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NRAD 201D Exam 3 > Lab Values: K+, Cl-, Na+ > Flashcards

Lab Values: K+, Cl-, Na+ Flashcards

1
Q

what is the most abundant electrolyte in the ICF?

A

K+

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2
Q

what is the most abundant electrolyte in the ECF?

A

na+

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3
Q

what are electrolytes responsible for?

A

fluid balance
nerve impulses
muscle contractions
acid-base balance

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4
Q

electrolytes are _______ ___________ particles

A

electrically charged

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5
Q

the ECF consists of what?

A

the interstitial fluid and plasma

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5
Q

cations have a ________ charge

A

positive

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6
Q

anions have a _________ charge

A

negative

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7
Q

what kind of protein is the sodium potassium pump?

A

a carrier protein

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7
Q

what kind of transport os the sodium potassium pump?

A

active transport

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8
Q

what is used to power the sodium potassium pump?

A

1 phosphate from ATP

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9
Q

what is the exchange in the sodium potassium pump?

A

3 Na+ ions exit to ECF for every 2 K+ ions that enter ICF

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10
Q

why is the electrical charge caused by the exchange of Na+ and K+ so important?

A

the ECF has a positive charge used in the generation of nerve impulses. this “voltage” is also called membrane potential

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10
Q

sodium levels are regulated by what?

A

the kidneys

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11
Q

what is the normal range for sodium?

A

135-145 mEq/L

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12
Q

sodium controls what?

A

water distribution and fluid balance

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12
Q

serum Na+ levels reflects the _________ of Na+ to water

A

ratio

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13
Q

sodiums functions include (5):

A

-ECF osmolality
-water distribution btw ECF and ICF
-maintain BP
-transmission of nerve impulses
-muscle contractility and -acid-base balance

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14
Q

what does osmolality determine?

A

the concentration of dissolved particles in a fluid, such as blood or urine. can measure the amount of sodium, chloride and potassium

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15
Q

what is hypovolemic hyponatremia?

A

both Na+ and water lost but more Na+ lost than water

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16
Q

what are the four causes of hypovolemic hyponatremia?

A

excessive sweating
vomiting
diarrhea
diuretics

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17
Q

what is hypervolemic hyponatremia

A

more water gained than Na+

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18
Q

what are the causes of hypervolemic hyponatremia?

A

fluid volume overload from:
1. kidney failure
2. liver failure
3. heart failure

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19
Q

what are the symptoms of mild hyponatremia?

A

headache
altered mental staus
muscle weakness/ cramps

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19
Q

what is a common sign of hypervolemic hyponatremia?

A

edema

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20
what are the s/Sx of severe hyponatremia?
SALT LOSS Stupor/coma anorexia lethargy tendon reflexes limp muscles orthostatic hypotension seizures stomach cramping
20
what does iso mean?
equal
21
what are the interventions for hypovolemic hyponatremia?
withhold diuretics replace sodium and water isotonic IV therapy
22
what are the interventions for hypervolemic hyponatremia?
fluid restriction (edema) tx of underlying disorder (HF, renal, hepatic)
23
what are the nursing implications for hyponatremia?
-assess : neuromuscular -precautions: fall and seizure -edema: monitor I/O and weight
24
what level is considered hypernatremia?
>145mEq/L
25
what are the two main ways to cause hypernatremia?
greater water loss than Na+ excessive Na+ gain
25
if serum level is high it is called _________ and if serum level is low it is called __________?
hyperosmolality hypoosmolality
26
how can you have greater water loss than Na+ in hypernatremia?
dehydration inadequate water intake high fever diarrhea (watery)
27
how can you have excess Na+ gain in hypernatremia?
-excess IV fluids containing Na+ -excess oral intake or Na+ (seawater, diet)
28
what are hypernatremia symptoms?
FRIED SALTS Flushed skin restless intense thirst lethargy decreased urine output skin is dry agitation low grade fever thirst, sticky mucous seizures/coma
29
what are the interventions for hypernatremia?
restrict Na+ intake replace fluids PO or IV (hypotonic: low Na+ fluids)
30
what are the dehydration related symptoms of hypernatremia?
flushed skin intense thirst decreased urine output skin is dry thirst/sticky mucous
31
what are the nursing implications for hypernatremia?
-neuromuscular assessment seizure and fall precautions measure I/O (urine color/ amt)
31
where is the majority of potassium stored?
muscles
32
how is potassium eliminated?
kidneys eliminate 90%
33
what is k+ relationship with aldosterone?
inverse relationship aldosterone increases Na+ and water reabsorption and K+ gets excreted
34
what is out main source of K+?
diet
35
what is the normal range for K+?
3.5-5 mEq/L
36
how is K+ related to glucose?
insulin moves K+ and glucose into the cell by increasing the # of sodium and potassium pumps
37
what is another way to say reabsorption?
retained
38
what are the 4 causes of hypokalemia?
drugs (laxatives, diuretics) inadequate intake too much insulin (moves K+ into cells) heavy fluid loss (vomiting)
39
what is paresthesis?
pins and needles sensation
39
how is mg+ related to low K+?
direct relationship, if Mg+ is low then so is K+
40
how does vomiting influence K+ levels?
heavy fluid loos will cause alkalosis from loss of HCl- in order to fix this the body moves K+ (neutral) into the cells and H+ (acid) out of the cells to decrease serum pH
40
what are dietary sources of K+?
BOATS bananas oranges avocados tomatoes spinach (source of vit K and K+)
40
what are the symptoms of hypokalemia?
5 Ls "slowing down" neurons less excitable and action potentials inhibited (lack of repolarization) 1. leg cramps 2. limp muscles, ↓reflexes, paresthesis 3. low, shallow respirations 4. lethal cardiac dysrhythmias 5. slow GI motility (ileus, nausea, constipation)
41
what are interventions for hypokalemia?
hold diuretics, laxatives infuse K+ if severe increase K+ in diet or supplements
42
what are the nursing implications for hypokalemia?
assess: motor function (and strength) reflexes respiratory function heart rhythm monitored bowel sounds
43
what are 5 Hyperkalemia causes?
1. renal failure (common) 2. excessive K+ intake 3. drugs (K+ sparing diuretics) 4. muscle breakdown 5. acidosis
44
why does acidosis cause hyperkalemia?
loss of HCO3- due to diarrhea causes a relative abundance of H+ acid ions. in order to fix this the body send the H+ into cells and the K+ into ECF causing hyperkalemia but raising pH
45
what are some symptoms of hyperkalemia?
↑cell excitability ⇣cardiac depolarization DEATH Decrease HR Early muscle twitching→weakness Arrhythmias Tummy trouble Hypotension
46
what are 5 hyperkalemia interventions?
-restrict K+ foods -ID K+ sparing meds and hold -diuretics to promote excretion -PO meds to excrete K+ -IV insulin w/ dextrose (move K+ into cell)
46
what are nursing implications for hyperkalemia?
-🖤 rhythm monitored -muscle function and strength -bowel function and type of stool -BP -Glucose levels (if insulin given)
47
what is the range of normal chloride levels?
95-105 mEq/L
48
what are the functions of chloride?
-acid-base balance -a component in HCl- -direct relationship w/ Na+ -inverse relationship with HCO3-
49
how are Cl- levels regualted?
-kidneys excrete Cl- -also excreted in sweat and gut juices
50
how does metabolic alkalosis cause hypochloremia?
metabolic alkalosis caused by excessive loss of HCl-
51
what are some hypochloremia causes?
-GI loss (vomiting, NG suction) -diuretics -fluid volume overload -metabolic acidosis
52
what are the symptoms of hypochloremia?
assoc. w/ the cause of hypoCl- ex: Na+ low = Cl- low SALT LOSS Stupor/coma anorexia lethargy tendon reflexes limp muscles orthostatic hypotension seizures stomach cramping
53
what are the interventions for hypochloremia?
-monitor Na+, Cl-, and HCO3- and K+ levels - Sodium chloride IVFs -intake of Cl- rich foods (salty foods)
54
why should you monitor K+ levels during metabolic alkalosis?
hypokalemia can be caused by the body's fix for alkalosis (exchange of K+ for H+)
55
why should you monitor HCO3- and Cl- levels during metabolic alkalosis?
because there is an inverse relationship btw Cl- and HCO3- (to maintain the anion gap)
56
what are the nursing implications for hypochloremia?
-Assess for hypoNa+ and Sxs -monitor K+ level (↓in alkalosis) -safety precautions -I/O, weight, VS
57
what is metabolic acidosis?
loss of HCO3- (strong base) due to diarrhea causes blood to become acidic
57
what are the causes of hyperchloremia?
-assoc. w/ excess Na+ or IVF high in Na+ (Na+Cl-) -not drinking enough water or loss of fluid -metabolic acidosis
58
why does metabolic acidosis cause hyperchloremia?
bc the more HCO3- lost the more Cl- is retained by the kidneys to maintain the anion gap. causing hyperchloremia
59
what are the symptoms of hyperchloremia?
ID cause similar to hyperNa+ FRIED SALTS Flushed skin Restless Intense thirst lEthargy Decreased urine output Skin is dry Agitation Low grade fever Thirst/sticky mucous Seizures/coma
59
what are the 3 interventions for hyperchloremia?
-monitor Na+, Cl-, and HCO3- levels -hold infusions w/ NaCl -limit intake of Na+ foods (also contain Cl-)
60
what are the 4 nursing implications for hyperchloremia?
-assess for hyperNa+ S/sx -monitor K+ level (↑acidosis) -safety precautions -I/O, weight and VS
61
what is normal body pH?
7.35 - 7.45
61
why is bicarbonate a base?
it accepts H+ ions and neutralizes acids
62
why is H+ an acid?
loses H+ in water the more H+ ions the more acidic
63
what role does K+ play in acid-base balance?
it exchanges with H+ into or out of ECF and ICF

NRAD 201D Exam 3 (3 decks)

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