Electrolyte Imbalances Flashcards
(12 cards)
HYPOKALEMIA:
HYPOKALEMIA:
Cardiovascular:
Thready, weak, irregular pulse.
Weak peripheral pulses.
Orthostatic hypotension.
Respiratory:
Shallow, ineffective respirations that results from profound weakness of the skeletal muscles of respiration.
Diminished breath sounds.
Neuromuscular: Anxiety, lethargy, confusion, coma. Skeletal muscle weakness, leg cramps. Loss of tactile discrimination. Paresthesias. Deep tendon hyporeflexia.
Gastrointestinal:
Decreased motility, hypoactive to absent bowel sounds.
Nausea, vomiting, constipation, abdominal distention.
Paralytic ileus.
Laboratory findings:
Serum potassium level lower than 3.5 mE/L.
Electrocardiogram changes: ST depression; shallow, flat, or inverted T wave; and prominent U wave.
HYPERKALEMIA:
HYPERKALEMIA:
Cardiovascular:
Slow, weak, irregular heart rate.
Decreased blood pressure.
Respiratory:
Profound weakness of the skeletal muscles leading to respiratory failure.
Neuromuscular:
Early: Muscle twitches, cramps, paresthesia (tingling, burning followed by numbness in hands/feet and around mouth).
Late: Profound weakness, ascending flaccid paralysis in arms/legs (trunk, head, and respiratory muscles become affected when the serum potassium level reaches a lethal level).
Gastrointestinal:
Increased motility, hyperactive bowel sounds.
Diarrhea.
Laboratory findings:
Serum potassium level that exceeds 5.0 mEq/L.
Electrocardiographic changes: Tall peaked T waves, flat P waves, widened QRS complexes, and prolonged PR intervals.
HYPONATREMIA:
HYPONATREMIA:
Cardiovascular:
Symptoms vary with changes in vascular volume.
Normovolemic- rapid pulse rat, normal BP.
Hypovolemic- thready, weak, rapid pulse rate; hypotension; flat neck veins; normal or low central venous pressure.
Hypervolemic- rapid, bounding pulse; blood pressure normal or elevated; normal or elevated central venous pressure.
Respiratory:
Shallow, ineffective respiratory movement is a late manifestation related to skeletal muscle weakness.
Neuromuscular:
Generalized skeletal muscle weakness that is worse in the extremities.
Diminished deep tendon reflexes.
Central Nervous System: Headache. Personality changes. Confusion. Seizures. Coma.
Gastrointestinal:
Increased motility and hyperactive bowel sounds.
Nausea.
Abdominal cramping and diarrhea.
Renal:
Increased urinary output.
Integumentary:
Dry mucous membranes.
Laboratory findings:
Serum sodium level less than 135 mEq/L.
Decreased urine specific gravity.
HYPERNATREMIA:
HYPERNATREMIA:
Cardiovascular:
Heart rate and BP respond to vascular volume status.
Respiratory:
Pulmonary edema if hypervolemia is present.
Neuromuscular:
Early- spontaneous muscle twitches; irregular muscle contractions.
Late- skeletal muscle weakness; deep tendon reflexes diminished or absent.
Central Nervous System:
Altered cerebral function is most common manifestation of hypernatremia.
Normovolemia or hypovolemia- agitation, confusion, seizures.
Hypervolemia- lethargy, stupor, coma.
Gastrointestinal:
Extreme thirst.
Renal:
Decreased urinary output.
Integumentary:
Dry, flushed skin.
Dry, sticky tongue and mucous membranes.
Presence or absence of edema, depending on fluid volume changes.
Laboratory findings:
Serum sodium level that exceeds 145 mEq/L.
Increased urine specific gravity.
HYPOCALCEMIA:
HYPOCALCEMIA:
Cardiovascular:
Decreased heart rate.
Hypotension.
Diminished peripheral pulses.
Respiratory:
Not directly affected; however respiratory failure or arrest can result from decreased respiratory movement because of muscle tetany or seizures.
Neuromuscular:
Irritable skeletal muscles- twitches, cramps, tetany, seizures.
Painful muscle spasms in the calf or foot during periods of inactivity.
Paresthesias (tingling/pricking, pins/needles) followed by numbness that may affect the lips, nose, and ears in addition to the limbs.
Positive Trousseau’s(BP cuff carpal spasms) and Chvostek’s(facial contraction in response to light tap of nerve in front of ear) signs.
Hyperactive deep tendon reflexes.
Anxiety, irritability.
Renal:
Urinary output various depending on the cause.
Gastrointestinal:
Increased gastric motility; hyperactive bowel sounds.
Cramping; diarrhea.
Laboratory findings:
Serum calcium level less than 9.0 mg/dL.
Electrocardiographic changes- prolonged ST interval,
prolonged QT interval.
HYPERCALCEMIA:
HYPERCALCEMIA:
Cardiovascular:
Increased heart rate in early phase; bradycardia that can lead to cardiac arrest in late phases.
Increased BP.
Bounding, full peripheral pulses.
Respiratory:
Ineffective respiratory movement as a result of profound skeletal muscle weakness.
Neuromuscular:
Profound muscle weakness.
Diminished or absent deep tendon reflexes.
Disorientation, lethargy, coma.
Renal:
Urinary output various depending on cause.
Gastrointestinal:
Decreased motility and hypoactive bowel sounds.
Anorexia, nausea, abdominal distention, constipation.
Laboratory findings:
Serum calcium exceeds 10.5 mg/dL.
Electrocardiographic changes- shortened ST segment,
widened T wave.
HYPOMAGNESEMIA:
HYPOMAGNESEMIA:
Cardiovascular:
Tachycardia.
Hypertension.
Respiratory:
Shallow respirations.
Neuromuscular: Twitches, paresthesias. Positive Trousseau's(BP inflated carpal spasm) and Chvostek's(facial muscle contraction from tapping on facial nerve in front of ear) signs. Hyperreflexia. Tetany, seizures.
Central Nervous System:
Irritability.
Confusion.
Laboratory findings:
Serum magnesium level less than 1.3 mEq/L.
Electrocardiographic changes- Tall T waves, depressed ST segments.
HYPERMAGNESEMIA:
HYPERMAGNESEMIA:
Cardiovascular:
Bradycardia, dysrhythmias.
Hypotension.
Respiratory:
Respiratory insufficiency when skeletal muscles or respiration are involved.
Neuromuscular:
Diminished or absent deep tendon reflexes.
Skeletal muscle weakness.
Central Nervous System:
Drowsiness and lethargy that lead to coma.
Laboratory findings:
Serum magnesium level that exceeds 2.1 mEq/L.
Electrocardiographic changes- prolonged PR interval,
widened QRS complexes.
Potassium containing foods:
Potassium containing foods (common): 3.5-5.0 mEq/L
Avocado, banana, cantaloupe, oranges, strawberries, tomatoes. Carrots, mushrooms, spinach. Fish, pork, beef, veal. Potatoes. Raisins.
Sodium containing foods:
Sodium containing foods (common): 135-145 mEq/L
Bacon, frankfurters, lunch meat. Butter, cheese. Canned food. Ketchup, mustard. Milk. Processed food. Snack foods. Soy sauce. Table salt.
Calcium containing foods:
Calcium containing foods (common): 9-10.5 mg/dL
Cheese. Collard greens. Kale. Milk and soy milk. Rhubarb. Sardines. Tofu. Yogurt.
Magnesium containing foods:
Magnesium containing foods (common): 1.3-2.1 mEq/L
Avocado. Canned white tuna. Cauliflower. Green leafy vegetables- spinach and broccoli. Milk. Oatmeal, wheat bran. Peanut butter, almonds. Peas. Pork, beef, chicken, soybeans. Potatoes. Raisins. Yogurt.
