Fluid Balance

Question 1

Adverse effect of Furosemide

Answer 1

1. My legs don’t want to hold me up( hypokalemia- weakness caused by it)
2. I cannot get enough to drink today (dehydration)
3. I feel like I might pass out( faintness)

Question 2

Hypocalcemia

Answer 2

Causes of hypocalcemia (LOW CALCIUM)
L: low parathyroid 
O: oral intake (alcohol) 
W: wound drainage( especially GI) 
C: Celiac and Crohn's disease 
A: acute pancreatitis 
L: Low Vitamin D levels 
C: Chronic Kidney issue 
I: increase phosphorus level ( phosphorus and calcium go back and forth) 
U: using medications such as magnesium supplement, laxatives, loop diuretic,  calcium binder drugs 
M: mobility issue 

Signs and Symptoms ( CRAMPS)
C: confusion
R: reflexes hyperactive
A: arrhythmias ( prolonged QT interval and ST interval)
M: muscle spam in calves or feet (tetany, seizures)
Nursing interventions for Hypocalcemia
1. Safety ( prevent falls )
2. Administer IV calcium ( 10% Calcium gluconate)
3. If phosphorus level is high, give aluminum hydroxide antacids (TUMS)

Question 3

Hypercalcemia

Answer 3

Causes of Hypercalcemia:
Mnemonic ( High Cal)
H: hyperparathyroidism
I: increase intake of Calcium
G: glucocorticoid usage ( suppresses calcium absorption which leaves more calcium in the blood)
H: Hyperthyroidism
C: Calcium excretion decreases with Thiazides ( thiazides retents Calcium)
A: Adrenal insufficiency ( Addison’s Disease)
Lithium usage: ( affects the parathyroid and causes phosphate to decrease and calcium to increase)

SIGNS AND SYMPTOMS (WEAK)
W