Fluids and Electrolytes

Question 1

what is the most common cause of acute hyponatremia

Answer 1

fluid overload in a surgical patient

Question 2

why does hyponatremia typically occur

Answer 2

due to an imbalance of water

Question 3

what are 5 clinical manifestations of hyponatremia

Answer 3

poor skin turgor, dry mucosa, decreased saliva production, orthostatic hypotension, abdominal cramping

Question 4

what clinical manifestation is commonly associated with a 48hr fall in sodium levels. why

Answer 4

brain herniation due to increased cerebral edema

Question 5

what are 5 clinical manifestations of edema of brain cells caused by hyponatremia

Answer 5

confusion, muscle twitching, seizures, lethargy, hemiparesis

Question 6

what is given to patients who have hyponatremia but cannot consume sodium

Answer 6

lactated ringers or 0.9% sodium chloride

Question 7

what is the treatment for patients with hyponatremia who have normal or excess fluid volume

Answer 7

restriction of fluid to a total of 800mL in 24hrs

Question 8

what are 4 GI manifestations of hyponatremia

Answer 8

anorexia, nausea, vomiting, abdominal cramping

Question 9

what are 4 NEURO manifestations of hyponatremia

Answer 9

lethargy, confusion, muscle twitching, seziures

Question 10

what are 2 dietary sources high in sodium that the nurse can give to a patient with hyponatremia

Answer 10

beef cube, tomato juice

Question 11

what is a common cause of hypernatremia

Answer 11

fluid deprivation in unconscious patients who cannot perceive, respond to, or communicate thirst

Question 12

is there is excessive water loss, sodium levels will _______ because…

Answer 12

increase because the patient is losing more water than sodium which causes the serum sodium concentration to increase and pull fluid out of cells

Question 13

what are less common causes of hypernatremia (3)

Answer 13

heat stroke, near drowning, malfunction in hemodialysis or dialysis equipment

Question 14

what mechanism of hypervolemia causes the clinical manifestations

Answer 14

water moves out of cells and into the ecf which causes cellular dehydration and a more concentrated ecf

Question 15

what are 5 NEURO clinical manifestation of hypernatremia

Answer 15

restlessness, weakness, disorientation, delusions, hallucinations

Question 16

what is the primary manifestation of hypernatremia

Answer 16

thirst

Question 17

what are 6 other signs of hypernatremia (not neuro or the primary manifestation)

Answer 17

dry mucosa, flushed skin, edema, hypotension, weak pulse, decreased deep tendon reflexes

Question 18

what fluids are given for the treatment of hypernatremia

Answer 18

hypotonic solutions such as 0.45% sodium chloride or an isotonic nonsaline solution such as D5W

Question 19

what are 2 common causes of hypokalemia

Answer 19

vomiting and diarrhea

Question 20

how can an alteration in acid-base balance cause hypokalemia

Answer 20

it can disrupt potassium distribution due to shifts in hydrogen and potassium ions between cells and the ecf

Question 21

how can insulin result in hypokalemia

Answer 21

persistent insulin hypersecretion may experience hypokalemia due to high carbohydrate parental nutrition

Question 22

what are 6 clinical manifestations of hypokalemia

Answer 22

fatigue, muscle weakness, muscle cramps, paresthesia, dysrhythmia, hypotension

Question 23

what are 5 dietary sources that are high in potassium

Answer 23

most fruits and veggies, legumes, whole grains, milk, meat

Question 24

what are the three major causes of hyperkalemia

Answer 24

decreased renal excretion of potassium, rapid administration of potassium, movement of potassium from the icf to the ecf

Question 25

what two patient populations are at increased risk for hyperkalemia

Answer 25

untreated kidney injury, addisons disease

Question 26

how can acid-base balance contribute to the development of hyperkalemia

Answer 26

acidosis causes potassium to move out of cells into the ecf

Question 27

what are the earliest changes that can be seen on an ECG in terms of detecting hyperkalemia

Answer 27

peaked and narrow T waves, ST segment depression, shortened QT interval

Question 28

what are 5 clinical manifestations of hyperkalemia

Answer 28

muscle weakness, paralysis of respiratory and speech muscles, nausea, diarrhea, intermittent intestinal colic

Question 29

what is administered in the case of dangerously elevated potassium levels

Answer 29

IV calcium gluconate

Question 30

what is the purpose of administering IV calcium gluconate

Answer 30

minimize the action of hyperkalemia on the heart

Question 31

what two things can be administered to correct hyperkalemia in emergency situations

Answer 31

IV sodium bicarbonate, IV regular insulin and hypertonic dextrose solution

Question 32

what is the purpose of administering IV sodium bicarbonate or IV regular insulin and hypertonic dextrose solution

Answer 32

it causes a temporary shift of potassium into cells

Question 33

what 3 populations are at increased risk for hypocalcemia

Answer 33

older adults, those with disabilities, sedentary lifestyle

Question 34

what are 5 causes of hypocalcemia

Answer 34

thyroid and parathyroid surgery, pancreatitis, kidney injury, magnesium deficiency, alkalosis

Question 35

what is the most common sign of hypocalcemia

Answer 35

tetany

Question 36

what are 4 signs of hypocalcemia

Answer 36

seizures, mental changes, prolonged QT interval, dyspnea

Question 37

what are 3 signs of chronic hypocalcemia

Answer 37

hyperactive bowel sounds,

Question 38

what iv solution is administered for those who have hypercalcemia

Answer 38

0.9% sodium chloride

Question 39

what hormone can be administered to lower serum calcium levels

Answer 39

calcitonin

Question 40

what two things can the nurse do in terms of prevention of hypercalcemia

Answer 40

encourage early ambulation and oral fluids

Question 41

what serum calcium level indicates hypocalcemia

Answer 41

lower than 2.18mmol/L

Question 42

what serum calcium level indicates hypercalcemia

Answer 42

greater than 2.6mmol/L

Question 43

what is serum magnesium level indicates hypomagnesemia

Answer 43

below 0.75mmol/L

Question 44

what is the main pathophysiology to explain hypomagnesemia

Answer 44

magnesium loss through the GI tract due to nasogastric suction, diarrhea, or fistulas

Question 45

what is the most common cause of symptomatic hypomagnesemia in canada

Answer 45

alcoholism

Question 46

what are 5 neuro clinical manifestations of hypomagnesemia

Answer 46

hyperexcitability, muscle weakness, tetany, nystagmus, seizures

Question 47

what are 2 clinical manifestations/predispositions of hypomagnesemia

Answer 47

altered ECG, cardiac dysrhythmia

Question 48

what are 5 dietary sources of magnesium

Answer 48

green leafy veggies, nuts, legumes, whole grains, seafood

Question 49

what serum magnesium level indicates hypermagnesemia

Answer 49

above 0.95mmol/l

Question 50

what is the most common cause of hypermagnesemia

Answer 50

kidney injury

Question 51

what are 5 signs of mild hypermagnesemia

Answer 51

hypotension, weakness, facial flushing, sensations of warmth, nausea/vomiting

Question 52

what are 5 signs of higher serum levels of hypermagnesemia

Answer 52

lethargy, difficulty speaking, loss of deep tendon reflexes, muscle weakness, paralysis