Lecture 4 management of electrolytes Flashcards

1
Q

Whats Hyponatremia

A

soduim loss < 135 mmol/L
Severe=< 125 Meq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes hyponatremia

A
  1. Loss Na-containing fluid
  2. Water excess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does Hyponatremia lower…

A

Plasma osmolality, shifting fluid into brain cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Symptoms hyponatremia:

A

-Neuro related
-Changes LOC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ECF fluid volume symptoms for patient with hyponatremia

A
  1. abnormal decrease in soduim loss (Hypovolemic hypontremia)

2.Abnormal increase in watter gain (hypervomeic hyponatremia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatement of hypoatremia

A

Iv’s, get soduim back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are severe symptoms of hypertonic saline/ what would you administer…

A

Seizures
administer (3% Nacl)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A hypertonic saline solution causes water to shift ______cells

A

outside cell causing cell death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why must Iv hypertonic saline be administered with caution

A

Much higher concentrated salt, cell’s could collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What’s the max rate of safe administration for hypertonic saline (3% Nacl)

A

100 ml/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is Hypertonic saline given

A

IV infusion pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What’s Hyperatremia

A

increase in soduim retention >145 mmol/L
life threatening at level >155 mmol/L
high mortality >180 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hypernatremia prevalence seen more in….

A

Critically ill patients particularly with neuro condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

1/5 of people with congestive heart failure experience….

A

Hypernatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are people with high protein tube feeding at risk for

A

Hypernatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Causes Hypernatremia

A

water deficiency, and NA accumulation, usually just looks like a water definiency. FEVER, HEATSTROKE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Does hypernatremia cause hyperosmolarity

A

YES! hyperosmolarity is a shift of water out of cells- cellular dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

usually body does things to prevent hypernatremia

A

-stimulate thirst
-ADH release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What’s hypothalamic disorder:

A

Lesion may cause disturbance of thirst mechanism but is rare

20
Q

Clinical manifestations of Hypernatremia:

A

-Change plasma osmolality
-Neurologic changes
-Nausea vomiting
-restlessness
-Thirst
-Body can tolerate high sodium levels

21
Q

Interventions for Hypernatremia:

A

-Remove sodium intake from diet
but if soduim go even lower give D5W IV

22
Q

Interventions for hyponatremia:

A

-Fluid restriction
But treatment associated with abnormal fluid loss give sodium containing solutions.

23
Q

Patient has sodium level 188 Meq/L and not drinking water: what is diagnosis..

A

Hypo(check)volemic Hypernatremia

24
Q

What is hypokalemia

A

Low levels of potassium in the ECF

25
What are primary routes of potassium loss
Kidneys
26
what would be a drop of 3.5 mmol/L in pottasium
Hypokalemia
27
Slight decrease in potttasium has ....
Profound effects since it's range is narrow
28
Causes of Hypokalemia
-Low potassium diet -starvation -GI losses: vomiting, diarrrehea -Renal losses: Diuretics, dialysis, magnesium depletion -skin losses: diaphoresis
29
Hypo and Hyper natremia major symptoms
NEURO
30
Shifts of potassium into cell
-increase insulin -alkalosis -Tissue repair
31
Diuretics...
remove excess fluid from body
32
Potassium wasting diuretics vs sparing examples...
Wasting: Thiazides, loop diuretics Sparing: Spironolactone, amiloride hydrochloride
33
Clinical manifestations of Hypokalemia
CARDIAC problems!!!!!!! -alters resting membrane potential -Fatigue -leg cramps -Fatigue -nausea
34
Nursing disgnosis for Hypokalemia
Electrolyte imbalance as evidence by low pottaosum levels and increased fluid loss
35
What does potassium do in body:
-Cardiac -muscle function -Regulates soduim
36
Hypokalemia interventions
KCL supplements added to Iv solution should never exceed 60 mmol/L
37
Guidelines for IV potassium administration
- Should not exceed 10/20 mmol per hour -use infusion devices -Potassium could also be replaced with pottasium phosphate -Max 200 meq/L in 24 hours
38
what should you monitor for patients
-TOXIC REACTION - muscle weakness - arrhythmias -cardiac rhythm -urine output
39
What's hyperkalemia
-high levels of potasium in blood -above 5.5 mmol/L
40
Causes of hyperkalemia
1. Excess potassium intake 2. Shifts of potassium out of cells (acidosis, tissue catabolism) 3. Failure to eliminate potassium -Renal disease -potassium sparing diuretics -ACE inhibitors -adrenal insuffinenecy
41
Clinical manifestations of Hyperkalemia
-CARDIAC STANDSTILL -anxiety -Abdominal cramping -muscle weakness -irregular pulse
42
Nursing diagnosis
evidence by <5.5 pottasium and decreased urine output =Hyperkalemia and this caused electrolyte balances, fever, sepsis...
43
Treatment of hyperkalemia
-Elimination potassium intake -Diurectics -dialysis -ion exchange resins (Force potassium from ECF to ICF) -increase fluid intake -Administer calcium gluconate (Reverse membrane effects of the elevated ECF)
44
How would force potassium from ECF to ICF
-administer IV insulin (so patient does not become hypoglycemic) -Administered Iv sodium bicarbonate (correct acidosis)
45
Whats alkalosis
causes potassium move from ECF to ICF
46
electrolytes have _____ limits
Narrow