Electrolyte imbalances Flashcards
This electrolyte imbalance is <136 mEq/L
Underlying causes include:
-Hypovolemic hypernatremia
-GI fluid loss
-Profuse diaphoresis (sweating)
-water intoxication
-prolonged use of hypotonic IV solutions
-SIADH
Hyponatremia (sodium)
Interventions:
monitor vital signs
monitor intake/output
monitor lab results
encourage foods high in sodium
restrict water intake
administer hypotonic IV saline
monitor make sure saline levels only increase by only 4-6 mEq/L in any 24 hour period
This electrolyte imbalance is >145 mEq/L
Underlying causes include:
-Excessive sodium intake
-Hypertonic IV solutions
-Hypertonic enteral feedings without adequate water
- excessive loss of water due to diarrhea, inadequate intake of water, insensible loss due to fever
Hypernatremia (sodium)
Interventions:
Monitor vital signs
Monitor level of consciousness
Monitor intake and output
Monitor lab results-serum sodium/osmolality
Limit salt intake
Increase water intake
Administer hypotonic IV solutions
This electrolyte imbalance is <3.5 mEq/L
Underlying causes include:
-vomiting, gastric suction, diarrhea,
-laxative abuse, frequent enemas
-use of potassium-sodium wasting diuretics
-inadequate intake seen in anorexia, alcoholism, debiliated patients
-hyperaldosteronism (overproduction of aldosterone)
Hypokalemia (potassium)
Interventions:
Monitor vitals
monitor cardiac rhythm with EKG
Monitor labs for serum potassium
Assess for signs of digitalis toxicity
Encourage foods high in potassium
administer potassium supplements
IV potassium is diluted properly and administered slowly never administer as IV bolus or IV push
This electrolyte imbalance is >5.0 mEq/L
Underlying causes include:
-renal failure
-massive trauma, crushing injuries, burns
-hemolysis
-IV potassium
-potassium-sparing diuretics
-acidosis, especially diabetic ketoacidosis
Hyperkalemia (potassium)
Interventions:
Monitor vital signs
Monitor cardiac rhythm with ECG
Monitor labs for serum potassium
limit potassium rich foods
Administer cation exchange resins kAyexalate
Administer glucose and insulin as oredered, potassium moves back into the cell
This electrolyte imbalance is <9 mg/dL
Underlying causes include:
-hypoparathyroidism
-pancreatitis
-Vitamin D deficiency
-Inadequate intake of calcium rich foods
-hyperphosphatemia
-chronic alcoholism
Hypocalcemia (calcium)
Interventions:
Monitor heart rate
Monitor cardiac rhythm with ECG
Institute fall and seizure precaution
Administer oral and IV calcium supplements as ordered
Encourage calcium rich foods
This electrolyte imbalance is >10.5 mg/dL
Underlying causes include:
-prolonged bed rest
-hyperparathyroidism
-bone malignancy
-Paget disease
-osteoporosis
Hypercalcemia (calcium):
Interventions:
Monito heart rate
monitor cardiac rhythm with ECG
Encourage increased fluid intake
Increase patient activity including active ROM
This electrolyte imbalance is <98 mEq/L
Underlying conditions include:
-overhydration
-heart failure
-SIADH
-vomiting or gastric suction
-Addison’s disease
-Burns
-Metabolic alkalosis
-medications like aldosterone, bicarbonates, steroids, loop and thiazide diuretics
Hypochloremia (chloride)
Interventions:
monitor vital signs
monitor intake and output
monitor lab results
restrict water intake
administer hypertonic IV saline solutions as ordered
This electrolyte imbalance is >106 mEq/L
Underlying conditions include:
-dehydration
-anemia
-excessive normal saline infusion
-Cushing syndrome
-Kidney disease
-Metabolic acidosis
-respiratory alkalosis or hyperventilation
Hyperchloremia (chloride)
Interventions:
monitor vital signs
monitor level of consciousness
monitor intake and output
monitor lab results
limit salt intake
increase water intake
administer hypotonic IV solutions as ordered
This electrolyte imbalance is <1.3 mEq/L
Underlying conditions include:
-Decreased intake
-TPN without magnesium
-Decreased absorption
-nasogastric suction
-draining fishtulas
-prolonged diarrhea
-laxative abuse
-mlabsorption syndrome
-ulcerative colitis
-Crohn’s disease
-increased renal excretion
-Diuresis
-loop and thiazide diuretics
Hypomagnesemia (magnesium)
Interventions:
assess vital signs
monitor cardiac rhythm with ECG
assess mental status
monitor lab results, potassium and calcium levels
assess swallowing before medication, food, fluid
institute seizure precautions
administer oral or IV supplements as ordered
This electrolyte imbalance is >2.1 mEq/L
Underlying conditions include:
-excessive intake of magnesium-containing antacids or cathartics
-TPN with too much magnesium
-Prolonged use of intravenous magnesium sulfate
-renal failure
-severe dehydration
-adrenal insufficiency
-leukemia
Hypermagnesemia (magnesium)
Interventions:
assess vital signs
monitor cardiac rhythm with ECG
assess mental status
assess neuromuscular strength and activity
encourage increased oral intake, increased IV fluids
administer loop diuretics
provide respiratory support
This electrolyte imbalance is <3 mg/dL
underlying conditions include:
-abnormal shift into the cell
-hyperventilation
-respiratory alkalosis
-hyperglycemia
-absorption from the GI tract
-Phosphorous-binding antacids
-starvation
-malabsorption syndrome
-inadequate vitamin D
-chronic diarrhea, laxative abuse
-increased excretion by kidneys
-thiazides and loop diuretics
-diabetic ketoacidosis
-hyperparathyroidism
-hypocalcemia
Hypophosphatemia (phosphate)
Interventions:
assess vital signs, especially respirations, O2, and BP
assess muscle strength and neuromuscular function
assess for signs of heart failure
encourage phosphate-rich foods
instruct patient to avoid phosphorous-binding antacids
administer oral and IV phosphorous
administer pain medications
monitor for signs of infection
This electrolyte imbalance is >4.5 mg/dL
Underlying conditions include:
-impaired renal function
-hypoparathyroidism
-acid-base imbalances
-cellular injury
Hyperphosphatemia (phosphate)
Interventions:
monitor vital signs
monitor serum phosphorous and calcium levels
Monitor BUN and creatine
Assess signs of hypocalcemia
Monitor intake and output
teach patient to avoid phosphorous-rich foods
Name the electrolyte imbalance:
lethargy
confusion
weakness
muscle cramping
seizures
anorexia, nausea, vomiting
Serum osmolality <285 mOsm/kg
Hyponatremia
Name the electrolyte imbalance:
Thirst
dry and sticky mucous membranes
weakness
elevated temperature
confusion
irritability
decreased levels of consciousness
hallucinations
seizures
serum osmolality >290 mOsm/kg
hypernatremia
Name the electrolyte imbalance:
weak
irregular pulse
fatigue lethargy
anorexia
nausea
vomiting
muscle weakness
cramping
decreased persistalsis
hypoactive bowel sounds
paresthesia
cardiac dysrhythmias
increased risk for digitalis toxicity
Hypokalemia
