Electrolyte Imbalances

Question 1

What are examples of Isotonic fluids

Answer 1

0.9% NaCL, NS, LR, D5W

Question 2

What are examples of hypotonic fluids?

Answer 2

0.45% NaCL, 0.33% NaCL, 0.2% NaCl

Question 3

What are examples of hypertonic fluids

Answer 3

3% NaCl, 5% NaCl

Question 4

What are s/s of fluid volume overload

Answer 4

Tachycardia, bounding pulse, hypertensions, tachypnea, weakness, altered LOC, seizures, crackles, cough

Question 5

What are s/s of fluid volume deficit

Answer 5

Hypothermia, tachycardia, threads pulse, hypotension/ orthostatics, dizziness, syncope, confusion, n/v, wt loss, oliguria

Question 6

What are Normal ranges of Urine specific gravity? What does high/ low mean?

Answer 6

1.010-1.025
High= dehydration
Low= FVE

Question 7

What are Normal ranges of BUN? What does high/ low mean?

Answer 7

10-20 mEq/dL
High = dehydration
Low= FVE

Question 8

What are Normal ranges of Creatinine? What does high/ low mean?

Answer 8

0.7-1.4 mg/dl
High = dehydration
Low= FVE

Question 9

What are Normal ranges of hematocrit? What does high/ low mean?

Answer 9

42-52% Males
35-47% Females
High= dehydration
Low= FVE

Question 10

S/s of hypernatremia

Answer 10

Thirst, tachycardia, restlessness, muscle twitching, irritability, seizures, coma, thirst, dry mucous membranes, n/v

Question 11

How to treat hypernatremia

Answer 11

Isotonic fluids/ hypotonic fluids
Na restrictions, diuretics
Daily wt, seizure precautions

Question 12

Sodium Levels

Answer 12

135-145

Question 13

S/s of hyponatermia

Answer 13

Hypothermia, tachycardia, rapid threads pulse, orthostatic hypotension, headache, confusion, lethargy, muscle weakness, fatigue, decreased DTR, seizures, hyperactive bowel sounds nausea

Question 14

How to treat hyponatremia

Answer 14

Isotonic fluids, hypertonic fluids, Na diet,
Monitor i/o, LOC

Question 15

Hyponatremia lab values

Answer 15

135-145

Question 16

S/s of hyperkalemia

Answer 16

Slow irregular pulse, hypotension, restlessness, irritability, weakness, parenthesis, v fib, peaked t waves, widened QRS, hyperactive bowel sounds

Question 17

How to treat hyperkalemia

Answer 17

1. Protect (Ca+)
2. Hide (dextrose + insulin)
3. Excrete (diuretic or Kayexalate)

Question 18

Potassium lab values

Answer 18

3.5-5

Question 19

Hypokalemia s/s

Answer 19

Decreased BP, threads pulse, orthostatic hypertention, altered mental status, confusion, coma, hypoactive bowel sounds, n/v, constipation, weakness, shallow breathing

Question 20

How does hypokalemia affect EKG changes?

Answer 20

Flattened T waves, prominent u wave, st depression

Question 21

What is the cause of hypokalemia

Answer 21

Excessive use of diuretics

Question 22

S/s hypocalcemia

Answer 22

Chvosteks, trousseau, seizures, parenthesis

Question 23

What is chvosteks/ trousseaus sign

Answer 23

C- facial twitching by tapping of face
T- muscle twitching by BP cuff inflation

Question 24

How to treat hypocalcemia

Answer 24

IV supplements, calcium rich foods

Question 25

Causes of metabolic acidosis

Answer 25

DKA, kidney failure, diarrhea

Question 26

What does ABG look like for metabolic acidosis?

Answer 26

Low PH 35-45 Low Hc03

Question 27

Causes of metabolic alkalosis

Answer 27

Vomiting or NG suction

Question 28

What does an ABG look like for metabolic alkalosis

Answer 28

High ph 35-45 High Hc03

Question 29

How to treat metabolic acidosis

Answer 29

Treat underlying cause (Diarrhea- give antidiarrheal, rehydration DKA- administer insulin)

Question 30

How to treat metabolic alkalosis

Answer 30

Treat underlying cause (Vomiting- administer fluids, electrolyte replacement, antiemetics)

Question 31

Causes of respiratory acidosis

Answer 31

COPD, sleep apnea, pneumonia, narcotic overdose, flu, covid etc

Question 32

What does an ABG look like for respiratory acidosis?

Answer 32

Low ph High pac02 21-28 hc03

Question 33

How to treat respiratory acidosis?

Answer 33

Oxygen therapy, maintain patent airway, bronchodilators etc

Question 34

Causes of Respiratory Alkalosis

Answer 34

Hyperventilation or panic attack

Question 35

What does an ABG look like for respiratory alkalosis

Answer 35

High ph Low pac02 21-28 Hc03

Question 36

How to treat respiratory alkalosis

Answer 36

Breathing techniques, oxygen therapy, anxiety reduction interventions

Question 37

Calcium lab values

Answer 37

9-11