Renal Deck 2 Flashcards
Hyponatremia
Serum sodium less than 135 mEq/L
Most common type of electrolyte imbalance of clients who are hospitalized
hyponatremia
Symptoms of hyponatremia are dependent on the
degree of sodium imbalance
Early signs of hyponatremia
Loss of appetite
Nausea and vomiting
Abdominal cramping
Late signs of hyponatremia
Confusion Lethargy Tremors Muscle twitching Convulsions Coma
Replacement therapy for Hyopnatremia include
sodium chloride in tablets or IV solutions depending on severity of condition
Hypernatremia
Serum sodium greater than 145 mEq/L
Symptoms of hypernatremia
Fatigue Weakness Muscle twitching Convulsions Changed mental status Reduced level of consciousness
treament of mild cases of hypernatremia
eating low-salt diet and drinking adequate water
treatment of hypernatremia severe
diuretics or infused 5% dextrose
Normal potassium range
3.5–5 mEq/L.
Hyperkalemia
> 5mEq/L
Mild hyperkalemia
the treatment of choice
restrict potassium-rich foods
potassium-rich foods
citrus fruits, bananas, dried fruits, broccoli, green leafy vegetables, and peanut butter.
In addition to dietary restrictions, it is important to assess this in hperkalemia
if the client is taking a potassium-sparing diuretic. If so, the dose may have to be decreased, or another type of diuretic prescribed in its place.
Severe hyperkalemiamay include administration of
Furosemide (Lasix), a diuretic that reduces potassium
Insulin with glucose or dextrose; causes potassium to enter cells
Calcium gluconate or calcium chloride; decreases cardiac complications
Sodium bicarbonate; corrects acidosis
Sodium polystyrene sulfonate (Kayexalate); binds with potassium in the intestinal tract for elimination
Hypokalemia
<3.5mEq/L
Hypokalemia
Very common electrolyte imbalance. It is most often caused by
potassium-wasting diuretics, vomiting, diarrhea, or excessive muscular activity.
Treatment for mild hypokalemia includes
eating foods high in potassium and/or taking dietary potassium supplements.
Treatment for severe hypokalemia
IV replacement of potassium is administered for more severe cases. Because cardiac problems can occur with IV potassium replacement, the client must be monitored very closely for adverse effects.
one of the biggest indicators of issues with sodium (either high or low)
normal mental status is not quite there.
Acidosis
<7.35 pH
Alkalosis
> 7.45 pH
Three systems work together to maintain pH
Buffer systems
Respiratory system
Renal system
Buffers prevent major
changes in pH
Buffers bind with
hydrogen ions when excess acid present
buffers act
act quickly
buffers release
hydrogen if the body fluids are too basic
three main buffer systems
Bicarbonate–carbonic acid buffer system
Phosphate buffer system
Protein buffers
Respiratory System
Regulates
carbonic acid by eliminating or retaining CO2
CO2 is potential
acid when combined with water
Increase in CO2or H+ stimulates
respiratory center
Increasing rate and depth of respiration increase
Eliminates CO2 and carbonic acid
Increases pH to normal range
Alkalosis decreases
rate and depth of respiration
decrease in respiration causes
CO2 retention
CO2 combines with H2O
Restores carbonic acid levels
pH back to normal
Renal System
Long-term regulation
of acid–base balance
Kidneys eliminate
nonvolatile acids
Kidneys regulate
bicarbonate (HCO3) in ECF
Kidney pH regulation is
slower
kidneys selectively excrete or retain
H+ to maintain pH
PaCO2 measures pressure of dissolved
CO2 in blood
PaO2 measures
measures pressure of oxygen dissolved in plasma
Serum HCO3 reflects
regulation of acid–base
Acid–base balance assessed by
measuring arterial blood gases (ABGs)
Sodium Bicarb goal
Goal in acidosis: reverse the effects of excess acids
Sodium return pH to
to normal levels quickly
Sodium Bicarb for acute acidosis
Administration of sodium bicarbonate infusions if bicarbonate level low
Monitor for signs of alkalosis (overcorrection of pH)
