week 8 Flashcards
potassium
affect muscle contraction and heart functions
hang out in the ICF
causes of hyperkalemia (high potassium)
o Renal/kidney failure (cannot excrete potassium)
o Excessive intake of potassium
o Massive cell destruction (burn, shift of potassium between cells)
o Metabolic (kidney) acidosis (high acidity, ph drops below 7.35) (K+ ions move out of the cell and H+moves in)
o Drugs (ie., potassium-sparing
diuretics)
o Hyperglycemia (high blood sugar level), insulin affects the sodium-potassium pump, insulins will make potassium to leave the cells and get into blood stream
Adrenal insufficiency (low Aldosterone ) aldosterone helps the kidneys to hold onto sodium, hold onto water, get rid of potassium
sign and symptoms of hyperkalemia
muscle contraction and cardiac function > too much stimulus, muscls and heart are tired
potassium >5 mEq
Symptoms: “Limp is a Fact”
Loss of muscle tone
Irregular pulse, rhythm
Muscle weakness
Paresthesias (tingling sensation)
reflexes
Fatigue,
irritability
Abdominal cramping (diarrhea)
Confusion
Twitching (muscle cramps)
Respiratory depression (in the late stage)
hypotonic
hypotonic solutions have more water than solutes (compared to isotonic)
Fluid will move into cells
Think: HIPPOS!
-Hypotonic solutions have more water than solutes (compared to isotonic solutions)
-Hypotonic solutions cause fluid to move INTO cells
-The cell will expand and burst
Hyperkalemia nursing implications
Nursing Implications:
Mild elevation and renal function: withhold K+ from diet
Assess medication use
Assess cardiac function (cardiac monitoring high level to
detect dysrhythmias)
Assess muscle function and strength
Assess reflexes
Assess bowel function and character of stool
May need diuretics to promote excretion
Assess glucose and K+ levels with insulin therapy
hypertonic
hypertonic solutions have more solutes (particles) than water(compared to isotonic)
Fluid will move out of cells
Think: HYPER cells!
-Hypertonic solutions have more solutes than water (compared to isotonic solutions)
-Hypertonic solutions will cause fluid to move OUT of the cell
-The cell will shrivel
high blood sugar lead to increase or decrease potassium ?
high blood sugar will lead to increase in potassium because potassium wants to move outside.
how does insulin affect potassium level ?
Insulin affects the sodium-potassium pump, and will make potassium drops.
Potassium moves back to the ICF.
If you give someone insulin, need to monitor potassium and make sure it is not low.
Aldosterone
It is released if the blood pressure or fluid volume get too low.
Kidney to Hold on to water
kidney to Hold on to sodium
Get rid of potassium
ADH Anti diuretics hormones
Anti diuretics (keep water)
Normal pH
acidic
basic
is 7.35-7.45
acidic when it is less than <7.35
basic when it is greater than >7.45
Sodium (Na+) normal level
(135-145mEq/L)
Chloride/bicarbonate level
chloride and bicarbonate has opposite relationship. When chloride is high, bicarb is low
Chloride imbalance needs to check what labs
sodium level
bicarb level
potassium level
Chloride (Cl-) normal range
95-105 mEq/L
sign and symptom of hyponatremia and hypochloremia
headache, lethargy, confusion,
seizures & coma (severe)
* muscle cramps
* dry mucous membranes
* postural hypotension,
tachycardia
They affect the nerve impulse, and muscle contraction (CNS + muscle contraction)
Monitor for neuro status
foods that are rich in chloride
seaweed, rye, tomatoes, lettuce, celery, and olives.
foods that are rich in potassium
Potatoes
Oranges
Tomatoes
Avocados
Strawberries
Spinach
raIsins
mUshrooms
Melon, cantaloupeBananas
acid ph base
0 1 7 (neutral) 8 9
lactated ringer’s and chloride level
Lactated ringers lower the chloride level because it increases bicarb and bicarb has opposite relationship with chloride.
BUN
blood urea nitrogen
Measures amount of urea (less toxic from of ammonia) nitrogen in the blood
+ liver converts ammonia to urea
Urea from protein breakdown
Indication of kidney and liver function
Elevated level:
↑ protein intake, excess protein breakdown, kidney disease,
fluid volume deficit
Decreased level:
liver failure, low protein diet, fluid volume excess
Nursing Implications:
assess protein levels, hydration status, assess other liver and
kidney function tests
BUN blood urea nitrogen normal lab value
8-20mg/dL
normal sodium level
135-145mEq/L
