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Fundamentals 2 Exam 1 Flashcards > Fluid & Electrolytes Part 2 (B) Flashcards > Flashcards

Fluid & Electrolytes Part 2 (B) Flashcards

1
Q

Electrolytes are all-

A

Minerals / Salts

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2
Q

What are the positively charged electrolytes (Cations)?

A

Potassium, Sodium, Calcium, Magnesium

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3
Q

What can you monitor to identify any electrolyte imbalances with your pt’s?

A

Lab Values

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4
Q

What are the 3 age groups at a greater risk for electrolyte imbalances?

A

Infants
Children
Older Adults

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5
Q

What groups of people are at risk for electrolyte imbalances?
(Aside from age groups)

A

People with Cognitive Disorders or Chronic Illnesses

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6
Q

What does Calcium play an important role in?

A

Skeletal Mineralization
Muscle Contractions
Nerve Transmission of Impulses
Blood Clotting
Hormone Secretion

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7
Q

What is Skeletal Mineralization?

A

The process of the deposits of minerals on the bone matrix for the development of the bone itself

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8
Q

Calcium is predominantly what kind of electrolyte?

A

An Extracellular Cation

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9
Q

Hypocalcemia is a Total Blood Calcium Level of-

A

Less than 9

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10
Q

What are the risk factors for Hypocalcemia?

A

Increased calcium output

Poor intake or absorption of Calcium

Movement of Calcium into the bone from extracellular fluid

Shifting of calcium to an inactive form

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11
Q

What can cause increased calcium output to occur?

A

Chronic Diarrhea

Misuse of Laxatives

Steatorrhea

Poor Intake / Absorption of Calcium

Movement of Calcium into the bone from extracellular fluid

Shifting of calcium to an inactive form

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12
Q

What is Steatorrhea?

A

An increase in fat secretion in your stools or bowel movements

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13
Q

What can cause a poor Intake / Absorption of Calcium ?

A

Crohn’s Disease

Vitamin Deficiency (Caused by alcohol use disorders or Chronic Kidney Disease)

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14
Q

What are the clinical manifestations/ expected findings of a pt with Hypocalcemia?

A

Tetany

Cardiovascular Manifestations

GI Manifestations

CNS Manifestations

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15
Q

What is Tetany?

A

Muscle Twitches/spasms/involuntary muscle contractions

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16
Q

What are the expected findings of a pt diagnosed with Muscle Twitches / Tetany?

A

Numbness/tingling: fingers & circumoral

Muscle spasms occurring frequently at rest

Hyperactive deep tendon reflexes

Chvostek’s sign: Positive

Trousseau’s sign: Positive

Laryngospasms

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17
Q

This is a test where you tap on a person’s cheek in front of the ear to assess for any facial twitching =

A

Chvostek’s Sign

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18
Q

Hand finger spasms with sustained blood pressure cuff inflation =

A

Trousseau’s Sign

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19
Q

What are the cardiovascular manifestations of Hypocalcemia?

A

Weak Thready Pulse

Bradycardia or Tachycardia

Cardiac Dysrhythmias

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20
Q

What are the GI manifestations of Hypocalcemia?

A

Hyperactive Bowel Sounds

Diarrhea

Abdominal Cramping

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21
Q

What are the Central Nervous System manifestations of Hypocalcemia?

A

Seizures

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22
Q

What are the nursing actions for Hypocalcemia?

A

Calcium supplements (oral or IV) with Vitamin D supplements

Seizure precautions

Fall precautions

Keep emergency equipment on standby

High calcium foods

Include dairy products and dark green veggies

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23
Q

Padding side rails is a precaution for-

A

Seizures

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24
Q

Orange juice is a good source of-

A

Calcium

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25
Q

Hypercalcemia is a Total Blood Calcium Level of-

A

Over 10.5

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26
Q

What are the causes of Hypercalcemia?

A

Thiazide diuretics
Glucocorticoids (long term use)
Paget’s Disease
Hyperthyroidism
Hyperparathyroidism
Bone Cancer

27
Q

What are the Neuromuscular manifestations of Hypercalcemia?

A

Decreased Reflexes

Bone Pain

28
Q

What are the Cardiovascular manifestations of Hypercalcemia?

A

Dysrhythmias

Increased Risk for Blood Clots

29
Q

What are the GI manifestations of Hypercalcemia?

A

Nausea & Vomiting
Constipation
Anorexia

30
Q

What are the Genitourinary manifestations of Hypercalcemia?

A

Hypercalciuria

31
Q

What are the CNS manifestations of Hypercalcemia?

A

Weakness
Lethargy
Confusion
Decreased LOC
Personality Changes

32
Q

What are the nursing actions for Hypercalcemia?

A

Restrict Calcium
Increase Fluid Intake
Monitor for Pathological Fractures

33
Q

What are Pathological Fractures?

A

Breaks in bones that are caused by an underlying disease and not from trauma

34
Q

Magnesium is found mostly in your-

A

Bones

35
Q

There is a small amount of magnesium in your-

A

Body Cells

36
Q

Magnesium is an electrolyte that plays a key part of many body reactions that affect-

A

Cellular Function, Nerve Conduction, etc

37
Q

What relies heavily on magnesium to do its job?

A

Brain, Heart, Muscles

38
Q

Magnesium has a direct effect on-

A

The balance of other electrolytes (Sodium, Calcium, Potassium)

39
Q

There is a very small amount of magnesium in the-

A

Extracellular Fluid

40
Q

Hypomagnesemia often occurs along side -

A

Hypocalcemia & Hypokalemia

41
Q

These organs are responsible for retaining normal magnesium levels:

A

Small & Large Intestines
Bones
Kidneys

42
Q

How do the Small & Large Intestines help retain normal magnesium levels?

A

Absorb magnesium from the food you eat

43
Q

How do the Bones help retain normal magnesium levels?

A

Storage system for magnesium

44
Q

How do the Kidneys help retain normal magnesium levels?

A

Excretion or release of magnesium via the urine

45
Q

A problem with the Small & Large Intestines, Bones, or Kidneys can all leave you at a high risk of acquiring-

A

Hypomagnesemia

46
Q

Hypomagnesemia is magnesium level of -

A

Lower than 1.3

47
Q

Hypermagnesemia is magnesium level of -

A

Higher than 2.1

48
Q

What are the risk factors of Hypomagnesemia?

A

Increased Magnesium Output
Shift to an inactive form
Inadequate magnesium intake
Inadequate magnesium absorption

49
Q

What can cause increased magnesium output?

A

Increased GI losses (Diarrhea or NG Tube set to suction)

Thiazides

Loop Diuretics

Can be associated with Hypocalcemia

50
Q

What can cause magnesium to shift to an inactive form?

A

A rapid infusion of citrated blood

51
Q

What can cause an inadequate magnesium intake and absorption?

A

Malnutrition, Alcohol Use Disorder, Misuse of Laxatives

52
Q

What are the Neuromuscular manifestations of Hypomagnesemia?

A

Increased Nerve Impulse Transmission:

Hyperactive Deep Tendon Reflexes, Paresthesia, Tetany, Positive Chvostek’s Sign, Positive Trousseau’s Sign, Insomnia, Seizures

53
Q

What are the GI manifestations of Hypomagnesemia?

A

Hypoactive Bowel Sounds
Constipation
Distended Abdomen
Paralytic Ileus

54
Q

Hypomagnesemia mainly effects your-

A

Neuromuscular System + Heart

55
Q

What are the Cardiovascular manifestations of Hypomagnesemia?

A

Dysrhythmias
Tachycardia
Hypertension
Premature Ventricular Contractions
ECG Waveform Changes

56
Q

What are the nursing actions for Hypomagnesemia?

A

Stop any meds that waste magnesium

Magnesium replacement: oral for mild manifestations and IV for severe
Oral replacement can potentially cause diarrhea making the depletion worse

High magnesium foods (include whole grains and dark green veggies)

57
Q

What are some foods that are high in Magnesium?

A

Pumpkin Seeds, Dry Roasted Almonds, Boiled Spinach, Dry Roasted Cashews, Pumpkin Seeds (In Shell), Oil Roasted Peanuts, Cereal (Shredded Wheat), Plain / Vanilla Soy Milk, Cooked Black Beans, Dark Chocolate (60-90% Cocoa), Smooth Peanut Butter, Bread (Whole Wheat), Avocado, Baked Potato (with Skin), Cooked Brown Rice, Plain Low-Fat Yogurt, Fortified Breakfast Cereals, Instant Oatmeal, Canned Kidney Beans, Bananas, Unsweetened Cocoa Powder, Farmed Atlantic Salmon, Milk, Cooked Halibut, Raisins, Roasted Chicken Breast, 90% Lean Ground Beef, Chopped & Cooked Broccoli, Apples, Cooked White Rice, Raw Carrots

58
Q

Causes of Hypermagnesemia =

A

Kidney impairment
Adrenal impairment
Increased intake of medications containing magnesium

59
Q

What meds contain magnesium?

A

Laxatives & Antacids

60
Q

What are the Neuromuscular Manifestations of Hypermagnesemia?

A

Muscle Paralysis
Shallow Respirations
Bradypnea
Diminished DTR’s (deep tendon reflexes)

61
Q

What are the Cardiovascular Manifestations of Hypermagnesemia?

A

Bradycardia
Hypotension
Cardiac Arrest
Dysrhythmias
ECG changes

62
Q

What are the CNS Manifestations of Hypermagnesemia?

A

Lethargy

63
Q

What are the nursing actions for Hypermagnesemia?

A

Assess vital signs, LOC, & reflexes frequently

Notify HCP if there are changes or absent reflexes

Loop diuretics and magnesium free fluids if kidney function is adequate

Calcium gluconate for severe cardiac changes

64
Q

How can you diagnose Hypermagnesemia?

A

ECG (prolonged PR interval and wide QRS)

Fundamentals 2 Exam 1 Flashcards (18 decks)

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