Electrolyte Review Flashcards

(63 cards)

1
Q

Sodium

-Normal Levels

A

135-145 mEq/L

Most abundant electrolyte in ECF

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2
Q

Potassium (K+)

-Normal Value

A

3.5-5 mEq/L

Major Cation in ICF

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3
Q

Calcium

-Normal Value

A

8.5-10.5 mg/dL

Most abundant mineral in the body

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4
Q

Magnesium

-Normal Value

A

1.8-2.5 mEq/dL

2nd most abundant cation in ICF

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5
Q

Phosphorus

-Normal Value

A

2.5-4.5 mg/dL

Most abundant anion in ICF

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6
Q

Sodium

-Overview

A
  1. Most abundant electrolyte in ECF
  2. Regulates neuromuscular impulses in the nerve and muscle fibers
  3. Controlled by renal reabsorption and excretion
    - ADH, RAAS, ANF
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7
Q

Sodium

-Dietary Sources

A
  1. Table salt
  2. Processed or cured meat
  3. Packaged foods
  4. Seafood
  5. Cheese
  6. Junk food
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8
Q

Hyponatremia

-Causes

A
  1. Diaphoresis
  2. Wound drainage
  3. Diuretic use
  4. Inappropriate ADH secretion
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9
Q

Hyponatremia

-Manifestations

A
  1. Muscle weakness
  2. Spasm, twitching
  3. Decreased deep tendon reflexes
  4. LETHARGY
  5. N/V/ anorexia
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10
Q

Hyponatremia

-Treatment

A
  1. Treat Cause

2. IV fluids -hypertonic or isotonic

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11
Q

Hyponatremia

-Nursing Interventions

A
  1. Monitor I&0 / DAILY WEIGHT
  2. Fluid Restriction
  3. Increase dietary intake
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12
Q

Hypernatremia

-Causes

A
  1. Increase in sodium intake

2. Excess loss of water or inadequate intake of water

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13
Q

Hypernatremia

-Manifestations

A
  1. Irritability, Restlessness

2. Confusion, agitation

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14
Q

Hypernatremia

-Treatment

A
  1. Treat Cause
  2. IV fluids for dehydration
  3. Correct fluid imbalance carefully
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15
Q

Hypernatremia

-Nursing Interventions

A
  1. Monitor Vital signs
  2. Daily weight
  3. Monitor edema
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16
Q

Potassium

-Overview

A
  1. Major Cation in the ICF
  2. Important for nerve-cell comm and initiation of muscle contraction (especially in the heart)
  3. Controlled by kidneys
    - Aldosterone (promotes excretion)
    - Insulin (moves K+ into the cells)
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17
Q

Potassium

-Dietary Sources

A
  1. Bananas
  2. Cantaloupe
  3. Green leafy veggies
  4. Potatoes
  5. Avocados
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18
Q

Hypokalemia

-Causes

A
  1. Diuretics
  2. N/Diarrhea
  3. Nasogastric Suction
  4. Decreased intake
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19
Q

Hypokalemia

-Manifestations

A
  1. Cardiac arrhythmias (orthostatic hypotension)
  2. Decreased bowel motility
  3. Shallow ineffective respirations
  4. Decreased deep tendon reflexes
  5. Frequent urination
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20
Q

Hypokalemia

-Treatment

A
  1. K+ supplements
    - Take w/ food to minimize GI side effects
  2. IV potassium
    - DILUTE it
    - Max rate of 10 mEq/hr
    - can cause BURNING sensation at IV site
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21
Q

Hypokalemia

-Nursing Interventions

A
  1. Cardiac monitor
  2. Monitor respiratory status
  3. Monitor Labs
  4. Do not crush or chew
  5. Encourage dietary intake
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22
Q

Hyperkalemia

-Causes

A
  1. Renal Failure
  2. Potassium-sparing diuretics
  3. K+ supplements or IV replacement
  4. Lack of insulin (DKA)
  5. Cell destruction
  6. Hemolysis of cells w/ extended tourniquet application
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23
Q

Hyperkalemia

-Manifestations

A
  1. Low BP
  2. Bradycardia / arrhythmias
  3. Numbness or tingling of face, tongue, hands, feet
  4. Fatigue, drowsiness, confusion
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24
Q

Hyperkalemia

-Treatment

A
  1. Insulin moves K+ from ECF to ICF (give dextrose if needed)
  2. Diuretics
  3. Kayexelate (orally or via retention enema
  4. Dialysis
  5. IV calcium to minimize cardiac toxicity
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25
Hyperkalemia | -Nursing Interventions
1. Monitor renal function 2. Cardiac Monitor 3. Dialysis if needed
26
Calcium | -Overview
1. Most abundant mineral in the body | 2. Controlled by Vit. D, PTH, Calcitonin, and serum concentration
27
Calcium | -Necessary For...
1. Transmission of nerve impulses 2. Normal muscle contraction 3. Regulation of the heart 4. Hormone secretion 5. Formation of blood clots
28
Calcium | -Dietary Sources
1. Milk 2. Yogurt 3. Cheese 4. Egg yolk 5. cauliflower, soybeans, green leafy veggies
29
Hypocalcemia | -Critical values
1. <6mg/dL may cause death
30
Hypocalcemia | -Causes
1. Renal failure 2. Acute pancreatitis 3. Hypoparathyroidism 4. Vit D deficiency 5. Low Mg, Serum albumin or Increased phosphorus
31
Hypocalcemia | -Manifestations
1. Chvostek's sign 2. Trousseau's sign 3. Cardiac arrhythmias 4. Osteoporosis
32
Hypocalcemia | -Treatment
1. Treat cause 2. IV calcium gluconate - monitor IV for tissue necrosis
33
Hypocalcemia | -Nursing Interventions
1. Monitor electrolytes | 2. Cardiac monitor monitor respiratory status
34
Hypercalcemia | -Critical level
>12mg/dL is life threatening
35
Hypercalcemia | -Causes
1. Hyperparathyroidism 2. Bone cancer cause breakdown of bone 3. Multiple fractures 4. Prolonged immobilization 5. prolonged use of aluminum-containing antacids
36
Hypercalcemia | -Manifestations
1. Anorexia, N/V/C 2. Muscle weakness, lethargy 3. Polydipsia, polyuria, dehydration 4. Cardiac arrhythmias
37
Hypercalcemia | -Treatment
1. Treat Cause 2. Diuretics 3. IV hydration w/ NS to increase renal blood flow and urinary excretion 4. IV bisphophonates (obstruct Ca release from bone) 5. CALCITONIN - inhibits release from bone and promotes renal excretion)
38
Hypercalcemia | -Nursing Interventions
1. Encourage oral fluids (3-4 L/ day) 2. Monitor VS 3. Cardiac monitor 4. Monitor neuro status 5. Encourage mobility
39
Magnesium | -Overview
1. Activating co-factor with more than 300 enzymes 2. 2nd most abundant cation in ICF 3. Influences PTH and calcium levels
40
Magnesium | -Important in
1. Blood clotting 2. DNA & RNA synth 3. Cardiovascular regulation
41
Magnesium | -Interactions
1. Mg increases w/ K+ 2. Increased intake of Ca or P decreases absorption of Mg 3. Decreased intake of Ca or P increases absorption of Mg
42
Magnesium | -Dietary Sources
1. Veggies -Spinach, broccoli, avocado 2. Potatoes 3. Whole grains 4. Beef, chicken, tuna, milk, yogurt, raisins 4.
43
Hypomagnesemia | -Critical Value
Symptoms not commonly seen until less than 1 mEq/L
44
Hypomagnesemia | -Causes
1. Alcoholism 2. Hypothyroidism 3. Medications - Diuretics - Aminoglycoside antibiotics
45
Hypomagnesemia | -Manifestations
1. Cardiac arrhythmias 2. Neuromuscular irritability, twitches, tremors, leg and feet cramping 3. Restlessness, disorientation 4. Anorexia N/V
46
Hypomagnesemia | -Treatment
1. IV magnesium sulfate - Max rate is 150 mg/min 2. Oral Supplements
47
Hypomagnesemia | -Nursing Interventions
1. Discontinue meds causing it 2. Monitor for digitalis toxicity 3. Cardiac Monitor 4. Monitor Neuro status and Labs
48
Hypermagnesemia | - Causes
1. Renal dysfunction | 2. Chronic excessive use of antacids or laxatives
49
Hypermagnesemia | - Manifestations
1. Flushing 2. Increased perspiration 3. Muscle weakness 4. Decreased deep tendon reflexes 5. N/V and Cardiac arrhythmias
50
Hypermagnesemia | - Treatment
1. IV calcium | 2. IV fluids increases excretion
51
Hypermagnesemia | - Nursing Interventions
1. Cardiac Monitoring 2. Discontinue meds causing it 3. Monitor renal and respiratory status 4. Dialysis if needed
52
Phosphorus | -Overview
1. Most abundant anion in ICF 2. Metabolism of protein, calcium and glucose 3. Muscle contractions 4. Maintaining acid-base balance 5. Found in ATP 6. Need Vitamin D for absorption
53
Phosphorus | -Interactions
1. When Ca is increased, P is decreased 2. When Ca is decreased, P is increased Controlled by PTH - stimulates kidney to excrete P
54
Phosphorus | -Dietary sources
1. Milk 2. Cheese 3. Egg yolk 4. Meat 5. Nuts
55
Hypophosphatemia | -Causes
1. HYPERVENTILATION (sepsis, anxiety, pain, heatstroke, DKA, alcohol withdrawal. 2. Hyperparathyroidism 3. Diuretic use - phosphorus-binding antacids 4. Hyperglycemia
56
Hypophosphatemia | -Manifestations
1. Numbness and tingling (paresthesia) 2. Staggering gait (ataxia) 3. Disorientation, confusion, seizures 4. Difficulty speaking and swallowing 5. Unequal eye movements 6. Bruising, GI bleeding
57
Hypophosphatemia | -Treatment
1. IV potassium phosphate - Must dilute - Max rate is 10 mEq/hr
58
Hypophosphatemia | -Nursing Interventions
1. Increase dietary intake 2. Assess LOC 3. Monitor electrolyte levels
59
Hyperphosphatemia | -Causes
1. Renal failure 2. Increased intake and excessive use of laxatives or enemas 3. Cell breakdown or injury (rhabdomyolysis) 4. Hypoparathyroidism
60
Hyperphosphatemia | -Manifestations
1. Usually asymptomatic 2. Tetany 3. S/S RT HYPOCALCEMIA
61
Hyperphosphatemia | -Treatment
1. Aluminum-based antacids bind w/ phosphorus in GI tract 2. Diuretics 3. Glucose and insulin moves phosphorus from ECF to ICF 4. Correct hypocalcemia
62
Hyperphosphatemia | -Nursing Interventions
1. Limit phosphorus intake (LOW PROTEIN DIET) 2. Dialysis if needed 3. Monitor electrolyte levels
63
Renal Failure | -Causes what electrolyte imbalances
1. Hyperkalemia 2. Hypocalcemia 3. Hypermagnesemia 4. Hyperphosphatemia