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Flashcards in chronic exam 1-electrolyte imbalance Deck (39):
1

etiology/risk factors for electrolyte imbalance

Decreased intake and availability or increase loss of an electrolyte
Increase intake and retention or decreased excretion of an electrolyte

2

diagnosis of imbalance

Through plasma levels in lab studies
Through clinical manifestations (signs and symptoms)

3

hyponatremia

sodium

4

etiology/risk factors for hyponatremia

Results from loss of sodium containing fluids (vomiting, diarrhea, diuretics)
Or excess fluids

5

clinical manifestations hyponatremia

confusion
nausea
seizures
coma

6

nursing diagnosis: hyponatremia

risk for injury
potential complication

7

nursing management: hyponatremia

for water excess causation: fluid restriction
Severe symptoms (seizures): give a small amount of IV hypertonic saline solution (3-5% NaCl)
treat underlying cause

8

hypernatremia

Na+ >145 mEq/L

9

pathophysiology: hypernatremia

Fluid shift causing cellular dehydration
B. Increase myocardial depolarization (increased excitability of heart muscle)

10

clinical manifestations: hypernatremia

thirst
Dry flushed skin
Dry tongue and mucous membranes
Polyuria, anorexia, weakness, and restlessness
cramping
_________

Agitation, confusion, lethargy
Seizures, coma
Tremors, muscle twitching, rigid paralysis
ataxia

11

nursing diagnosis:hypernatremia

potential complication, seizures and coma leading to irreversible brain damage

12

nursing management: hypernatremia

If oral fluids cannot be ingested, IV solution of 5% dextrose in water or hypotonic saline (0.45)
Diuretics

13

Hypokalemia

K+

14

etiology/risk factors: hypokalemia

Low serum potassium caused by metabolic acidosis, abnormal losses of K+ via the kidneys or GI tract (Vomiting, Diarrhea, Diuretics)
i. K+ sparing (conserve K+)
ii. Thiazide (hydrochlorothiazide HCTZ)
iii. Loop diuretics (strongest, Lasix (furosemide))
Metabolic alkalosis

15

clinical manifestations: hypokalemia

most serious are cardiac
Lose nervous impulse
• Skeletal muscle weakness
• Weakness of respiratory muscles
• Decreased GI motility

16

nursing diagnosis: hypokalemia

risk for injury
potential complications: dysrhythmias

17

nursing management: hypokalemia

KCL Supplements orally (Give with food or diluted (PO/IV) to minimize venous or gastric irritation)
KCL Supplements IV (Should not exceed 10 to 20 mEq/hr to prevent hyperkalemia and cardiac arrest)

18

hyperkalemia

K+ > 5.0 mEq/L

19

etiology/causes: hyperkalemia

Massive intake
Impaired renal excretion
Shift from ICF to ECF
Common in massive cell destruction (Burn, crush injury, or tumor lysis)

20

clinical manifestations: hyperkalemia

Weak or paralyzed skeletal muscles
Ventricular fibrillation or cardiac standstill
Abdominal cramping or diarrhea

21

nursing diagnosis: hyperkalemia

dysrhythmias

22

nursing management: hyperkalemia

Eliminate oral and parenteral K+ intake
Increase elimination of K+ (diuretics, dialysis, Kayexalate oral or as enema)

23

hypocalcemia

Ca++

24

etiology: hypocalcemia

Decreased production of PTH
Acute pancreatitis
Multiple blood transfusions
Alkalosis
Decreased intake

25

clinical manifestations: hypocalcemia

Positive Trousseau’s or Chvostek’s sign
Laryngeal stridor
Dysphagia
Tingling around the mouth or in the extremities (paresthesias)

26

nursing diagnosis: hypocalcemia

Potential complication: fracture or respiratory arrest, bleeding, tetany

27

nursing management: hypocalcemia

Treat underlying cause
Oral or IV calcium supplements (Not IM to avoid local reactions)
Treat pain and anxiety to prevent hyperventilation-induced respiratory

28

hypercalcemia

Ca++ >10.5-11 mg/dL

29

etiology: hypercalcemia

Hyperparathyroidism (2/3 of cases)
Malignancy of the bone
Vitamin D overdose (helps absorb calcium in the intestine)
Prolonged immobilization

30

clinical manifestations: hypercalcemia

Urinary (Polyuria r/t osmotic diuresis)
GI (Anorexia, constipation, abdominal distention0
Neuromuscular (Fatigue, depression, muscle weakness)

31

nursing diagnosis: hypercalcemia

dysrhythmias

32

nursing management: hypercalcemia

Excretion of C2+ with loop diuretic
Hydration with isotonic saline infusion
Synthetic calcitonin
Mobilization/Weight-bearing activity

33

phosphate

Lab value (normal) 2.5-4.5mg/dl
Primary anion in ICF
Essential to function of muscle, red blood cells, and nervous system
Deposited with calcium for bone and tooth structure
Inversely related to calcium
Inverse relationship to K+

34

hypomagnesemia

Mg++

35

clinical manifestations:

Confusion
Hyperactive deep tendon reflexes
Tremors
Seizures
Cardiac dysrhythmias

36

nursing management: hypomagnesemia

Oral supplements
Increase dietary intake
Parenteral IV or IM magnesium when severe

37

hypermagnesemia

mg++ >2.5 mEq/L or 3mg/dL

38

etiology: hypermagnesemia

Increased intake or ingestion of products containing magnesium when renal insufficiency or failure is present

39

clinical manifestations:

Lethargy or drowsiness
Nausea/vomiting
Impaired reflexes
Respiratory and cardiac arrest