Wk 3 Sodium Imbalances

Question 1

What is the normal range for sodium?

Answer 1

135-145

Question 2

What is the normal range for potassium?

Answer 2

3.5-5

Question 3

What is the normal range for calcium?

Answer 3

9-10.5

Question 4

What is the range for magnesium?

Answer 4

1.3-2.1

Question 5

What is the range for phosphorous?

Answer 5

3.0-4.5

Question 6

What is the chemical abbreviation for phosphorous?

Answer 6

PO4

Question 7

Sodium is the major…

Answer 7

extracellular fluid cation

Question 8

Cations have what electrical charge?

Answer 8

Positive

Question 9

What does osmolality mean?

Answer 9

Particles per solution/concentration

Question 10

2 important functions of sodium

Answer 10

Governs osmolality

Activates muscle/nerve cells (Action potential)

Question 11

What are two intakes that can cause hypernatremia?

Answer 11

Hypertonic IVF

Tube feedings without water supplements

Question 12

To be a hypertonic solution, the Na+ concentration must be greater than…

Answer 12

0.9%

Question 13

The water that is added to tube feedings is called…

Answer 13

Free water

Question 14

Why is an elderly person at risk for hypernatremia?

Answer 14

Inadequate water intake, inadequate thirst mechanism

Question 15

What are some other possible reasons for inadequate water intake?

Answer 15

Anorexia
Depression
Vomiting
Diarrhea

Question 16

What are examples of excessive water loss that would lead to hypernatremia?

Answer 16

Insensible water loss
Diarrhea
Osmotic diuretics

Question 17

What is an example insensible water loss?

Answer 17

Breathing (Running or sweating)

Question 18

Why is it called insensible water loss?

Answer 18

Because you can’t see it

Question 19

3 pathological causes of hypernatremia

Answer 19

Diabetes insipidus
Uncontrolled diabetes mellitus (DKA)
Cushing syndrome

Question 20

What are causes of hyponatremia related to excess sodium loss? (5)

Answer 20

GI losses
Renal losses
Diuretics
Burns
Wounds

Question 21

What are two other reasons a patient may have hyponatremia?

Answer 21

Inadequate sodium intake

Excess water gain, such as hypotonic IVF

Question 22

What are 4 disease processes that can cause hyponatremia

Answer 22

SIADH
Heart failure
Kidney failure
Cirrhosis

Question 23

Why does a chance in sodium concentration cause altered mental status?

Answer 23

Sodium causes the cells to shrink or enlarge, included the cells in the brain

Question 24

What are symptoms of change in mental status?

Answer 24

Headache
Irritability
Difficulty concentrating
Confusion
Seizures
Coma

Question 25

When someone has sodium imbalance you should think...

Answer 25

mental status changes

Question 26

Postural hypotension Tachycardia Weakness These are signs of what concerning sodium?

Answer 26

Hypernatermia/fluid volume deficit

Question 27

If someone has a sodium imbalance you should aim to achieve normal sodium levels in what amount of time?

Answer 27

48 hours

Question 28

Why is adjusting sodium imbalances done over a longer period of time?

Answer 28

To avoid edema of cerebral cortex

Question 29

Weight gain and increased blood pressure are characteristic of?

Answer 29

Hyponatremia

Question 30

A patient with heart failure would most likely have what sodium imbalance?

Answer 30

Hyponatremia

Question 31

If a patient has mild hyponatremia, we might...

Answer 31

Restrict fluids and loop diuretics

Question 32

Fluid restrictions are super common for which three pathologies?

Answer 32

End-stage renal disease Heart failure Cirrhosis of the liver

Question 33

If a patient is severely hyponatremic, what might the provider order?

Answer 33

Hypertonic NS (3%) over 48 hours

Question 34

What nursing consideration should you do for a patient who is hyponatremic?

Answer 34

Provide a safe environment as needed

Question 35

Both hyper and hyponatremia can lead to...

Answer 35

Seizures and coma