Lecture 6.1 - Electrolyte Imbalances Flashcards
Which demographics are most vulnerable to dehydration from vomiting?
Older adults, children, and infants
What is the normal range for sodium in blood?
136-145 mEq/L
What cation is most common in ECF?
Na makes up 90% of ECF, being the main factor in determining ECF volume
changes in K effect the heart. What do changes in Na do?
Effect the brain
What can cause hypernatremia? What can it lead to and how does the body protect from it?
–> Excessive intake
–> Diabetes insopidus
–> Renal failure
–> Cushing Syndrome
Causes hyperosmolarity leading to cellular dehydration
Protected with thirst centre in hypothalamus
What are the manifestations for moderate and severe hypernatremia?
Moderate: Confusion, thirst, dry mucous membranes, low urinary output
Severe: HTN, tachycardia, flushed skin
–> Restlessness, agitation, confusion, seizures, coma
–> Hyper-reflexia, muscle twitching
Nausea, vomiting
–> Poor tissue turgor
How do we correct hypernatremia?
Fluids, diuretics to increase sodium output
–> Monitor daily weights, neuro deterioration, fluid imbalance
What are some nursing diagnoses associated with hypernatremia?
Electrolyte imbalance
Risk for injury: seizures
What is the normal potassium level?
3.5-5.1 mmol/L
What is the major ICF cation?
Potassium
Sodium is necessary for:
Maintaining fluid levels and regulating blood fluids to prevent low blood pressure.
Helps muscles contract, and sends nerve impulses throughout the body
Potassium is necessary for:
–> Transmission and conduction of nerve and muscle impulses
–> Cellular growth
–> Maintain cardiac rhythms (depolarizes and generates APs, low K is shown as a flat T wave in cardiac rhythm)
–> Regulates protein synthesis, and glucose storage and use.
K administration should never exceed what? Why?
20 mEq/hr
–> Prevents hyperK + cardiac arrest
–> Burns when infusing
What is the normal range for calcium? What is is necessary for?
2.10-2.75 mmol/L
–> Blood clotting
–> Muscle contraction (including myocardium)
–> Nerve function
What is the normal serum range for magnesium?
0.65-1.05 mml/L
What is the normal serum level for phosphorus? What does it do?
1.0-1.5 mmol/L
–> Activates vitamins and enzymes, forms ATP, and assists in cell growth and metabolism
–> Maintains acid-base balance
–> Maintains calcium homeostasis.
What are the different kinds of fluid spacing?
First Spacing
–> Normal distribution of ICF and ECF
Second Spacing
–> Abnormal accumulation on interstitial fluid (edema)
Third Spacing
–> Fluid accumulation in a part of the body not easily exchanged with ECF and in transcellular space
–> Fluid fills cavity and compresses soft structures, resulting in ascites, pleural effusions, pericardiac effusion or tamponade
We have to have a normal ____ before administering IV P-dye
Creatinine - verifies kidney function
What is pOSM?
Serum osmolarity by weight
What is an eGFR?
Creatinine clearance/24 hours to measure kidney function
What does ACTH do?
Triggers the release of aldosterone –> Sodium reapsorption
What does ADH do?
Signals for water reabsorption in the renal tubules/collecting ducts.
What does renin do?
Signals for Ang I (+ ACE) –> Vasoconstriction and aldosterone
What are some potential causes for hyponatremia?
Excessive loss through sweat, GI loss, or renal dysfunction.
Excessive H2O gain