MOD 7 Electrolytes Flashcards
135-148 mEq/L
Sodium (Na+)
Causes:
- Diuretics
- GI fluid loss
- Hypotonic tube feedings
- D5W or hypotonic fluids
- diaphoresis
Sodium (Na+)
Hyponatremia
Assessment Findings:
- anorexia, nausea, vomiting
- weakness
- lethargy
- confusion
- muscle cramps, twitching
- seizures
Sodium (Na+)
Hyponatremia
Causes:
- water deprivation
- hypertonic tube feedings
- diabetes insipidus
- heatstroke
- hyperventilation
- watery diarrhea
- renal failure
- Cushing syndrome
Sodium (Na+)
Hypernatremia
Assessment Findings:
- thirst
- hyperpyrexia
- sticky mucous membranes
- dry mouth
- hallucinations
- lethargy
- irritability
- seizures
Sodium (Na+)
Hypernatremia
3.5 – 5 mEq/L
Potassium (K+)
Assessment Findings:
- Fatigue
- Anorexia
- Nausea and vomiting
- Muscle weakness
- Decreased GI motility
- Dysrhythmias
- Paresthesia
- Flat T waves on ECG
Potassium (K+)
Hypokalemia
Causes:
- Diuretics
- Diarrhea
- Vomiting
- Gastric suction
- Steroid administration
- Hyperaldosteroneism
- Amphotericin B
- Bulimia
- Cushing syndrome
Potassium (K+)
Hypokalemia
Causes:
- Hemolyzed serum sample produces pseudohyperkalemia
- Oliguria
- Acidosis
- Renal failure
- Addison’s disease
- Multiple blood transfusions
Potassium (K+)
Hyperkalemia
Assessment Findings:
- Muscle weakness
- Bradycardia
- Dysrhythmias
- Flaccid paralysis
- Intestinal colic
- Tall T waves on ECG
Potassium (K+)
Hyperkalemia
90 – 110 mEq/L
Chloride (Cl-)
8.8-10 mg/dL
Calcium (Ca++)
Causes:
- Renal failure
- Hypoparathyroidism
- Malabsorption
- Pancreatitis
- alkalosis
Calcium (Ca++)
Hypocalcemia
Assessment Findings:
- diarrhea
- numbness
- tingling of extremities
- convulsions
- positive Trousseau sign
- positive Chavostek’s sign
- At risk for tetany
Calcium (Ca++)
Hypocalcemia
Causes:
- Hyperparathyroidism
- Malignant bone disease
- Prolonged immobilization
- Excess calcium supplements
Calcium (Ca++)
Hypercalcemia
Assessment Findings:
- Muscle weakness
- Constipation
- Anorexia
- Nausea, vomiting
- Polyuria
- Polydipsia
- Neurosis
- Dysrhythmias
Calcium (Ca++)
Hypercalcemia
1.7 - 2.6 mEq/L
Phosphorus (HPO-4)
Causes:
- Refeeding after starvation
- Alcohol withdrawal
- Diabetic ketoacidosis
- Respiratory alkalosis
Phosphorus (HPO-4)
Hypophosphatemia
Assessment Findings:
- Parathesias
- Muscle weakness
- Muscle pain
- Mental changes
- Cardiomyopathy
- Respiratory failure
Phosphorus (HPO-4)
Hypophosphatemia
Causes:
- Renal failure
- Excess intake of phosphorous
Phosphorus (HPO-4)
Hyperphosphatemia
Assessment Findings:
- Short term: tetany
- Long-term: phosphorous precipitation in nonissues sites
Phosphorus (HPO-4)
Hyperphosphatemia
1.3 – 2.1 mEq/L
Magnesium (Mg++)
Causes
- Alcoholism
- Malabsorption
- Diabetic ketoacidosis
- Prolonged gastric suction
- Diuretics
Magnesium (Mg++)
Hypomagnesemia
Assessment Findings:
- Anorexia, distention
- Neuromuscular irritability
- Depression
- Disorientation
Magnesium (Mg++)
Hypomagnesemia
Causes:
- Renal failure
- Adrenal insufficiency
- Excessive replacement
Magnesium (Mg++)
Hypermagnesemia
Assessment Findings:
- Flushing
- Hypotension
- Drowsiness, lethargy
- Hypoactive reflexes
- Depressed respirations
- Bradycardia
Magnesium (Mg++)
Hypermagnesemia
Causes:
- Vomiting
- Diarrhea
- Sweating
- Inadequate fluid intake
- Massive edema, as in the initial stage of major burns
- Ascites
- Elderly forgetting to drink
Hypovolemia
Assessment Findings:
- Weight loss (1 pint of fluid loss equals 1 pound of weight loss!)
- Decreased skin turgor
- Oliguria (concentrated urine)
- Dry and sticky mucous membranes
- Postural hypotension or weak, rapid pulse
Hypovolemia
Causes:
- Heart failure
- Renal failure
- Cirrhosis, liver failure
- Excessive ingestion of table salt
- Over-hydration with sodium-concentrating fluids
- Poorly controlled IV therapy, especially in young and old clients.
Hypervolemia
Assessment Findings:
- Peripheral edema
- Increased bounding pulse
- Elevated BP
- Distended neck and hand veins
- Dyspnea: moist crackles heard when lungs auscultated
- Attention loss, confusion, aphasia
- Altered LOC
Hypervolemia
Osmolality close to the ECF
Do not cause RBCs to swell or shrink
Are indicated for intravascular dehydration (dehydration caused by running, labor, fever, etc)
Isotonic solutions
NS (0.9%NaCl
LR (Lactated Ringers)
D5W (careful, isotonic in bag, but hypotonic in person!)
Isotonic
Osmolality lower than ECG
Cause fluid to shift from ECF into ICF
Indicated for cellular dehydration (such as from prolonged dehydration; not common)
Hypotonic solutions
0.45% - 0.5% NS
D 2.5/.045% NS
Hypotonic
Osmolality higher than ECF
Indicated for intravascular dehydration with interstitial or cellular over-hydration
To be used with extreme caution
Some may contain high concentrations of dextrose (TPN) and must be infused into a central vein for rapid
dilution.
Used to treat intravascular dehydration with cellular or interstitial over-hydration
Only used when osmolality is dangerously low (such as dehydration resulting from surgery [blood loss
causes intravascular dehydration, but tissue cuts inflame and pull fluid into the area causing interstitial
overhydration], ascites, 3rd spacing.
Hypertonic
shock
cardiac arrest
starvation
diabetic ketoacidosis
renal failure
ASA overdose
loss of intestinal fluid
wound drainage
Metabolic Acidosis
Causes:
deep and rapid breathing
Kussmaul breathing
nausea
headache
flushing
abdominal pain
weakness
Metabolic Acidosis
S/S:
excessive bicarbonate-containing drugs
diuretic therapy
vomiting, gastric suctioning
Metabolic Alkalosis
Causes:
Metabolic Alkalosis
S/S:
anorexia
nausea
paresthesia’s
confusion
hypertonic reflexes
decreased respirations
pneumothorax
pulmonary edema
asthma
pneumonia
drug overdose
head injuries CF
Respiratory Acidosis
Causes:
cyanosis
tremors
respiratory insufficiency
Respiratory Acidosis
S/S:
Respiratory Alkalosis
Causes:
anxiety
fever
overactive thyroid
ASA poisoning
mechanical ventilation
increased respiratory rate
light-headedness
numbness and tingling of fingers and toes
paresthesia
sweating
panic
Respiratory Alkalosis
S/S:
Normal
Represents Respiratory
PaCO2
35-45
Normal
Represent Metabolic
Bicarbonate
HCO2
22 - 26
