week 3 Flashcards
value useful to determine cause of acid/base imbalance
anion gap
increased intracranial pressure could occur with respiratory ___
acidosis
chronic alcohol abuse is the most common cause for ____
hypomagnesemia
calcium concentration in the blood is regulated by the ___ ____
parathyroid hormone
patients with hyperkalemia should avoid ___ ____
salt substitutes
most common cause of hypercalcemia is ___ & ___
malignancies & hyperthyroidism
oncotic pressure is osmotic pressure exerted by ____
proteins
major anion (-) electrolyte
chloride
3 cations (+)
potassium
sodium
calcium
calcium & ____ have an inverse relationship
phosphorus
sodium (Na+)
135-145
Potassium (K+)
3.5-5
Calcium (Ca+)
8.5-10.5
chloride (Cl-)
96-108
Magnesium (Mg+)
1.3-3
Phosphorus(P)
2.5-4.5
Chloride moves where ____ does
sodium
causes of hyponatremia
deficient aldosterone
antidepressants
desmopressin
SIADH
Hyponatremia: clinical manifestations
depressed and deflated:
poor skin turgor
dry mucous membranes
decreased salvation
anorexia and abd cramping
ortho hypo
increases ICP
Hyponatremia: nursing management
I/O
daily weights
mental status assess
fluid restriction
lab values
fall/seizure precautions
Hypernatremia: Clinical manifestations
Big and bloated:
thirst
increased temp
tachy
hypotension
change in mental status-disorientation
irritability, restlessness
decreased DTR
seizures
n/v
anorexia
Hypernatremia: Nursing management
I/O
LOC
fall/seizure precautions
neuros
PO water
____ drives K+ into cells
insulin
Hypokalemia: Actual causes
diuretics
GI tract loss
corticosteroids
Hypokalemia: relative causes
alkalosis, TPN, water intox, hyperinsulinism
Hypokalemia: clinical manifestations
low and slow:
hypotension
cardiac arrest
respiratory depression
fatigue
anorexia
muscle weakness, cramps, parathesias
decreased gastric motility
abd distension
metabolic alkalosis
Flattened T wave, prominent U wave
ST depression, prolonged PR interval
determine loss of K source- ____ toxicity?
digoxin
Hyperkalemia: relative causes
acidosis,
tissue damage- cells burst and release K+
decreased insulin production
60% caused by meds
Hyperkalemia: Clinical manifestations
tachy then late bradycardia (late sign)
abd cramps/ distension
hyperactive bowel sounds
anxiety/irritability
TALL tented t-waves
prolonged PR interval & QRS duration
absent p waves
ST-depression (late sign)
Hyperkalemia: last resort medical management
dialysis
Hyperkalemia: Medical management
sodium polystyrene (kayexalate)
calcium gluconate (protects heart)
sodium bicarbonate
loop diuretics
insulin/dextrose
albuterol (drives K+ into cell)
Calcium assists with ____ ____
blood clotting
If calcium is elevated—> calcitonin released —> bones ___ Ca+
absorb
If calcium is decreased—> PTH released—> bones ___ Ca+
release
Hypocalcemia: value
<8.5
Hypocalcemia: Causes
hypoparathyroidism
kidney injury
alkalosis
Hypocalcemia: Clinical manifestations
tetany
hyperactive DTRs
numbness
trousseau/chvostek sign
seizures
abnormal clotting
anxiety
dyspnea/laryngospasms
Prolonged QT interval
lengthened ST segment
Will have positive Trousseau/Chvostek sign
hyperphosphatemia
hypomagnesemia
hypocalcemia
Hypercalcemia: serum level
> 10.5 (rare)
Hypercalcemia: Clinical manifestations
polyuria
thirst
muscle weakness
intractable nausea
abd cramps
constipation
diarrhea
peptic ulcer
bone pain
Shortened ST segment and QT interval
bradycardia and heart blocks
Hypercalcemia: management
furosemide,
phosphates
calcitonin
increase mobility
Hypomagnesemia: serum level
<1.3
Hypomagnesemia: patho
alcoholism
GI losses
Hypomagnesemia: Manifestations
Chvostek/Trousseau signs
apathy
depressed mood
psychosis
muscle weakness
tremors
increased tendon reflexes
diarrhea
nystagmus
flat or inverted t waves
depressed ST segment
widened QRS
prolonged PR interval
Hypomagnesemia: management
monitor for dysphagia
seizure precautions
EKG
avoid osmotics & loop diuretics
Hypermagnesemia: serum level
> 3.0 (rarest)
Hypermagnesemia: patho
dka
Hypermagnesemia: manifestations
hypoactive reflexes
drowsiness
muscle weakness
depressed respirations
prolonged PR and QRS
peaked t waves
CARDIAC ARREST
direct antidote for mag toxicity
calcium gluconate
Hypophosphatemia: serum level
<2.5
Hypophosphatemia: patho
alcoholism
respiratory alkalosis
dka
hyperparathyroidism
Hypophosphatemia: manifestations
nystagmus
confusion
muscle weakness
muscle/bone pain
increased risk for infection
Foods to encourage with Hypophosphatemia
milk
fish/poultry
whole grains
soda
Hyperphosphatemia: serum level
> 4.5
Hyperphosphatemia: causes
acidosis
chemo
hypoparathyroidism
Hyperphosphatemia: manifestations
tetany
Hyperphosphatemia: management
calcium-binding antacids (while eating)
avoid: hard cheese, sardines, meat, dried fruit
hypochloremia: serum level
<96
hypochloremia: manifestations
agitation/irritability
weakness
seizures/coma
hypochloremia: causes
dka
metabolic alkalosis
fever, burns, excessive sweating
hyperchloremia: serum level
> 108
hyperchloremia: causes
head injury
hypernatremia
dehydration/diarrhea
respiratory alkalosis
metabolic acidosis
hyperchloremia: manifestations
tachypnea
lethargy, weakness
HTN
cognitive changes
The sodium potassium pump transports ___ into the ECF
Na
the sodium potassium pump contributes to creating ___ transmission and maintaining ___ level in the ICF
electrical; K+
