Fluids/Electrolytes

Question 0

Hypernatremia

Answer 0

> 145

• Caused by: Fluid volume loss (dehydration)
• S/S: extreme thirst, short attention spand, seizures,twitching(early), weakness(late), dry sticky mucous membranes, decreased contractility, edema, increased BP
• Intervention: drink fluids reg., monitor replacement of water loss, diuretics, monitor specific urine gravity, increase fluid retention

Question 1

Sodium

Answer 1

• Normal range: 136-145
• Foods:soup, salt, salad dressings, cured meats, cheese, snack foods,pickled prod.
• Needed for proper muscle contraction and mentation

Question 2

Hyponatremia

Answer 2

<135

• caused by fluid volume overload
• S/S: headache, confusion, fatigue, decreased weakness, increased motility & bowel sounds, orthostatic hypotension
• Interventions: normal saline, replace body fluid losses with fruit juice or bouillon

Question 3

Potassium

Answer 3

• Normal range: 3.5-5
• Primary intracellular
• Foods: Meat, poultry, fish, oranges, milk, lima beans, spinach,tomatoes, potatoes

Question 4

Hypokalemia

Answer 4

<3.5

• Caused by: vomiting, gastric suction, diarrhea, laxative abuse
• S/S: decreased BP, weakness (fall risk), weak, thready decreased pulse, EKG changes, decreased peristalsis, paralytic ileus (constipation)
• Interventions: administer K (never IV push)

Question 5

Hyperkalemia

Answer 5

> 5.0

• Caused by: Rapid IV, Excessive use of salt substitute, acute and chronic renal failure, decreased prod. of aldosterone, adrenal insufficiency, tissue injury, insulin deficiency
• S/S: twitching(early), mental confusion, diarrhea, spastic colon, peaked T waves, cardiac arrest
• Interventions: always evaluate renal function before meds, avoid foods high in potassium, increase urine output(use K depleting diuretics) insulin

Question 6

Calcium

Answer 6

• Normal range: 8.5-11
• Foods: shell fish, cheese, dairy, nuts, dried fruits/veggies
• Inversely related to phosphate

Question 7

Hypercalcemia

Answer 7

> 11

• Caused by: hyperparthyroidism, metastatic carcinoma, multiple myeloma
• S/S: rapid HR, BP, Fast clotting, muscle weakness,constipation, confusion, CNS depression
• Interventions: avoid Vit D, administer loop diuretics, normal saline

Question 8

Hypocalcemia

Answer 8

<8.5

• Caused by: Vit D deficiency, overuse of antacids, hypoparathyroidism, overuse of phosphate-containing laxatives and enemas, chronic renal failure, lactose intolerance(at risk: African Americans, Asians, American Indians)
• S/S: muscle cramps, +Cvosteks sign, +Trousseau, tetany
• Interventions: mngmt of antacids, increase Vit D, Increase calcium

Question 9

Phosphorus

Answer 9

*normal range: 3-3.5
*Foods: meat, fish, dairy, nuts,coffee, coke
*Found in bones
*activates vitamins and enzymes
Inversely related to calcium

Question 10

Hypophosphonatremia

Answer 10

<3

S/S: general muscle weakness…think breathing

Question 11

Hyperphosphonatremia

Answer 11

> 3.5

Caused by: Decreased Calcium

Question 12

Magnesium

Answer 12

• Normal range: 1.3-2.1

* Needed for skeletal muscle contraction

Question 13

Hypomagnesium

Answer 13

<1.3

• caused by: chronic diarrhea, malnutrition, prolonged ng suction, prolonged excessive diuretic therapy
• S/S: increased DTR, increased nerve impulses, increased membrane excitability, intestine slows down, + Chvostek & trousseau
• Interventions: diet counseling, evaluate renal function, IM or IV administering

Question 14

Hypermagnesium

Answer 14

> 2.5

• caused by: overuse of antacids and/or laxatives, adrenal insufficiency, adv. renal fail.
• S/S: decreased mem. Excitability, decreased DTR, musc. Weakness, decreased HR, decreased mentation
• Interventions: reduce antacid and/or laxative use, diuretics

Question 15

Chloride

Answer 15

• Normal range: 98-106
• Imbalances caused by: other fluid/ electrolyte imbalance
• Intervention: treat underlying problem