Wk 3 Sodium Imbalances Flashcards
What is the normal range for sodium?
135-145
What is the normal range for potassium?
3.5-5
What is the normal range for calcium?
9-10.5
What is the range for magnesium?
1.3-2.1
What is the range for phosphorous?
3.0-4.5
What is the chemical abbreviation for phosphorous?
PO4
Sodium is the major…
extracellular fluid cation
Cations have what electrical charge?
Positive
What does osmolality mean?
Particles per solution/concentration
2 important functions of sodium
Governs osmolality
Activates muscle/nerve cells (Action potential)
What are two intakes that can cause hypernatremia?
Hypertonic IVF
Tube feedings without water supplements
To be a hypertonic solution, the Na+ concentration must be greater than…
0.9%
The water that is added to tube feedings is called…
Free water
Why is an elderly person at risk for hypernatremia?
Inadequate water intake, inadequate thirst mechanism
What are some other possible reasons for inadequate water intake?
Anorexia
Depression
Vomiting
Diarrhea
What are examples of excessive water loss that would lead to hypernatremia?
Insensible water loss
Diarrhea
Osmotic diuretics
What is an example insensible water loss?
Breathing (Running or sweating)
Why is it called insensible water loss?
Because you can’t see it
3 pathological causes of hypernatremia
Diabetes insipidus
Uncontrolled diabetes mellitus (DKA)
Cushing syndrome
What are causes of hyponatremia related to excess sodium loss? (5)
GI losses Renal losses Diuretics Burns Wounds
What are two other reasons a patient may have hyponatremia?
Inadequate sodium intake
Excess water gain, such as hypotonic IVF
What are 4 disease processes that can cause hyponatremia
SIADH
Heart failure
Kidney failure
Cirrhosis
Why does a chance in sodium concentration cause altered mental status?
Sodium causes the cells to shrink or enlarge, included the cells in the brain
What are symptoms of change in mental status?
Headache Irritability Difficulty concentrating Confusion Seizures Coma
When someone has sodium imbalance you should think…
mental status changes
Postural hypotension
Tachycardia
Weakness
These are signs of what concerning sodium?
Hypernatermia/fluid volume deficit
If someone has a sodium imbalance you should aim to achieve normal sodium levels in what amount of time?
48 hours
Why is adjusting sodium imbalances done over a longer period of time?
To avoid edema of cerebral cortex
Weight gain and increased blood pressure are characteristic of?
Hyponatremia
A patient with heart failure would most likely have what sodium imbalance?
Hyponatremia
If a patient has mild hyponatremia, we might…
Restrict fluids and loop diuretics
Fluid restrictions are super common for which three pathologies?
End-stage renal disease
Heart failure
Cirrhosis of the liver
If a patient is severely hyponatremic, what might the provider order?
Hypertonic NS (3%) over 48 hours
What nursing consideration should you do for a patient who is hyponatremic?
Provide a safe environment as needed
Both hyper and hyponatremia can lead to…
Seizures and coma
