Unit 2 test Acid-base balance--- Electrolyte -- EOD Flashcards
Facts of Potassium
3.5-5.0
Major ICF Cation
Function: some control over ICF osmolarity and volume
regulate protein synthesis , glucose use, and storage
pH balance
nerve conduction
Hypernatremia
sodium level greater then 145
H20 movement from the ICF to the ECF
ICF = dehydration
Causes: increase in Na intake decreases in Na excretion decrease in H20 intake Increase in water loss
Signs and Symptoms of Hypernatremia
Thirsty ICF dehydration Lethargy convulsion pulmonary edema hypotension tachycardia restless irritable oliguria seizures coma warm skin dry mucous membranes
What is convulsion
brain cell dehydration
Nursing interventions for hypernatremia
Monitor CVA, RESP, Renal, Skin status Monitor I&O if d/t fluid loss- admin IV fluid if d/t inadequate renal exertion- administer diuretics May restrict Na+ intake education
Hyponatremia signs and symptoms
Na level under 135 too much H20 decrease osmolatiry tachycardia weak rapid thready pulse hypotension orthostatic hypotension nausea and vomiting diarrhea decreased deep tendon reflexes lethargy headache confusion cramps muscle weakness and fatigue
Nursing Interventions for Hyponatremia
IV fluids - NS or 1/2 NS Osmotic diuretics increase in sodium intake monitor Na levels monitor LOA Safety precautions-- seizures, falls education Monitor I&O Daily weights
Causes of Hypocalcemia
Hypoparathyroidisim malabsorption-- chrones disease hypersecretion of calcitonin deficient serum albumin increase inn serum pH lack of Vit D-- lactose chronic renal failure
Calcium
9.0-10.5 Mostly found in ECF 98% stored in bones Works with Vit.D functions: bone and teeth muscle contraction and relaxation blood clotting Regulated by parathyroid hormone increase in blood calcium by stimulation osteoclasis increase GI aborption and renal retention calcitonin
Signs and symptoms of Hyperkalemia
increase in neromuscular irritability tingling and numbness found in the lips, fingers, and toes restless cardiac dysrthmias -- widen QRS and spiked T wave nausea fatigue little or no urine output decrease in pH acidosis
Interventions for hyperkalemia
Monitor status Monitor EKG monitor renal function d/c KCL medication prepare dialysis if needed education nutrition
Treatment:
Insulin+ glucose— D5W to counteract low blood sugar levels
Sodium Bicarb
Ca++ counter acts effects on heart
Causes of hyperkalemia
end stage renal disease aldosterone defect use of K+ sparing diuretic leakage of ICF K+ into ECF insulin defficient uncontrolled DM multiple blood transfusions
Causes of hypokalemia
diarrhea diuresis w/ diuretic use Increase in aldosterone or glutocosteroids decrease in dietary intake Treatment of DKA w/ insullin Increase in loss of urine increase of K+ into the cells
Interventions of hypokalemia
Monitor status Monitor EKG administer PO K 1st then IV therapy if needed potassium sparing diuretic saftey nutrition education
Normal ABG lab values
pH: 7.35-7.45 CO2 35-45 HCO3 22-26 O2 80-100 anion gap 10-14 albumin 4
Signs and symptoms of hypokalemia
cardiac dysrthmias --> cardiac arrest fatigue and muscle weakness parathesis (sensation anorexia nausea shallow respirations increase in urine output increase in serum pH depressed T wave. forms a U wave
hypertonic solution dehydration
deficit of fluid is greater than the deficit of electrolytes
fluid shifts out of ICF and into ECF space neurologic
Isotonic dehydration
Loss of fluid and electrolyte is balanced most of loss is sustained by ECF
Most Common
hypotonic dehydration
electrolytes deficit is greater then fluid deficit
ECF moves into ICF space
signs of dehydration
tachycardia weak pulse restless flushed dry skin dry mucous membranes decrease in urine output increase in HCT increased Na Increase in hgb , osmolatiry, and specific gravity
Magnesium
1.3-2.1
critical for skeletal muscle contraction, cell growth, ATP formation, and carbohydrate metabolism
Phosphorus
30-4.5
found in bones
activates vitamins and enzymes
assist in cell growth and metabolism
treat with Aluminum Hydroxide
Hypercalcemia signs and symptoms, and Interventions
depressed neuromuscular activity muscle weakness, loss of muscle lethargy cardiac arrest, bradycardia anorexia nausea interffernece with ADH in the renal loss of absorption of H2O = poyuria
Interventions
Monitor status, ca level, and EKG
Causes of hypercalcemia
uncontrolled use of ca+ ions from the bones causes by neoplasms (cancer cells) Immobility hypothyroidism renal disease hyperparathyroid hormone Increase in Ca and Vit D Certain drugs
SIgns of hypocalcemia
Increase neuromuscular stimulation muscle spasm muscle cramps Chvostck sign + Trosseau sign + arrhythmias bradycardia intestinal cramping pain
Common causes of fluid overload
excessive fluid replacement kidney failure heart failure long term corticosteroid use SIADH pysch disorders w/ polydipsia water intoxication
