Metabolism Flashcards
1
Q
Normal sodium range
A
135-145 mEq/L
2
Q
What is sodium responsible for in the body?
A
- Essential for maintaining osmolality, water balance, acid-base balance
- Water travels with or toward sodium
- Sodium movement is linked between water retention, blood volume, and blood pressure
- Regulated by kidneys and aldosterone
- Sodium major electrolyte in extracellular fluid
3
Q
Hypernatremia range and cause?
A
— Sodium level above 145 mEq/L
— Most commonly caused by kidney disease
— Sodium accumulates
- Decreased excretion
- High net water loss (watery diarrhea, fever, burns)
- High doses of corticosteroids or estrogen
4
Q
Physiology of hypernatremia?
A
- Elevated sodium increases osmolality
— Draws fluid from interstitial space and cells
— Causes cellular dehydration - Signs and symptoms
— Thirst, fatigue, weakness, muscle twitching
— Convulsions, altered mental status, decreased level of consciousness
5
Q
Treatment of hypernatremia?
A
- Can be treated with low-salt diet
- Acute hypernatremia treated with hypotonic intravenous fluids (if hypovolemic) or diuretics (if hypervolemic).
6
Q
Hyponatremia range and cause?
A
- Sodium level below 135 mEq/L
- Caused by excessive dilution of plasma
— Excess antidiuretic hormone (ADH) secretion
— Excessive administration of hypotonic intravenous solution - Vomiting, diarrhea, gastrointestinal suctioning, diuretic use
7
Q
Symptoms of hyponatremia?
A
- Early symptoms
— Nausea, vomiting, anorexia, abdominal cramping - Later signs
— Altered neurologic function such as confusion, lethargy, convulsions, coma, muscle twitching, tremors.
8
Q
Treatment of hyponatremia?
A
- Hyponatremia caused by excessive dilution
— Treat with loop diuretics to cause an isotonic diuresis - Hyponatremia caused by sodium loss
— Treat with oral sodium chloride or intravenous fluids containing salt
+++ Normal saline
+++ Lactated ringer’s
9
Q
What to be alert for and teach patient about Sodium replacement therapy?
A
- Assess sodium and electrolyte balance
- Be alert for signs of hyponatremia and hypernatremia
- Monitor serum sodium levels, urine specific gravity, serum and urine osmolality
- Teach patient
— To report symptoms that may relate to fluid overload
— To drink water or balanced sports drinks to replenish lost fluids and electrolytes.
10
Q
Normal potassium range and use?
A
- Normal range: 3.5 - 5 mEq/L
- Essential for proper nerve and muscle function.
- Maintaining acid-base balance
- Influenced by aldosterone
— For each sodium ion reabsorbed, one potassium ion is secreted into renal tubes - Imbalances can be serious, even fatal
11
Q
Hyperkalemia range and cause?
A
- Potassium level above 5 mEq/L
- Caused by high consumption of potassium-rich food, dietary supplements
- Risk with patient taking potassium-sparing diuretics
- Accumulates when renal disease causes decreased excretion
12
Q
Symptoms of hyperkalemia?
A
- Most serious are dysrhythmias and heart block
- Other symptoms are muscle twitching, fatigue, paresthesias, dyspnea, cramping, and diarrhea
13
Q
Treatment of hyperkalemia?
A
- Restrict dietary source
- Decrease dose of potassium-sparing diuretics
- Administer glucose and insulin
- Administer calcium to counteract potassium toxicity on heart
- Administer polystyrene sulfonate and sorbitol to decrease potassium levels
14
Q
Hypokalemia range and cause?
A
- Potassium level below 3.5 mEq/L
- Caused by:
— High doses of loop diuretics
— Strenuous muscle activity
— Severe vomiting or diarrhea
15
Q
Symptoms of hypokalemia?
A
- Neurons and muscle fibers most sensitive to potassium loss
- Muscle weakness, lethargy, anorexia, dysrhythmias, cardiac arrest
