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NURS 2750 Health and Healing > Week 1: Electrolytes > Flashcards

Week 1: Electrolytes Flashcards

1
Q

what is the function of potassium

A

maintains heart and muscle contraction

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2
Q

how does potassium maintain heart and muscle contraction

A

keep each muscle cell charged or polarized via the Na-K pump

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3
Q

whats K+ regulated by

A

kidneys

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4
Q

what is potassium influenced by

A

aldosterone hormone (renin angiotesnin aldosterone system) and acid base levels

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5
Q

what promotes movement of k+ into cells

A

insulin

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6
Q

wheres K+ found

A

intracellular

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7
Q

normal range for K+ levels

A

3.5-5.0

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8
Q

hyperkalemia

A

above 5

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9
Q

hypokalemia

A

below 3.5

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10
Q

what are the causes of hyperkalemia? (MACHINE)

A

medication
acidosis
cellular destruction
hypoaldesternonism
increase in K+ intake
nephrons broken
excretion issues

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11
Q

what are the signs of hyperkalemia

A

heart:
irregular HR
hypotension
bradycardia
arrythmias
vfib or cardiac standstill

respiratory: failure
GI: diarrhea hyperactive bowel sounds
Neurologic: confused increased DTR

neuromuscular:
muscle weakness heaviness
paralysis
tinging burning numbness hands feet mouth

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12
Q

how is hyperkalemia managed (MDKID)

A

monitor EKG
diet- no salf fruit greens
kayexalate
IV solutiosn- sodium bicarb correct acidosis
diuretics and dialysis

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13
Q

what IVs are used to manage hyperkalemia

A

sodium bicarb for acidosis
calcium gluconate (decrease NM irrit)
insulin and albuterol beta 2 agonist (push K+ in cell)

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14
Q

what diuretics are used to manage hyperkalemia

A

furosemide loop
hydrochlorothiazide (k wasting)
dialysis for renally impaired

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15
Q

what causes hypokalemia (GOT SHOT)

A

GI loss- vomit diarrhea
osmotic diuresis- freq pee
thiazide and loop diuretics- hydrochlorothiazide and furosemide k wasting
severe acid base imbalance- alkalosis
hyperaldosteronism
other meds deplete potassium; corticosteroids insulin
transcellular fluid shift: insulin albuterol

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16
Q

signs and symptoms of hypokalemia (LOW and SLOW)

A

heart:
bradycardia severe tachy early
orthostatic hypotension
arrythmias

respiratory:
slow shallow breathing diminished breath sounds
respiratory arrests with severe hypokalemia

GI:
decreased motility hypoactive bowels
constipation abdominal distention
paralytic ileus small bowel obstruction

neurological:
loss of conciousness
confusion anxiety
lethargy fatigue

neuromuscular:less responsive
low weak DTR muscle cramps
weakness paralyzed limbs

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17
Q

how is hypokalemia managed

A

admin K-dur
iv potassium chloride,k,kcl in saline
diet

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18
Q

what diet should someone with hypokalemia go on

A

salt substitutes
fruit
avacado
green leafy veggies

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19
Q

why should u never push straigh k+

A

causes death intense heart contraction causes it to stop[

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20
Q

where is sodium found

A

ecf vascular and isf

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21
Q

what follows sodium

A

water

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22
Q

what is a determinatn of sodium

A

ecf
bp

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23
Q

how is sodium transported into and out cells

A

sodium potassium pump

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24
Q

how is sodium regulated

A

kidneys thorugh ADH and aldosterone
(hold Na in body blocks Na at kidney)

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25
whats normal serum sodium levels
135-145
26
hypernatremia levels are
sodium level in plasma greater than 145
27
hyponatremia levels are
sodium level in plasma lower than 135
28
what causes hypernatremia (FAIR AD)
fluid loss higher than sodium loss- hemoconc (dehydration from infection, sweat, diarrhea) ADH insufficiency- diabetes insipidus increase sodium intake- processed food, vitamins renal issues- imparied excretion of na aldosterone excess- cushings (hyperaldosteronism) deprivation of fluids
29
what are the signs and symptoms of hypernatremia (big and bloated)
heart: hypertension bounding pulses tachycardia and dysrhythmias respiratory: shortnesss breath fluid overload clogs lungs GI- nausea vomiting GU- decreased urinary output high urine specific gravity neurological: thick salty csf brain cells shrink muscle fatigue weakness (early) confusion irritability restlessness hyperreflexia (late) nausea vomit seizures comas (severe) neuromuscular: increased muscle tone twitching of muscles cramps hyperreflexia integumentary: edema, pitting dry mouth swollen dry tongue
30
what causes hyponatremia
losses from excessive sweating vomiting diarrhea use of diuretic drugs with low salt diet hormonal imbalances excessive water intake
31
what hormonal imbalances cause hyponatremia
insufficient aldosterone adrenal insufficiency excess adh secretion
32
what are the 2 types of hyponatremia
hypovolemic- loss of fluid and na+ hypervolemic- increase in body water greater than na+
33
what are the signs and symptoms of hypovolemic hyponatremia
low fluid and na increased HR decreased BP increased RR
34
what are the signs and symptoms of hypervolemic hyponatremia
increase HR increased BP decreased RR
35
what does elevated EKG indicate
ventricles cramping up
36
what are the general signs and symptoms of hyponatremia
lungs; fluid imbalance improper air exch- shortness of breath and dyspnea GI; nausea vomiting abdominal cramping neurological- decreased osmotic pressure CSF and cerebral edema restlessness, confusion seizures and coma muscular- general weakness
36
how is hypovolemic hyponatremia treated
administer iv salty solutions isotonic like NS or LR diet high in salt canned food processed meat cheese packaged food
36
what regulates chloride levels
sodium
37
what is the function of chloride
maintain blood volume blood pressure pH of body fluids
38
what does low chloride lead to
high serum bicarb (alkalosis)
39
what are normal chloride levels
97-107
40
hyperchloremia
high chloride in blood higher than 107
41
hypochloremia
low chloride in blood lower than 97
42
what causes hyperchloremia
hypernatremia dehydration & hemoconc- severe diarrhea metabolic acidosis (low hco3) respiratory alkalosis (hyperventilating blowing off co2)
43
what are the signs and symptoms of hyperchloremia
same as hypernatremia -edema -weight gain -hypertension -tachypnea
44
what are the main causes of hypochloremia (CHAMP)
chloride loss from fluid loss (vomit diarhhea sweat fever burns) hyponatremia addisons disease adrenal crisis meds- diuretics increase excretion of Cl, Na and K Ph imbalances- metabolic alkalosis
45
what are the signs and symptoms of hypochloremia
same as hyponatremia- depressed deflated heart; hypotension dysrhythmia respiratory; dyspnea short of breath neurological; aggitation confusion seizures coma GI; diarrhea musculoskeletal; tremors twitching muscle cramping
46
where is calcium found
ecf
47
where is calcium ingested stored and excreted
food bone urine stool
48
what is calcium balance controlled by
parathyroid hormone calcitonin
49
parathyroid hormone
increases ca conc in blood
50
calcitonin
puts ca in bones
51
what promotes ca absorption from intestines
vitamin D activated in kidneys ingested/synthesized by UV rays
52
what is calciums function
blood bone beats (heart) fills function of Mg- linear relation enemy of phosphate- inverse relation
53
what are normal calcium levels
9-10.5mg
54
hypercalcemia
plasma calcium level greater than 10.5
55
hypocalcemia
plasma calcium level lower than 9
56
what causes hypercalcemia (HAM-LI)
hyperparathyroidism Anti acids containing calcium like tums malignancies- uncontrolled release of ca low phosphae immobility- decrease stress on bones leading to bone demineralization
57
what are the signs and symptoms of hypercalcemia
heart; decreased hr conduction slows decreased RR decreased BP EKG- arrythmias heartblock Lungs; shortness of breath weak respiration GI; hypoactive bowel sounds constipation, nausea vomiting GU; kidney stones interfere with ADH less absorption of water and polyuria neurologic; altered mental status decrease reflexes loss conciousness musculoskeletal; decrease excitability severe muscle weakness bone pain
58
hypocalcaemia causes
hypoparathyroidism malabsorption syndrome deficient serum albumin increased serum pH level renal failure
59
what are the symptoms of hypocalcaemia
weak 3 B's 1. weak bones- fractures 2. weak blood clotting- bleed risk 3. weak heart beats- dysrhythmias
60
what are the symptoms of hypocalcaemia
excited heart; ventricular tachycardia severe slow clotting factors congestive heart failure lungs; spasm of vocal cords (laryngospasm) dyspnea and crackles GI: diarrhea intestinal cramping neurologic; confusion personality changes seizures dementia or psychosis musculoskeletal; trousseau (arm twerks) chvostek (twitching when temporal area touched)
61
what are the functions of phosphate
bone tooth mineralizaiton metabolism importance for ATP phosphate buffer system- acid base balance
62
what does phosphate have a recipricoal relationship with
serum calcium
63
what is phosphate regulated by
parathyroid hormone and calcitriol
64
what are normal serum phosphate levels
3-4.5
65
hyperphosphatemia
high phosphate more than 4.5
66
hypophosphatemia
low phosphate level less than 3
67
what causes hyperphosphatemia
excess vitaminD - suppress parathyroid decrease renal excretion of Ph hypoparathyroidism (causes hypocalcemia) low ca decreased excretion by kidneys
68
what are the signs and symptoms of hyperphosphatemia
same as hypocalcemia heart: arrythmias respiratory; crackles neurological; altered conciousness level confusion seizure GI; diarrhea Musculoskeletal; weakness hyperreflexes, troussaeu,chvestok
69
what causes hypophosphatemia
malabsorption diarrhea antacids alkalosis low Mg low Potassium hyperparathyroidism alc withdrawal
70
what are the signs and symptoms of hypophosphatemia
same as hypercalcemia- low lonely heart; slow weak pulses dysrhythmias respiratory; shallow and rapid respiration renal; kidney stones neurologic; altered mental status CNS depression GI: constipation musculoskeletal; decreased DTR muscle weakness
71
what is the function of magnesium
keep peace in muscles calms muscles down (uterus and heart)
72
what are normal mg levels
1.3-2.1
73
hypermagnesemia
serum level more than 2.1
74
hypomagnesemia
serum level less than 1.3
75
what is hypermagnesemia caused by
renal failure
76
what are the signs and symptoms of hypomagnesemia
heart; bradycardia (60b/min) hypotension arrythmias lungs; depressed respirations slow and shallow GI; hypoactive bowel sounds neurological; drowsiness and lethargy that progress to Coma musculoskeletal; weakness, diminsihed or absent reflexes
77
what are the causes of hypomagnesemia
diuretics diabetic ketoacidosis hyperparathyroidism hyperaldosteronism
78
what are the signs and symptoms of hypomagnesemia
buck wild heart; tachycardia arrhythmias severe; Vfib GI; diarrhea neurologic; confusion, irritability, insomnia neuromuscular; increased DTR hyperflexion (clonus) muscle twitching numbness (paresthesia) neuromuscular; increased DTR

NURS 2750 Health and Healing (11 decks)

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