Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURSADN6 Med Surg > Week 2 Fluid and Electrolytes Balance and Disturbance > Flashcards

Week 2 Fluid and Electrolytes Balance and Disturbance Flashcards

1
Q

Movement of fluid from region of low solute to region of high across semipermeable membrane

A

Osmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Changes in water or volume related to water pressure

A

Hydrostatic Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Movement of solutes from area of greater concentration to lesser concentration

Solutes in an intact vascular system are unable to move so diffusion normally should not be taking place

A

Diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Movement of molecules against the concentration gradient and requires ATP as energy; process typically takes place at cellular level and is not involved in vascular volume changes

A

Active Transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the nursing role in Fluid and Electrolyte balance

A

Help prevent, treat fluid and electrolyte disturbances

Understand physiology of F&E and Acid Base balances to anticipate, identify and respond to possible imbalances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The body is approximately how many % of fluid?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Intracellular is ?

A

28 L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Extracellular fluid is how many?

A

14L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Extracellular fluid is broken into

A
  1. Intravascular-3-4 L
  2. Interstitial - 10-11 L
  3. Transcellular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Loss of ECF into space that does not contribute to equilibrium

Moves from intravascular to interstitial (Nonfunctional area between cells)

A

Third Spacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Fluid is not available in the ICF or ECF

Does not contribute to equilibrium between ICF/ ECF

A

Third Spacing

Sign is decreased urine output Hallmark Sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Third Spacing is seen in what kind of patients

A
  1. Decreased Potassium
  2. Decreased Fe
  3. Severe liver dz
  4. Alcholishm
  5. Hypothyroidism
  6. Malabsorption
  7. Burns
  8. Fluid Volume Overload
  9. Cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

As volume deficits are detected by the kidneys they retain fluids in an effort to

A

Maintain CO and BP

Examples ascites, pleural effusion, pericardial effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Other compensatory signs of Third Spacing includes

A

Increased HR
Decreased BP
Decreased CVP
edema
Increased body wt
Imbalance
I & O’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Low oncotic pressure exerted by plasma proteins is loss from?

A

IV space

Will result in leakage into the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name causes of fluid shifts

A

Albumin losses can occur in liver failure, liver dysfunction, and malnutrition
- Albumin losses can lead to fluid shifting into the peritoneum causing ascites
- Destruction of endothelial cells such in bowel surgery can cause fluid to move and be trapped in interstitial spaces

Fluid trapped in the lungs can lead to pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Active chemicals that carry positive and negative charges are

A

Electrolytes
cation= +
anions= -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name the major cations

A

Sodium
Potassium
Calcium
Magnesium
Hydrogen Ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name the major anions

A

Chloride
Bicarbonate
Phosphate
Sulfate
Proteinate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Electrolyte concentrations differ in fluid compartments

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Most in extracellular fluid includes

A

Na
Ci
Osmolality
HCo3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Most in intracellular fluids include

A

Potassium
Mg
Phosphates
Osmolality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How can we regulate fluid?

A

Osmosis
Diffusion
Filtration
Active Transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Regulation of fluid is movement through capillary walls depends on what?

A

Direction of fluid movement depends on differences of hydrostatic, osmotic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Average intake includes?

A

Metabolism-10%,250 ml
Foods-30%-750ml
Beverages-60%1500ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Average output includes?

A

Feces- 4%, 100 ml
Sweat- 8%, 200ml
Insensible losses via skin and lungs- 28%, 700ml
Urine-1500ml, 60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Gain is what?

A

Dietary intake of fluid, food or enteral feeding
Parenteral fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Routes of losses includes

A

Kidney : Urine output
Skin loss: Sensible/ insensible losses
-Lungs
- GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

As blood flows through the lungs what happens?

A

Co2 removed and 02 is added

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What moves in Cells? Out of cells?

A

In cells are nutrients
Out of cells are metabolic wastes move out of cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Kidneys clear

A

Plasma filtrate of nitrogenous wastes, ion excesses, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Name homeostatic mechanisms

A

Kidney
Heart and Blood vessels
Lung
Pituitary
Adrenal
Parathyroid
Baroreceptors

RAAS
ADH
Osmoreceptors
Natriuretic Peptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Gerontologic Considerations includes

A

Reduced Homeostatic mechanisms, cardiac, renal, and resp. function

Decreased body fluid percentage

Medication use

Presence of concomitant conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Imbalance may be subtle
Fluid deficit may cause delirium
Decreased cardiac reserve
Reduced renal function
Dehydration is common
Age - related thinning of skin and loss of strength and elasticity

A

Gerontologic Considerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Fluid Volume deficit is also known as

A

Hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

FVE is also known as

A

Hypervolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the relationship between Volume and osmolarity?

A

Decrease volume, increased Osmol

Decreased Osmol, Increased Volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

This may occur alone or in combination with other imbalances

A

FVD

Hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

-Loss of extracellular fluid exceeds intake ratio of water

  • Electrolytes lost in same proportion as they exist in normal body fluids
A

Fluid Volume Deficit

  • Hypovolemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Not the same as FVD

  • Loss of water alone, with increased serum sodium levels
A

Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

-Abnormal Fluid Losses
- Decreased Intake
- Third Space Fluid Shifts
- Additional Causes

A

Causes of FVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Manifestations of this include

  • Rapid weight loss
  • Decreased skin turgor
  • Oliguria
  • Concentrated urine
  • Postural hypotension
  • Rapid weak pulse
  • Increased temperature
  • Cool clammy skin due to vasoconstriction
  • Lassitude
  • Thirst
  • Nausea
  • Muscle weakness
  • Cramps
A

Fluid Volume Deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Lab Data is showing
- Elevated BUN in relation to serum creatinine
- Increased HCT
- Increased serum and urine osmo and specific gravity
- Decreased urine Na

A

FVD

  • Serum Electrolyte changes may occur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Medical Management of FVD

A

Provide fluids to meet body needs

—-Oral Fluids
—-Iv Solutions

FVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Name the risk for Dehydration or Hypovolemia

A
  1. Diminished kidney function
  2. Elevated Temperature
  3. Highly concentrated tube feedings without enough supplemental water
  4. Young infant with diaper- Inaccurate assessment of output
  5. Diarrhea; diuretic overuse; diabetes
  6. Reduction in body water content; LOC, temp. and fluids= Tachycardia
    –esp. in elderly
  7. ADH production decreases
    8.Thirst mechanism reduced
  8. Increase in serum glucose
  9. Other conditions-N/V
  10. Not able to obtain fluid without help
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Concept Map RAAS

A

Slide 29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Regulation of water intake and output

A

Slide 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Labs are all increased
- HCT
- Serum Osmolality
- Protein level
- BUN
- Na
- Glucose
- Urine Specific Gravity

A

FVD or Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

System Specific assessment

A
  • Decreased moisture of mucous membranes
  • Decrease in vascular volume= Tachycardia
  • Decrease in postural BP= Syncope
  • Decrease in neck vein (Flat)
  • Decrease in UO
  • Decrease BP too much= Shock
  • Decrease in skin turgor- not valid in elderly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the normal Serum Osmol?

A

270-300 mOsm/ kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Fluid replacement is determined based on how the fluid was loss

A

Crystalloids- Small molecules

Colloids- Large molecules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

-This is due to fluid overload or diminished homeostatic mechanisms
- Risk factors: Heart failure, renal failure, cirrhosis

A

FVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Contributing factors includes
- Excessive dietary sodium or sodium containing IV solutions

A

FVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Manifestations include
- Edema
- Distended Neck Veins
- Abnormal lung sounds( crackles)
-Tachycardia
- Increased Blood pressure
- Pulse pressure and CVP
- Increased weight
- Increased urine output
- SOB
- Wheezing

A

FVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Medical management includes
- Directed at cause
- Restriction of fluids and sodium
- Administration of diuretics

A

FVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

ANP/ ANF does what?

A

increases
- NaCl concentration
- Blood volume
- Blood Pressure

Then stretches increase of atria
Then increases ANP/ ANF release from cardiac cells in the atria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Then the atria ANP/ ANF

A
  • Decreases suppression of RA system, angiotensin II
  • Decreases Aldosterone release by adrenal cortex
  • Decreases ADH release by posterior pituitary gland
  • Increase GFR and increases Na excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

With decrease ADH release it increases what?

A

Urine production and water excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Increase rate of urine production and water excretion does what?

A

Decreases
- Blood volume
- CVP
- CO
- Arterial Blood pressure
- Preload
- HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

System Specific Assessment of FVE includes

A

Increase Pulse - may be bounding
-Increase BP
- Increase confusion
- Increase in edema
- Increase wt more than 2ILBS/ 24 hr
- Increase in ascites
- Increase crackles in lungs
- Increase RR, dyspnea, orthopnea
- Increase neck veins JVD
- Increase R/F skin breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

FVE Labs will show what?

A

Decreased
- HCT
- Protein Level
- Na
- Urine SG
- Serum Osmolality
- BUN
- Glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

This includes
- Postural hypotension
- Tachycardia
- Absence of JVP
- Decreased skin turgor
- Dry mucosa
- Supine Hypotension
- Oliguria
- Organ Failure

A

Volume Depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

This includes
- HTN
- Tachycardia
- Raised JVP/ Gallop rhythm
- Edema
- Pleural Effusions
- Pulmonary Edema
- Ascites
- Organ Failure

A

Volume Overload

59
Q

Sodium- Hyponatremia/ Hypernatremia
Potassium- Hypokalemia/ Hyperkalemia
Calcium- Hypocalcemia/ Hypercalcemia
Magnesium- Hypo magnesium/ Hyper magnesium
Phosphorus- Hypophosphatemia/ Hyperphosphatemia
Chloride- Hyperchloremia/ Hypochloremia

A

Electrolyte Imbalances

60
Q

Serum Sodium less than is 135

A

Hyponatremia

61
Q

Causes include Adrenal Insufficiency
- Water intoxication
- SIADH
-Losses by vomiting
- Diarrhea
- Sweating
- Diuretics
- Renal Disease

A

Hyponatremia

  • Na deficit

FVE - Dilutional

62
Q

Name the S/S of hyponatremia

A
  • Poor skin turgor
  • Dry mucosa
  • Headache
  • Decreased salivation
  • Decreased BP
  • Nausea
  • Muscle weakness
  • Abd. cramping
  • Neurologic changes
  • Seizures
63
Q

Name the medical management of Hyponatremia

A
  • Water restriction
  • Sodium replacement
64
Q

What is the nursing management of hyponatremia?

A
  • Assessment and prevention
  • Dietary sodium and fluid intake
  • Identify and monitor at- risk patients
  • Effects of medications - ( diuretics, Lithium)
65
Q

System Specific Assessment Solution Deficit includes

A
  • Decrease in cerebral function
  • Decrease LOC- risk for seizures
  • Decrease muscle strength
  • Decrease DTR
  • Decrease volume= Increase HR
  • Decrease BP; orthostatic
  • Decrease UO
  • Decrease weight
  • Decrease sodium intake
66
Q

System specific assessment solution deficit includes both cause depending on ECF includes

A

Decrease in cerebral function
Decrease LOC risk for seizures
Decrease muscle strength

67
Q

Name system Specific Assessments Dilutional Water excess includes

A
  1. Decrease Cerebral function
  2. Decrease LOC- risk for seizures
  3. Decrease muscle strength
  4. Decrease DTR
  5. Decrease UO
  6. Increase BP
  7. Increase weight
  8. Increase HR
68
Q

Causes of this includes
- Excess water loss, excess sodium administration, DI, heat stroke, Hypertonic IV solutions

A

Hypernatremia more than 145

69
Q

S/S include
- Thirst
- Elevated Temp.
- Dry, swollen tongue
- Sticky mucosa
- Neuro symptoms
restlessness
- Weakness

A

Hypernatremia

70
Q

Thirst may be impaired in the ?

A

Elderly
ill

71
Q

_________________________ occurs in patients with normal fluid volume, FVD, FVE

A

Hypernatremia

72
Q

In hypernatremia what is the serum osmolality

A

Greater than 300mOsm/ kg

73
Q

Increased urine specific gravity and osmolality

A

Hypernatremia

74
Q

Fluid Deficit Dried Specific System Assessments

A
  • Dryness of mucous membranes
    —–Increase concentration in urine/ decrease UO
    -Red Flushed Skin
    —-Increase restless progressing to confusion
  • Increased Temp. ; I &O
    —- Increase concentration in urine/ decrease UO
  • Increase thirst ( may not be present in elderly)
  • Increase risk for seizure
    -Elevated HR
  • Decreased weight, BP, CVP, and UO
75
Q

Name the system specific Assessments “Edema”
- Fluid excess/ Na retention

A
  1. Edema
  2. Decrease in HCT; diet high in Na
  3. Elevated weight; elevated BP and HR
  4. Mentation decreased - Lethargic
  5. A flushing of the skin
76
Q

Interventions for hypernatremia

A

Restrict fluid intake with retention
- restrict foods high in Na

Evaluate for cerebral changes-(HA, nausea, seizure precautions)
- Strict I&0 safety falls
- BP is elevated d/t excess fluid excess. BP is low - Fluid deficit
- Review origin of hypernatremia
- Fluid deficit- hypotonic IV fluids
- Check daily weight; neuro assessments
- The excess fluids removed by diuretics

77
Q

Below normal potassium may occur with normal potassium levels with ALKALOSIS due to shift of potassium into cells

A

Hypokalemia

78
Q

Name the causes of Hypokalemia

A

GI losses/ NGT, medications, alterations of acid- base balance, hyperaldosterism, poor dietary intake

79
Q

Name s/s of hypokalemia

A
  • Fatigue
  • Anorexia
  • Nausea
  • Vomiting
  • Dysrhythmias
  • Muscle weakness
  • Cramps
  • Paresthesias
  • Glucose intolerance
  • Decreased muscle strengths
  • DTRs
80
Q

Medical management of hypokalemia includes

A

Increased dietary potassium
Potassium replacement
IV for severe deficit

81
Q

Nursing Management of hypokalemia

A

Assessment
Severe hypokalemia is life threatening
- Monitor ECG and ABGs
- Dietary potassium
- Nursing care related to IV potassium administration

82
Q

Name foods high in potassium

A
  1. tomatoes
  2. Avocados
  3. Bananas
  4. Orange
83
Q

________ substitutes are ______ in ____

A

Salt; potassium

84
Q

Potassium level higher than 5.0
What are causes of this?

A

Hyperkalemia
1. Usually treatment related
2. Impaired renal function
3. Hypoaldosteronism
4. Tissue Trauma
5. Acidosis

85
Q

Name the S/S of hyperkalemia includes

A
  • Cardiac changes and dysrhythmias
  • Muscle weakness with potential respiratory impairment
  • Paresthesia
  • Anxiety
  • GI manifestations
86
Q

Name the medical management of Hyperkalemia

A
  • Monitor ECG
  • Limitation of dietary potassium
  • Cation exchange resin ( Kayexalate)
  • IV sodium bicarbonate
  • IV calcium gluconate
  • Regular insulin
  • Hypertonic dextrose IV
  • Dialysis
87
Q

Nursing Management of Hyperkalemia

A

Assessment of serum potassium levels
- Ivs containing K
- Monitor medication affects
- Dietary potassium restrictions/ dietary teaching for patient’s at risk

88
Q

________ may result in false lab result positive of hyperkalemia

A

Hemolysis or drawing of blood above IV site

89
Q

______ sub. may contain potassium

A

Salt

90
Q

What may cause elevation of potassium

A

Potassium sparing diuretics

  • Not used in renal DZ
91
Q

-Renal Function deteriorates with age
-Elimination is decreased due to decrease in oral fluid intake
-Note that plasma renin and aldosterone decrease with age
- Alteration in renal blood flow
-Likely to take meds that interfere with K excretion

A

Hyperkalemia in Elderly Adults

92
Q

Hyperkalemia and the EKG

A

Peaked T waves
Flat Ps

93
Q

What is C-BBIG-K?

A

Calcium Gluconate or CaCI- Cardio protective- Prevents deleterious cardiac effects

BBIG- K back into the cell
–B2 agonist
- Bicarb– if acidosis
- I and G- Insulin and glucose together

K - Get rid of the potassium
- Kayexalate
- Diuretics
- Dialysis

94
Q

Hypocalcemia has normal output but low intake/ absorption

A
  • Low Ca rich foods
  • Vit D deficiency
  • Malabsorption Crohns
95
Q

Hypocalcemia increased output not balanced by increase Ca intake and absorption

A
  • Binds Ca in GI secretions in addition to the intake of Ca in diet- steatorrhea
96
Q

Hypocalcemia is serum less than

A

8.6 must be considered in conjunction with serum albumin levels

97
Q

Causes of hypocalcemia

A

Hypoparathyroidism
Malabsorption, Pancreatitis, alkalosis, massive transfusion of citrated blood, renal failure medications

98
Q

S/S neuromuscular Hypocalcemia

A

Tetany
Circumoral numbness
Parethesias
DTRs
Trousseaus
Chovstek’s
Seizures
Resp. symptoms of dyspnea and laryngospasm
- abnormal clotting
- Anxiety

99
Q

Cuff of blood pressure is what sign seen in hypocalcemia

A

Trousseau’s

100
Q

Tapping of the cheek is a sign of what?

A

Hypocalcemia and is known as Chvostek’s sign

101
Q

System Assessments for Hypocalcemia

A

T- Trousseau’s
W- Watch for dysrhythmias
I- Increases bowel sounds/ diarrhea
T- Tetany, twitching, tingling, seizures, spasms at rest can progress to tetany
C- Chvostek’s
H- Hypotension, Hyperactive DTRs

102
Q

First to do priority Interventions Hypocalcemia “SAFE”

A

S- seizure precautions
A- administer Ca supplements
F- foods high in C ( dairy, greens) educate client
E- emergency equipment on standby

103
Q

Name the medical management of Hypocalcemia includes

A
  • IV calcium gluconate
  • Calcium and vitamin D supplements
  • Diet
104
Q

_____________ _____________ is life threatening

A

Severe hypocalcemia

105
Q

What type of exercises one can do to decrease bone calcium loss?

A

Weight Bearing

Also teach patient about related diet and medications

Nursing care is related to IV calcium administration

106
Q

Name the drugs associated with hypocalcemia

A

A- aluminum containing antacids
A- anticonvulsants
B- beta blockers
C- caffeine
C- corticosteroids
D- diuretics (loop)

107
Q

Serum level is above 10.5

A

Hypercalcemia

108
Q

Name the s/s of hypercalcemia

A
  • muscle weakness
  • low coordination
  • anorexia
  • constipation
  • N/V
  • Abd bone pain
  • polyuria
  • thirst
  • ECG changes
  • Dysrhythmias
109
Q

Name the causes of hypercalcemia

A
  • Malignancy
  • Hyperparathyroidism
  • Bone loss related to immobility
110
Q

Medical Management of hypercalcemia

A

-Treat underlying causes
- fluids
- Furosemide
- phosphates
- calcitonin
- bisphosphonates

111
Q

______ normal output, increased Ca and intake and absorption

A

hypercalcemia

112
Q

Decreased output not balanced by decrease Ca intake

A

Thiazide Diuretics

Hypercalcemia

113
Q

Rapid Ca shift from bone to ECF ..

A
  • Hyperparathyroidism
  • Metastatic malignancy that secretes bone resorbing factors
    Padgett’s disease

Chronic immobility

114
Q

System specific Assessment for Calcium includes

A

C- cardiac dysrhythmias ( decrease QT, short ST); CNS is decreased
A- anorexia, nausea, constipation
L- LOC decreased
C- Ca level above 10.5
I- increase in drowsiness
u- Underactive reflexes
M- muscle weakness
F- fat Ca

115
Q

Serum is less than 1.3 mg/ dL and evaluate with serum albumin

A

Hypomagnesemia

116
Q

Name causes of Hypomagnesemia

A
  • Alcoholism
  • GI losses
  • IBS/ IBD medications
  • Rapid administration of citrated blood
  • Contributing causes include DKA
  • Sepsis
  • Burns
  • Hypothermia
117
Q

S/S of hypomagnesemia include

A
  • Neuromuscular irritability
  • Muscle weakness/ fatigue
  • Tremors/ convulsions
  • ECG changes
  • ALOC
  • Nystagmus
118
Q

What is the medical management of Hypomagnesemia?

A

Includes
- Diet
- Oral magnesium
Mag sulfate IV

119
Q

Mg has similar relation to?

A

Calcium

120
Q

Assessment for Magnesium

A

TWITCH
T- Trousseau’s
W- watch for dysrhythmias
I- Increase neuromuscular excitability
T- Tetany, twitching ( seizures)
C- Chhvostek’s sign
H- Hypoactive bowel sounds, constipation, hyperactive DTR; HTN

121
Q

Interventions for low mag.

A

SAFE
S- Seizure/ fall precautions
A- Administer Mg sulfate IV per order
F- foods high in Mg
E- Emergency equipment stand by, eliminate drugs that decrease magnesium, Evaluate DTRs

122
Q

What is the nursing management of hypomag.?

A

Assessment
- Ensure safety
- pt teaching related to diet
- medications
- alcohol use
- Nursing care related to IV mag sulfate
- Often accompanied by hypocalcemia
- Dysphagia common in mag. depleted patients

123
Q

Name foods high in Mg

A

Nuts
Dark chocolate
Seafood
Introduce Peas and dry beans
Use whole grain bread and cereal
Meats

124
Q

Rhythm to watch with Mg is

A

Torsades de Pointes

125
Q

Hypermagnesemia is serum above

A

2.3

126
Q

Name causes of Hypermagnesemia

A
  • Renal Failure
  • DKA
  • Excessive administration of mg
127
Q

S/S of Hypermag

A
  • Low BP
  • n/v
  • hypoactive reflexes
  • drowsiness
  • muscle weakness
  • depressed respirations
  • ECG changes
  • Dysrhythmias
128
Q

Medical management of hypermag. includes?

A

IV calcium gluconate, Loop diuretics, IV NS of RL
- Hemodialysis

129
Q

Nursing management of Hypermag.

A
  • Assessment
  • Do not administer medications containing magnesium
  • Pt teaching regarding magnesium containing OTC medications
130
Q

Name the similarities between Ca and Mg

A
  • Both predominantly in bone
  • Assessments are similar
  • Both can twitch
  • Elevated levels, drowsiness, decrease muscle tone, dysrhythmias
  • differences - diarrhea- too much Mg
  • Constipation- too much calcium
131
Q

Below serum of 2.5

A

Hypophosphatemia

132
Q

Name S/S of hypophosphatemia

A
  • Neurologic symptoms, confusion, muscle weakness, tissue hypoxia, muscle and bone pain, increased susceptibility to infection
133
Q

What is the nursing management of Hypophosphatemia?

A
  • Assessment
  • Encourage food high in phosphorus
  • Gradually introduce calories for malnourished patients receiving paternal nutrition
134
Q

Name the causes of hypophosphatemia

A
  • Alcoholism, refeeding of patients after starving
  • Pain, heat stroke, resp. alkalosis, hyperventilation
  • DKA
  • Hepatic encephalopathy
  • Major Burns, Hyperparathyroidism
  • Low Mg
  • Low potassium
  • Diarrhea
  • Vitamin D deficiency
  • Use of diuretic and antacids
135
Q

Name the medical management of hypophosph.

A
  • Oral or IV phosphorus replacement
136
Q

Serum above 4.5 is known as

A

Hyperphosphatemia

137
Q

Name the S/S of hyperphosphatemia

A
  • Soft tissue calcifications
  • Symptoms include and associated with hypocalcemia
138
Q

Nursing management of Hyperphosphatemia include ?

A
  • Assessment
  • Avoid high phosphorus foods
  • Pt teaching related to diet
  • Phosphate containing substances and signs of hypocalcemia
139
Q

Name the causes of Hyperphosphatemia

A
  • Renal Failure
  • Excess phosphorus
  • Excess vitamin D
  • Acidosis
  • Hypoparathyroidism
  • Chemotherapy
140
Q

Name the medical management of Hyperphosphatemia

A
  • Treat underlying disorder
  • Vitamin D preparations
  • Calcium Binding antacids
  • Phosphate Binding gels or Antacids
  • Loop Diuretics
  • NS IV
  • Dialysis
141
Q

Hypochloremia is less than

A

97

142
Q

Name the causes of hypochloremia

A
  • Addison’s disease
  • Reduced chloride intake
  • GI loss
  • DKA
  • Excessive sweating
  • Fever
  • Burns
  • Medications
  • Metabolic Alkalosis
143
Q

Loss of __________________ occurs with loss of other electrolytes, potassium, sodium

A

Chloride

144
Q

S/S of hypochloremia includes

A
  • Agitation
  • Irritability
  • Weakness
  • Hyperexcitability of muscles
  • Dysrhythmias
  • Seizures
  • Coma
145
Q

Medical management of hypochloremia

A
  • Replace chloride IV NS
    or 0.45 NS
146
Q

What is the nursing management of hypochloremia?

A
  • Assessment
  • Avoid free water
  • Encourage high chloride foods
  • Patient teaching related to high chloride foods
147
Q

Serum more than 107 mEQ/ L is

A

Hyperchloremia

148
Q

Name causes of hyperchloremia

A
  • Excess sodium infusions with water loss
  • Head injury
  • Hypernatremia
  • Dehydration
  • Severe diarrhea
  • Resp. Alkalosis
  • Metabolic acidosis
  • Hyperparathyroidism
  • Medications
149
Q

Name the S/S of hyperchloremia

A
  • Tachypnea
  • Lethargy
  • Weakness
  • Rapid deep respirations
  • HTN
  • Cognitive changes
150
Q

Hyperchloremia includes

A

Normal serum anion gap

151
Q

Medical management of hyperchloremia includes

A

Restore electrolyte and fluid balance
- LR
- Sodium Bicarbonate
- Diuretics

152
Q

Name the nursing management of Hyperchloremia

A
  • Assessment
  • Pt teaching r/t diet and hydration

NURSADN6 Med Surg (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions