QUIZ 2 ELECTROLYTE IMBALANCES

Question 1

Sodium imbalances:

Answer 1

Hypernatremia & Hyponatremia

Question 2

IMPORTANCE of NA in many physiologic functions

Answer 2

• facilitating impulse transmission in nerve muscle fibers by participating in the sodium-potassium pump.
• assists in acid-base balance by combining bicarbonate and chloride.

Question 3

↑ serum Na+ >145 mEq/L
urine specific gravity >1.025

Answer 3

Hypernatremia

Question 4

Signs and Symptoms

FRIED

Answer 4

Fever-low grade , Flushed skin
Restless (irritable)
Increased fluid retention
EDema ( peripheral and pitting)
Decrease urine output, Dry mouth

Question 5

Signs and Symptoms (too much salt)

SALT

Answer 5

Skin flushed
Agitation
Low grade fever
Thirst

Question 6

Nursing Management

Answer 6

Restrict Na+ (butter, bacon, canned, processed food, pizza, chips
Encourage to eat banana, oranges, apples, fresh fruits and vegetables
Refrain from using condiments.
Daily weight & vital signs monitoring
Monitor & record 24 hr Intake & output

Question 7

Documentation

Answer 7

With bipedal pitting edema grade ++ . Kept elevated and supported with a pillow.

Question 8

Grading of edema: 6mm deep pit 10-12 sec to rebound

Answer 8

3+

Question 9

Grading of edema: 4mm a few sec to rebound

Answer 9

2+

Question 10

Grading of edema: 2 mm depression immediate rebound

Answer 10

1+

Question 11

Grading of edema: 8 mm very deep pit > 20 sec to rebound

Answer 11

4+

Question 12

AVPU

Answer 12

Awake
Verbal
Pain
Unresponsive

Question 13

↓ serum Na+ <135 mEq/L
Urine specific gravity <1.005

Answer 13

Hyponatremia

Question 14

Signs and Symptoms: HYPONATREMIA

SALT

Answer 14

Stupor/Coma
Anorexia
Lethargy
Tendon reflexes ↓↓ - Depressed DTR

Question 15

DEEP TENDON REFLEXES: GRADING
Brisker than average, slightly hyperreflexic

Answer 15

3+

Question 16

very brisk, hyperactive, with clonus

Answer 16

4+

Question 17

Somewhat diminished, low normal

Answer 17

1+

Question 18

Average, expected response; normal

Answer 18

2+

Question 19

No response, absent

Answer 19

0+

Question 20

Signs and Symptoms (Loss)

Answer 20

Limp muscles
Orthostatic hypotension
Seizures
Stomach cramping

Question 21

For Hypovolemic Hyponatremia

Answer 21

Hypertonic 0.3% NS - slow IV infusion via central line.
***Watch out for fluid overload!

Question 22

. For Hypervolemic Hyponatremia

Answer 22

Restrict fluid intake and in some cases administer diuretics to excretion the extra water rather than sodium to help concentrate the sodium.
***If the patient has renal impairment they may need dialysis.

Question 23

Euvolemic Hyponatremia

Answer 23

Caused by SIADH antidiuretic hormone problems: fluid restriction or treated with antidiuretic hormone antagonists called Declomycin (don’t give with food especially dairy or antacids…bind to cations and this affect absorption).

Question 24

Common Nursing Management in Sodium Imbalance

Answer 24

Weigh daily.
Accurately document intake and output.
Watch for signs and symptoms of fluid overload or dehydration.
Monitor serial serum electrolyte levels.
Nutrition interventions (optimizing the patient’s oral intake, providing oral nutrition supplements, and administering enteral and parenteral nutrition.)