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Nursing > Ch. 40 Electrolytes > Flashcards

Ch. 40 Electrolytes Flashcards

1
Q

What are the names of the major electrolytes?

Hint: there are 7

A 
Sodium
Potassium
Calcium
Magnesium
Chloride
Bicarbonate
Phosphate
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2
Q

Main function of sodium?

A

controls of body fluids

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3
Q

Main function of potassium?

A

cellular enzyme activity and water content and cardiac rhythm

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4
Q

Main function of calcium?

A

Nerve impulse, blood clotting, muscle contraction

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5
Q

Main function of magnesium?

A

metabolism of carbohydrates and proteins, vital actions involving enzymes. aids in dilating arteries and facilitating circulation, may prevent calcification of vessels, lowers total cholesterol, raises HDL cholesterol, inhibits platelet aggregation

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6
Q

Main function of chloride?

A

maintains osmotic pressure in blood, produces hydrochloric acid

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7
Q

Main function of bicarbonate?

A

body’s primary buffer system

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8
Q

Main function of phosphate?

A

cell division, hereditary traits

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9
Q

What is the normal range for sodium?

A

135-145 mEq/L

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10
Q

What is the normal range for potassium?

A

3.5-5 mEq/L

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11
Q

What is the normal range for calcium?

A

8.6-10.2 mg/dL

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12
Q

What is the normal range for magnesium?

A

1.5-2.5

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13
Q

What is the normal range for bicarbonate?

A

22-26

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14
Q

What is the normal range for phosphate?

A

2.5-4.5

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15
Q

Hypovolemia stands for ____ ____ ____
What symptoms can a patient experience if they have hypovolemia?
List 3-5 symptoms

A

Fluid Volume Deficit

dry mucous membranes
urine output <30mL/hr
postural hypotension
weak, rapid pulse
increased urine specific gravity
Sunken eyes
flat neck veins
poor skin and tongue turgor
thirst
weight loss over short period
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16
Q

What can cause hypovolemia? Risk factors

A

GI: Vomiting, diarrhea,
Hemorrhage
Excessive sweating
burns, draining wounds

Excessive laxative or diuretic use
Polyuria

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17
Q

What are nursing interventions/assessments that are to be done with a patient with hypovolemia?

A

Assess for presence or worsening of FVD.
Administer oral fluids if indicated.
If patient unable to eat and drink, anticipate TPN or tube feedings to be ordered.
Monitor patient’s response to fluid intake, either oral or parenteral.
Be alert for signs of fluid overload.
Provide appropriate skin care

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18
Q

Hypervolemia stands for ____ ___ _____
What symptoms/sign can you experience with hypervolemia?
list 3-5 symptoms/signs

A 
Weight gain over short period
Peripheral edema (may be pitting)
Increased BP
Shortness of breath
Crackles and wheezes in lungs
Full, bounding pulse
Neck vein distention

Pulmonary edema
↓Urine specific gravity

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19
Q

What can cause hypervolemia? risk factors

A

Compromised regulatory mechanisms: renal failure, CHF,
Excess IV fluids with sodium
Corticosteroid therapy
Excessive ingestion of sodium-containing substances in diet or sodium-containing medications

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20
Q

Nursing interventions or assessment that can be done for a patient with hypervolemia

A

Assess for presence or worsening of FVE.
Encourage adherence to sodium-restricted and fluid-restricted diet, if ordered.

Encourage rest periods.
Monitor patient’s response to diuretics.
Teach self-monitoring of weight and intake and output.
Attentive skin care.
Monitor respiratory status
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21
Q

T/F hyponatremia is due to increased amounts of sodium

A

FALSE. Due to loss of sodium

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22
Q

What are symptoms of hyponatremia? List 3-5

A 
Anorexia
Nausea and vomiting
Lethargy
Confusion
Muscle cramps
Muscular twitching
Seizures
Coma
Serum Na below 135 mEq/L
Urine specific gravity <1.010
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23
Q

What can cause hyponatremia? risk factors

A 
Loss of sodium, as in:
 Loss of GI fluids
 Use of diuretics
  Water intoxication
Disease states associated with SIADH (a form of hyponatremia)

SIADH- Syndrome of Inappropriate Antidirurectic Hormone

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24
Q

Which patient is likely to be experiencing dehydration? Hypovolemia or hypervolemia?

A

Hypovolemia

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25
Q

Nursing interventions/assessments for hyponatremia?

A

Monitor fluid losses and gains.
Monitor for the presence of GI and CNS symptoms.
Monitor serum Na levels.
Check urine-specific gravity.
If able to eat, encourage foods and fluids with high sodium content.
Be aware of sodium content of common IV fluids.
Avoid giving large water supplements to patients receiving isotonic tube feedings.
Take seizure precautions when hyponatremia is severe.

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26
Q

What are symptoms of hypernatremia? list 3-5

A 
Thirst
Elevated body temperature
Tongue dry and swollen, sticky mucous membranes
Severe hypernatremia
 Disorientation
 Hallucinations
 Lethargy when undisturbed
 Irritable and hyperactive
 Focal or grand mal seizures
 Coma
Serum Na above 145 mEq/L
Urine specific gravity >1.015
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27
Q

What can cause hypernatremia? risk factors

A

Water deprivation
Increased sensible and insensible water loss
Ingestion of large amount of salt
Excessive parenteral administration of sodium-containing solutions
Profuse sweating
Diabetes insipidus

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28
Q

Nursing interventions/assessments for Hypernatremia

A

Monitor fluid losses and gains.
Observe for excessive intake of high sodium foods.
Monitor sodium content of prescriptions and OTC drugs.
Monitor for changes in behavior such as restlessness, lethargy, and disorientation.
Look for excessive thirst and elevated body temperature.
Monitor serum Na levels.
Check urine specific gravity.
Give sufficient water with tube feedings to

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29
Q 
Fatigue
Anorexia, nausea, and vomiting
Muscle weakness
Decreased bowel motility
Cardiac arrhythmias
Increased sensitivity to digitalis
Serum K below 3.5 mEq/L
ECG changes
Paresthesias or tender muscles

These are all symptoms of which electrolyte imbalance?

A

Hypokalemia

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30
Q

Diarrhea
Vomiting or gastric suction
Potassium-wasting diuretics
Steroid administration and certain antibiotics
Poor intake as in anorexia nervosa, alcoholism, potassium-free parenteral fluids
Polyuria

These are all causes/risk factors that can cause which electrolyte imbalance?

A

Hypokalemia

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31
Q

Nursing interventions/assessments for hypokalemia

A

Monitor for occurrence of hypokalemia.
Assess digitalized patients at risk for hypokalemia, which potentiates the action of digitalis
Prevent hypokalemia by:
Encouraging extra K intake if possible
Educating about abuse of laxatives and diuretics
Administer oral K supplements if ordered.
Be knowledgeable about danger of IV potassium administration.

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32
Q

Cardiac arrhythmias
Paresthesias of face, tongue, feet, and hands
Flaccid muscle paralysis
GI symptoms such as nausea, intermittent intestinal colic, or diarrhea may occur
Serum K >5.0 mEq/L

These are symptoms of which electrolyte imbalance?

A

Hyperkalemia

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33
Q 
Decreased potassium excretion
Oliguric renal failure
Potassium-sparing diuretics
Hypoaldosteronism
High potassium intake

These are causes/risk factors for which electrolyte imbalance/

A

Hyperkalemia

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34
Q

Nursing interventions/assessments for Hyperkalemia

A

Monitor for hyperkalemia, which is life threatening.
Prevent hyperkalemia by:
Following rules for safe administration of K
Avoiding giving patients with renal insufficiency K-saving diuretics, K supplements, or salt substitutes
Cautioning about foods high in potassium content

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35
Q 
Trousseau and Chvostek signs
Numbness and tingling of fingers and toes
Mental changes
Seizures
Spasm of laryngeal muscles
ECG changes
Cramps in muscles of extremities
Total serum calcium <8.6 mg/dL

These are symptoms of which electrolyte imbalance?

A

Hypocalcemia

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36
Q 
Surgical hypoparathyroidism
Malabsorption
Vitamin D deficiency
Acute pancreatitis
Excessive administration of citrated blood

These are causes/risk factors for which electrolyte imbalance?

A

Hypocalcemia

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37
Q

Nursing interventions/assessments for hypocalcemia

A

Take seizure precautions when hypocalcemia is severe.
Monitor condition of airway.
Take safety precautions if confusion is present.
Educate people at risk for osteoporosis about the need for dietary calcium intake.
Discuss calcium-losing aspects of nicotine and alcohol use.

38
Q

What symptoms for hypercalcemia?

A 
Muscular weakness
Tiredness, lethargy
Constipation
Anorexia, nausea, and vomiting
Decreased memory and attention span
Polyuria and polydipsia
Renal stones
Neurotic behavior
Cardiac arrest
Serum calcium >10.5 mg/dL
39
Q

What are causes for hypercalcemia? risk factors

A

Hyperparathyroidism
Prolonged immobilization
Large doses of vitamin D
Overuse of calcium supplements

40
Q

Increase mobilization when feasible.
Encourage sufficient oral intake.
Discourage excessive consumption of milk products.
Encourage bulk in the diet.
Take safety precautions if confusion is present.
Be alert for signs of digitalis toxicity
Force fluids to prevent formation of renal stones.

These are nursing interventions/assessments you would do as a nurse for which electrolyte imbalance?

A

Hypercalcemia

41
Q

What are symptoms of hypomagnesemia?

A 
Cardiac manifestations
Tachyarrhythmias
Increased susceptibility to digitalis toxicity
Mental changes
Disorientation
Mood changes
Serum magnesium <1.3 mEq/L
42
Q

What are causes for hypomagnesemia? risk factors

A 
Chronic alcoholism
Intestinal malabsorption
Diarrhea
Drugs
Thiazide diuretics
Aminoglycoside antibiotics
43
Q

Assess for magnesium deficit because it predisposes patient to digitalis toxicity.
Take seizure precautions if necessary.
Monitor condition of airway because laryngeal stridor can occur.
Educate the patient if abuse of diuretics or laxatives is a problem.
Educate about intake of foods rich in magnesium

These are nursing interventions/assessments done as a nurse for which electrolyte imbalance?

A

Hypomagnesemia

44
Q

Renal failure
Adrenal insufficiency
Excessive magnesium administration during treatment of eclampsia
Hemodialysis with hard water or dialysate high in magnesium content

these are causes/risk factors for which electrolyte imbalance?
Hypomagnesemia
Hypermagnesemia
Hypovolemia
Hyperkalemia
A

Hypermagnesemia

45
Q

What symptoms of hypermagnesemia?

A

Early sign is serum magnesium level of 3–5 mEq/L
Flushing and sense of skin warmth
Hypotension
Depressed respirations
Drowsiness, hypoactive reflexes, and muscular weakness
Cardiac abnormalities

46
Q

If _______is present, be alert for low BP and shallow respirations, lethargy, drowsiness, and coma.
Do not give magnesium-containing medications to patient with renal failure or compromised renal function.
Be cautious of OTC drugs.
Check deep tendon reflexes frequently.

These are nursing interventions/assessment for which electrolyte imbalance?

A

Hypermagnesemia

47
Q 
Cardiomyopathy
Acute respiratory failure
Seizures
Decreased tissue oxygenation
Joint stiffness
Serum phosphate <2.5 mg/dL

These are symptoms of which electrolyte imbalance?

A

Hypophosphatemia

48
Q

Parenteral nutrition
Alcohol withdrawal
Diabetic ketoacidosis
Respiratory alkalosis

These are risk factors/causes for which electrolyte imbalance?

A

Hypophosphatemia

49
Q

Nursing interventions/assessments for hypophosphatemia

A

Be aware that severely hypophosphatemia patients are at greater risk for infection.
Administer IV phosphate products cautiously.
Introduce parenteral nutrition cautiously in patients who are malnourished.
Monitor for diarrhea when taking oral supplements.
Sudden increase in serum phosphate level can cause hypocalcemia.

50
Q

Hyperphosphatemia can cause what type of symptoms?

list 3-5

A

Short-term consequences:
Symptoms of tetany, such as tingling of the fingertips and around the mouth, numbness, and muscle spasms
Serum phosphate >4.5 mg/dL

51
Q

What are causes for hyperphosphatemia? riskf actors

A

Large intake of milk
Excessive intake of phosphate-containing laxatives (Fleet phosphosoda)
Large vitamin D intake
Hyperthyroidism

52
Q

What are nursing interventions/assessments as a nurse for patients with hyperphosphatemia?

A

Monitor for signs of tetany.
Be aware that soft tissue calcification can be a long-term complication of chronically elevated serum phosphate levels.
Instruct patients that use of phosphate-containing laxatives can result in hyperphosphatemia.
Avoid foods high in phosphorus content.

53
Q

Respiratory acidosis occurs when there is a primary excess/deficit of carbonic acid/bicarbonate in ECF

“circle” your answer

A

Respiratory acidosis occurs when there is a primary excess of carbonic acid in ECF

54
Q

Respiratory alkalosis occurs when there is a primary excess/deficit of carbonic acid/bicarbonate in ECF

“circle” your answer

A

Respiratory alkalosis occurs when there is a primary deficit of carbonic acid in ECF

55
Q

Metabolic acidosis occurs when there is a proportionate excess/deficit of carbonic acid/bicarbonate in ECF

“circle” your answer

A

Metabolic acidosis occurs when there is a proportionate deficit of bicarbonate in ECF

56
Q

Metabolic alkalosis occurs when there is a primary excess/deficit of carbonic acid/bicarbonate in ECF

“circle” your answer

A

Metabolic alkalosis occurs when there is a primary excess of bicarbonate in ECF

57
Q

What is a normal pH range?

  1. 45-7.55
  2. 35-7.40
  3. 35-7.45
  4. 25-7.35
A

Normal: 7.35-7.45

58
Q

T/F anything below 7.35 is a base and anything above 7.45 is acidic for pH?

A

FALSE

anything below 7.35 is ACIDIC and anything above 7.45 is BASE

59
Q

What is a normal range for PaCO2 (mm Hg) ?
(partial pressure of carbon dioxide)

35-45
30-40
32-42
25-35

A

35-45- Normal

60
Q

What is considered acidic and base for PaCO2

A

Acidic: >45
Base: <35

61
Q

What is a normal range for HCO3 (mEq/L) ?
(hydrogen carbonate)

20-30
25-35
22-32
22-26

A

22-26

62
Q

T/F an acidic hydrogen carbonate (HCO3) is anything less than 22 mEq/L

A

TRUE

63
Q

What is a base for HCO3?

A

> 26

64
Q 
FIB:
Respiratory acidosis has a
\_\_\_\_\_\_ pH
\_\_\_\_\_\_ PaCO2
\_\_\_\_\_\_ HCO3

hint: think of what increases, what decreases, and what stays in the normal range

A

Decreased pH (<7.35)
Increased PaCO2
Normal HCO3

65
Q 
FIB:
Respiratory alkalosis is
\_\_\_\_\_ HCO3
\_\_\_\_\_ pH
\_\_\_\_\_ PaCO2

hint: think of what increases, what decreases, and what stays in the normal range

A

Normal HCO3
Increased pH (>7.45)
Decreased PaCO2

66
Q

Which acid-based imbalance has a decreased pH level, decreased HCO3 level, and normal PaCO2 level ?

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis

A

Metabolic acidosis

67
Q

Which acid-based imbalance has an increased pH, increased HCO3, and normal PaCO2?

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis

A

Metabolic alkalosis

68
Q

pH: 7.42
PaCO2: 38 mm Hg
HCO3: 24 mEq/L

This is an example of ?

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
This is a normal acid-base balance
A

This is a normal acid-base balance

69
Q

pH: 7.34
PaCO2: 43 mm Hg
HCO3: 21 mEq/L

This is an example of ?

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
This is a normal acid-base balance
A

Metabolic acidosis

70
Q

pH: 7.47
PaCO2: 32 mm Hg
HCO3: 24 mEq/ L

This is an example of ?

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
This is a normal acid-base balance
A

Respiratory alkalosis

71
Q

pH: 7.33
PaCO2: 47 mm Hg
HCO3: 25 mEq/L

This is an example of ?

Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
This is a normal acid-base balance
A

Respiratory acidosis

72
Q

When a patient is on fluid restrictions, how many cups of fluid TOTAL can they receive in a day?

2
4
6
8

A

4 cups total

73
Q

T/F You cannot give patients salty foods or high in sugar snacks when on fluid restrictions?

A

TRUE

74
Q

What are foods that are recommended to patients who are hypovolemic?

A

Foods with high water content
citrus fruit
melons
celery

75
Q

What are foods recommended to patients who are hypokalemic?

A

Increase foods with high potassium

bananas, citrus fruits, apricots, melons, broccoli, potatoes, raisins, lima beans

76
Q

What foods are recommended to avoid for hypernatremia patients?

A

avoid foods high in sodium
processed cheese, lunch meats, canned soups and vegetables, salted snack foods
also eliminate table salt

77
Q

Leading food sources: fruits and vegetables, dried peas and beans, whole grains, milk, meats

are an example of where which electrolyte can be found?

A

Potassium

78
Q

Sources include milk and milk products; dried beans; green, leafy vegetables; small fish with bones; and dried peas and beans

are an example of where which electrolyte can be found?

A

Calcium

79
Q

Sources include green, leafy vegetables; nuts; seafood; whole grains; dried peas and beans; cocoa

are an example of where which electrolyte can be found?

A

Magnesium

80
Q

Almost all ______ in the diet comes from salt

Found in foods high in sodium, processed foods

A

chloride

81
Q

Sources include all animal products (meat, poultry, eggs, milk, bread, ready-to-eat cereal)

for which electrolyte?

A

Phosphate

82
Q

What are assessments/symptoms you can see in a patient who has a respiratory acidosis disturbance?

A 
Acute respiratory acidosis
Mental cloudiness
Dizziness
Muscular twitching
Unconsciousness
ABGs
pH <7.35
PaCO2 >45 mm Hg (primary)
HCO3− normal or only slightly elevated
Chronic respiratory acidosis
Weakness
Dull headache
ABGs
pH <7.35 or low N
PaCO2 >45 mm Hg (primary)
HCO3− >26 mEq/L (compensatory)
83
Q

What are assessments/symptoms you can see in a patient who has a respiratory alkalosis disturbance?

A

Lightheadedness

Inability to concentrate

Hyperventilation syndrome

Tinnitus

Palpitations

Sweating

Dry mouth

Tremulousness

Convulsions and loss of consciousness

ABGs

pH >7.45

PaCO2 <35 mm Hg (primary)

HCO3− <22 mEq/L (compensatory)

84
Q

What are assessments/symptoms you can see in a patient who has a metabolic acidosis disturbance?

A

Headache

Confusion

Drowsiness

Increased respiratory rate and depth

Nausea and vomiting

Peripheral vasodilation

ABGs

pH <7.35

HCO3− <22 mEq/L (primary)

PaCO2 <35 mm Hg

Hyperkalemia frequently present

85
Q

What are assessments/symptoms you can see in a patient who has a metabolic alkalosis disturbance?

A

Dizziness

Tingling of fingers and toes

Hypertonic muscles

Depressed respirations (compensatory)

ABGs

pH >7.45

HCO3− >26 mEq/L (primary)

PaCO2 >45 mm Hg (compensatory)

Hypokalemia may be present

86
Q

What percentage of NaCl (normal saline) would you give for isotonic solutions?

A

0.9 % NaCl (normal saline)

87
Q

What percentage of NaCl (normal saline) would you give for hypotonic solutions?

A
  1. 33 % NaCl (1/3- strength of normal saline)

0. 45 % (1/2- strength of normal saline)

88
Q

What percentage of NaCl (normal saline)/ dextrose would you give for hypertonic solutions?

A

5% dextrose in Lactated Ringer’s solution

5% dextrose in 0.9 % NaCl

89
Q

What are the major cations in body fluid?

A

sodium, potassium, calcium, hydrogen, and magnesium.

90
Q

What are the major anions in body fluid?

A

chloride, bicarbonate, and phosphate.

Nursing (7 decks)

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