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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
Q

whats normal serum sodium levels

A

135-145

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26
Q

hypernatremia levels are

A

sodium level in plasma greater than 145

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27
Q

hyponatremia levels are

A

sodium level in plasma lower than 135

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28
Q

what causes hypernatremia (FAIR AD)

A

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

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29
Q

what are the signs and symptoms of hypernatremia (big and bloated)

A

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

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30
Q

what causes hyponatremia

A

losses from excessive sweating vomiting diarrhea
use of diuretic drugs with low salt diet
hormonal imbalances
excessive water intake

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31
Q

what hormonal imbalances cause hyponatremia

A

insufficient aldosterone
adrenal insufficiency
excess adh secretion

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32
Q

what are the 2 types of hyponatremia

A

hypovolemic- loss of fluid and na+
hypervolemic- increase in body water greater than na+

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33
Q

what are the signs and symptoms of hypovolemic hyponatremia

A

low fluid and na
increased HR
decreased BP
increased RR

34
Q

what are the signs and symptoms of hypervolemic hyponatremia

A

increase HR
increased BP
decreased RR

35
Q

what does elevated EKG indicate

A

ventricles cramping up

36
Q

what are the general signs and symptoms of hyponatremia

A

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
Q

how is hypovolemic hyponatremia treated

A

administer iv salty solutions
isotonic like NS or LR
diet high in salt canned food processed meat cheese packaged food

36
Q

what regulates chloride levels

A

sodium

37
Q

what is the function of chloride

A

maintain blood volume
blood pressure
pH of body fluids

38
Q

what does low chloride lead to

A

high serum bicarb (alkalosis)

39
Q

what are normal chloride levels

A

97-107

40
Q

hyperchloremia

A

high chloride in blood higher than 107

41
Q

hypochloremia

A

low chloride in blood lower than 97

42
Q

what causes hyperchloremia

A

hypernatremia
dehydration & hemoconc- severe diarrhea metabolic acidosis (low hco3)
respiratory alkalosis (hyperventilating blowing off co2)

43
Q

what are the signs and symptoms of hyperchloremia

A

same as hypernatremia
-edema
-weight gain
-hypertension
-tachypnea

44
Q

what are the main causes of hypochloremia (CHAMP)

A

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
Q

what are the signs and symptoms of hypochloremia

A

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
Q

where is calcium found

A

ecf

47
Q

where is calcium ingested stored and excreted

A

food
bone
urine
stool

48
Q

what is calcium balance controlled by

A

parathyroid hormone
calcitonin

49
Q

parathyroid hormone

A

increases ca conc in blood

50
Q

calcitonin

A

puts ca in bones

51
Q

what promotes ca absorption from intestines

A

vitamin D
activated in kidneys
ingested/synthesized by UV rays

52
Q

what is calciums function

A

blood
bone
beats (heart)
fills function of Mg- linear relation
enemy of phosphate- inverse relation

53
Q

what are normal calcium levels

A

9-10.5mg

54
Q

hypercalcemia

A

plasma calcium level greater than 10.5

55
Q

hypocalcemia

A

plasma calcium level lower than 9

56
Q

what causes hypercalcemia (HAM-LI)

A

hyperparathyroidism
Anti acids containing calcium like tums
malignancies- uncontrolled release of ca
low phosphae
immobility- decrease stress on bones leading to bone demineralization

57
Q

what are the signs and symptoms of hypercalcemia

A

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
Q

hypocalcaemia causes

A

hypoparathyroidism
malabsorption syndrome
deficient serum albumin
increased serum pH level
renal failure

59
Q

what are the symptoms of hypocalcaemia

A

weak 3 B’s
1. weak bones- fractures
2. weak blood clotting- bleed risk
3. weak heart beats- dysrhythmias

60
Q

what are the symptoms of hypocalcaemia

A

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
Q

what are the functions of phosphate

A

bone tooth mineralizaiton
metabolism importance for ATP
phosphate buffer system- acid base balance

62
Q

what does phosphate have a recipricoal relationship with

A

serum calcium

63
Q

what is phosphate regulated by

A

parathyroid hormone and calcitriol

64
Q

what are normal serum phosphate levels

A

3-4.5

65
Q

hyperphosphatemia

A

high phosphate more than 4.5

66
Q

hypophosphatemia

A

low phosphate level less than 3

67
Q

what causes hyperphosphatemia

A

excess vitaminD - suppress parathyroid decrease renal excretion of Ph
hypoparathyroidism (causes hypocalcemia)
low ca
decreased excretion by kidneys

68
Q

what are the signs and symptoms of hyperphosphatemia

A

same as hypocalcemia
heart: arrythmias
respiratory; crackles
neurological; altered conciousness level confusion seizure
GI; diarrhea
Musculoskeletal; weakness hyperreflexes, troussaeu,chvestok

69
Q

what causes hypophosphatemia

A

malabsorption
diarrhea
antacids
alkalosis
low Mg low Potassium
hyperparathyroidism
alc withdrawal

70
Q

what are the signs and symptoms of hypophosphatemia

A

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
Q

what is the function of magnesium

A

keep peace in muscles
calms muscles down (uterus and heart)

72
Q

what are normal mg levels

A

1.3-2.1

73
Q

hypermagnesemia

A

serum level more than 2.1

74
Q

hypomagnesemia

A

serum level less than 1.3

75
Q

what is hypermagnesemia caused by

A

renal failure

76
Q

what are the signs and symptoms of hypomagnesemia

A

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
Q

what are the causes of hypomagnesemia

A

diuretics
diabetic ketoacidosis
hyperparathyroidism
hyperaldosteronism

78
Q

what are the signs and symptoms of hypomagnesemia

A

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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