Risk Factors

Question 1

Hyponatremia: Actual Sodium Deficits

Answer 1

Excessive sweating, diuretics, wound drainage, NG tube suction, decreased secretion of aldosterone, hyperlipidemia, kidney disease, inadequate sodium intake, hyperglycemia, cerebral salt wasting syndrome, low sodium diet.

Question 2

Hyponatremia: Relative sodium deficits due to dilution:

Answer 2

hypotonic fluid excess, freshwater submersion accident, kidney failure, heart failure, syndrome of inappropriate ADH secretion, anticonvulsant medications, SSRIs, or desmopressin, older adult clients at a greater risk due to increased incidence of chronic illness

Question 3

Hypernatremia: Actual Sodium Excess

Answer 3

kidney failure, cushings syndrome, aldosteronism, some medications, excessive intake

Question 4

Hypernatremia: Relative excess due to decreased fluid volume

Answer 4

Water deprivation (NPO), hypertonic enteral feedings without adequate water, diabetes insipidus, heatstroke, hyperventilation, watery stools, burns, excessive sweating

Question 5

Hypokalemia: Actual Deficit

Answer 5

overuse of diuretics, digitalis, corticosteroids, increased secretion of aldosterone, cushings syndrome, loss via gi tract, NPO status, kidney disease

Question 6

Hypokalemia: Relative Deficit

Answer 6

alkalosis, hyperinsulinism, hyperalimentation, TPN, water intoxication, older adult clients due to increased use of diuretics and laxatives

Question 7

Hyperkalemia: Actual Excess

Answer 7

older adults decreases in renin and aldosterone and increased use of salt substitutes, ACE inhibitors, and K sparing diuretics
overconsumption of foods, excessive or rapid K replacement, RBC transfusions, Adrenal insufficiency, ACI inhibitors, kidney failure

Question 8

Hyperkalemia: Relative Excess

Answer 8

EC shift caused from decreased insulin production, acidosis, tissue damage (sepsis, trauma, surgery, fever, MI), hyperuricemia

Question 9

Hypocalcemia: Actual Deficit

Answer 9

inadequate intake of calcium including lactose intolerance and malaborption issues, diarrhea or steatorrhea, inadequate vitamin D intake, end stage kidney disease,wound drainage

Question 10

Hypocalcemia: Relative Deficit

Answer 10

Conditions: alkalosis, acute pancreatitis, hyperproteinemia, hyperphosphatemia, immobility
Treatments: calcium chelators, citrate, mithramycin, sodium cellulose phophate, penicillamine, pamidronate
immobility, Parathyroid removal or damage

Question 11

Hypomagnesemia: Risk Factors

Answer 11

celiac disease or crohns disease, malnutrition, ethanol ingestion, diarrhea, steatorrhea, or chronic laxative use, citrate from blood products, MI or heart failure, concurrent hypokalemia and hypocalcemia, medication therapy

Question 12

Hypovolemia: Causes

Answer 12

excessive GI loss, vomiting, ng suctioning, diarrhea
diaphoresis without sodium and water replacement, excessive diuretic therapy, kidney disease, adrenal insufficiency, third spacing, hemorrhage or plasma loss, altered intake

Question 13

Hypervolemia: Causes

Answer 13

Kidney failure, kidney disease, cirrhosis, overdose of luids, fluid shifts that occur following burns, prolonged use of corticosteroids, severe stress, hyperaldosteronism