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N230 exam 1 and 2 > Electrolyte Imbalances > Flashcards

Electrolyte Imbalances Flashcards

(45 cards)

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1
Q

***Sodium

A

135-145

Main electrolyte in ecf

Major role in ecf volume/distribution in the body

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2
Q

Sodium imbalances

A

Hyponatremia <135

Hypernatremia >145

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3
Q

***Potassium

A

3.5-5
Major icf electrolyte
Transmission of nerve impulses
Skeletal and cardiac muscle contractility

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4
Q

Potassium imbalances

A

Hypokalemia <3.5

Hyperkalemia >5

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5
Q

***Calcium

A

8.8-10.4

99% of calcium is stored in bones

The rest is bound to plasma proteins (albumin) or free/ionized (active form)

Transmits nerves impulses

Muscle contraction (skeletal and cardiac)

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6
Q

Calcium imbalances

A

Hypocalcemia <8.8

Hypercalcemia >10.4

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7
Q

***Magnesium

A

1.8-2.6

Regulates muscle contraction

Metabolizes carbs and proteins

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8
Q

Magnesium imbalances

A

Hypomagnesemia <1.8

Hypermagnesemia >2.6

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9
Q

***Phosphorous

A

2.7-4.5

Most phosphorus is in bones/teeth

Involved in acid/base balance, metabolism

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10
Q

Phosphate imbalances

A

Hypophosphatemia: <2.7

Hyperphosphatemia: >4.5

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11
Q

***Hyponatremia

A

Sodium loss (GI,Renal,skin)

Water gained (excessive hypotonic ivf, psych issues, tumors/endocrine diseases)

CHF

Exercise induced

Low sodium in bv= fluid leaves and goes to cell causing edema

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12
Q

Hyponatremia symptoms ***

A

Neuro changes :
Mild:
Irritability, headache
Severe:
Confusion, seizures
Vomiting
Coma
Fatal
Severe if less than 115

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13
Q

Hyponatremia tx ***

A

NO DIURETICS (bc itll get rid of sodium too)
Sodium replacement (SLOWLY) (
*PO or LR/0.9% NS
*more sever require hypertonic saline
Fluid restriction
Strict I/O
Daily weights
Seizure precautions (edema cause seizure risk)

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14
Q

Hypernatremia ***

A

Sodium gain
Water loss or low intake
Endocrine issues (uncontrolled DM)

Sodium is high in BV (ECF) eater moves into BV (shrinks cells)

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15
Q

Hypernatremia s/s ***

A

Thirst
Sticky mucous membranes
Elevated body temp
Restlessness, irritability
Seizures

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16
Q

Hypernatremia tx ***

A

Fluid replacement: depends on cause
Slow and steady

Usually isotonic, sometimes hypotonic

Monitor neurological status

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17
Q

High Na diet ***

A

Good for hyponatremia
Processed foods
Canned
Fast foods
Chips
Chees
Lunch meat

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18
Q

Low Na foods ***

A

Good for hypernatremia
Fruits
veggies
Freshmeats, fish
Oatmeal

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19
Q

Hypokalemia ***

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A

GI, Renal, Skin loss

Shift of potassium into cells
-high insulin levels
-alkalosis (ph imbalance)

20
Q

Hypokalemia s/s ***

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A

Muscle weakness
Decreased reflexes
Constipation, paralytic ileus
Weal/irregular pulse
Bradycardia

*pearl: increased risk for digoxin toxicity (it also slows down heart)

21
Q

Hypokalemia tx ***

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A

Oral replacement via diet or supplement

IV potassium if severe (but it could stop heart) (hard on veins could cause phlebitis)

Cautious replacement if kidney disease or decreased renal function

22
Q

IV Potassium ***

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A

Always dilute and must use a pump

NEVER IV push or bolus

Use largest peripheral site possible or central if available

Cardiac monitor pt

23
Q

Hyperkalemia ***

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A

Excess intake (salt substitutes, potassium in meds)

Shifts potassium out of cells because of destruction of cell membrane (burns, trauma, sepsis, intense exercise, acidosis)

Failure to eliminate extra potassium (renal disease)

24
Q

Hyperkalemia s/s ***

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A

Weakness
Flaccid paralysis
Abdominal cramps
Peaked T waves (heart getting irritable)
*can progress to cardiac arrest

25
Hyperkalemia tx ***
Obtain ECG Potassium restrictions/med changes (PO intake) May use kayexalate by mouth or enema Loop diuretics (kidney removal) *both too slow for severe IVP insulin with IVP dextrose solution then use other methods May require dialysis for removal
26
Why do you give IVP insulin and IVP dextrose for hyperkalemia? ***
Ivp insulin will push K into cells Dextrose prevents low glucose
27
Hyperkalemia interventions ***
Monitor I/O Monitor cardiac rhythm Apical pulse (bc of heart arrhythmias) Pt education diet
28
Hypocalcemia ***
Loss thru: Hypoparapthyroidism Chronic kidney disease Chronic alcohol abuse Diarrhea Get large amounts of citrated blood Med SEs
29
Hypocalcemia s/s ***
Increased nerve excitability tetany *tetany=constant muscle contractions Chvosteks sign=contraction of facial muscles in response to tap over facial nerve Trousseaus sign=carpal spams when BP cuff inflated above systolic pressure CATS: Convulsion, Arrhythmias, Tetany, Stridor and spasms
30
Hypocalcemia tx ***
Mild: PO calcium/ vit d Symptomatic: IV calcium gluconate Cardiac monitor (can cause hypotension), and seizure precautions
31
Hypercalcemia ***
Hyperparathyroidism PTH moves calcium into plasma Cancers Dietary intake Rare: prolonged immobilization
32
Hypercalcemia s/s ***
BACKME: Bone pain Arrhythmia Cardiac Arrest Kidney stones Muscle weakness Excessive urination
33
Hypercalcemia interventions ***
Mild: decrease intake of calcium Severe: Isotonic IVF to dilute it Bisphosphonate(causes bone absorption of calcium moves from plasma) *gold standard, 2-4 days for max effect HD if life threatening
34
Hypomagnesemia ***
GI loss Chronic ETOH Long term PPI use
35
Hypomagnesemia s/s ***
Muscle cramps Hyperactive DTR Arrhythmia (tachycardia) Tremors, seizures, confusion
36
Hypomagnesemia management ***
Oral replacement Iv replacement with: magnesium sulfate *must use pump, rapid administration can cause hypotension and cardia/resp arrest
37
Hypermagnesemia ***
Renal failure IV magnesium use Antiacids Laxatives
38
Hypermagnesemia S/S ***
Initial: Hypertension Facial flushing Lethargy Urinary retention As levels increase: Loss of DTR Muscle paralysis Coma
39
Hypermagnesemia management ***
Decrease po intake Po fluids/diuretics HD IV calcium gluconate (cardio protective) *prevents heart from freaking out while removing magnesium
40
Hypophosphatemia***
Malabsorption Chronic diarrhea Chronic ETOH CKD
41
Hypophosphatemia s/s ***
Mild to moderate often asymptomatic Severe: CNS depression, resp/heart failure, muscle weakness Chronic will cause osteomalacia/rickets
42
Hypophosphatemia management ***
Mild: oral replacement Severe: IV phosphate replacement *any electrolyte replacement needs cardiac monitoring
43
Hyperphosphatemia***
Renal failure Excess intake (laxatives/enemas) Rhabdomyolysis Hypoparathyroidism
44
Hyperphosphatemia s/s ***
May be asymptomatic If calcium binds to ectra phosphate in blood=s/s of HYPOCALCEMIA Long term can cause calcified deposits in soft tissue
45
Hyperphosphatemia management ***
Phosphate binders (calcium carbonate) HD Can be chronic in pt with renal failur, managed by nephrologist

N230 exam 1 and 2 (11 decks)

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