Answer 12

-1/2 NS IV
-oral
-enteral

Question 13

What are the priorities of care for hypernatremia?

Answer 13

mental status, brain function

Question 14

One of your patients is admitted with a sodium level of 160 mEq/L. Which of the following would be most likely?

Answer 14

severe thirst and fluid deficit

Question 15

What is a normal potassium value?

Answer 15

3.5-5.3 mEq/L

Question 16

What are the functions of potassium?

Answer 16

-nerve impulses
-cardiac rhythms
-muscle contraction

Question 17

What plays a role in potassium regulation?

Answer 17

-sodium potassium pump
-kidneys and aldosterone

Question 18

Pathophysiology of Hypokalemia

Answer 18

-inadequate potassium
-excessive renal, intestinal, or skin losses
-redistribution between ICF and ECF

Question 19

What could cause loss of Potassium?

Answer 19

-vomiting and gastric suctioning
-diarrhea
-heavy perspiration
-use of diuretics
-hyperaldosteronism

Question 20

Hypokalemia Manifestations

Answer 20

-nausea and vomiting
-muscle weakness
-cramps
-decreased cardiac output, irregular pulses
-polyuria

Question 21

How should you diagnose hypokalemia?

Answer 21

-serum potassium

-arterial blood gases

-renal function

-ECF readings

Question 22

How should medications for potassium be given?

Answer 22

oral and/ or parenteral supplements

Question 23

How should potassium NEVER be given?

Answer 23

Through IV Push

Question 24

What are the normal calcium levels?

Answer 24

8.5-10.5 mg/dL

Question 25

What are the signs and symptoms of hypocalcemia?

Answer 25

C.A.T.S.

C - Convulsions
A- Arrhythmias
T - Tetany (muscle cramping)
S - Spasms and stridor (Chvostek and Trousseau)

Question 26

What are the signs and symptoms of hypercalcemia?

Answer 26

Muscle weakness, lethargy, Polyuria, Polydipsia