Electrolytes

Question 1

Normal lab value for Sodium Na+?

Answer 1

135-145 mEq/L

Question 2

Most common type of dehydration?

Answer 2

Isotonic

Question 3

What is the best indicator for fluid gains and losses?

Answer 3

Changes in daily weight

Question 4

Most important areas to monitor during dehydration therapy?

Answer 4

Pulse rate and quality and urine output

Question 5

Name causes of Hypervolemia?

Answer 5

Heart Failure, Renal Failure, Liver Failure!! Others-Cancer, drug therapy, high sodium intake, protein malnutrition

Question 6

Signs and Symptoms to assess for for Hypervolemia?

Answer 6

Dyspnea, Crackles in lungs, bounding pulse, increased BP, constant irritating cough, JVD, Pitting edema, rapid weight gain, Changes in LOC

Question 7

Patient with CHF admitted with complaints of SOB, lung sounds are bilaterally coarse with an oxygen saturation of 92% on O2 at 2 Liters. The Nurse anticipates
A: Administering a diuretic
B: Educating the patient on daily weight monitoring.
C: Elevating the patients feet on pillows
D: Administering IV fluids

Answer 7

A: Administering a diuretic

Question 8

Name a specific form of Hypoproteinemia?

Answer 8

Hypoalbuminemia

Question 9

Normal lab value for Potassium K+?

Answer 9

3.5-5.0 mEq/L

Question 10

Normal lab value for Calcium Ca++?

Answer 10

9.0-10.5 mg/dL

Question 11

Normal lab value for Magnesium Mg++?

Answer 11

1.3-2.1 mEq/L

Question 12

Normal lab value for Chloride Cl-?

Answer 12

98.106 mEq/L

Question 13

Normal lab value for Phosphate PO4-?

Answer 13

3.0-4.5 mEq/L

Question 14

What are the names for the imbalances for Sodium?

Answer 14

Hyponatremia and Hypernatremia

Question 15

What are the names for the imbalances for Potassium?

Answer 15

Hypokalemia and Hyperkalemia

Question 16

What are the names for the imbalances for Calcium?

Answer 16

Hypocalcemia and Hypercalcemia

Question 17

What are the names for the imbalances for Magnesium?

Answer 17

Hypomagnesemia and Hypermagnesemia

Question 18

What are the names for the imbalances for Chloride?

Answer 18

Hypochloremia and Hyperchloremia

Question 19

What are the names for the imbalances for Phosphate?

Answer 19

Hypophosphatemia and Hyperphosphatemia

Question 20

At what level does cerebral symptoms start to show with Hyponatremia?

Answer 20

129 mEq/L

Question 21

Key factors with hyponatremia?

Answer 21

FLOPPY weakness, Depolarization of nerve impulses to muscles and tissues slower. Bounding Pulse, Diminished deep tendon reflexes,

Question 22

What is the priority intervention for nursing care of the patient with hyponatremia?

Answer 22

Monitoring the patient’s response to therapy to prevent hypernatremia and fluid overload.

Question 23

Nursing management for hyponatremia?

Answer 23

24-hour I&O record
Check for bounding pulses or bulging neck veins (why?)
Check for BP and Respiratory changes
Changes in LOC and signs of Cerebral edema
Check and compare daily weights
Drug therapy that promotes water excretion only leaving sodium intact. (Samsca or Vaprisol).
Hypertonic fluids in severe cases.

Question 24

Causes of Hypernatremia?

Answer 24

High sodium intake 
Low water intake 
Severe GI loss
Diarrhea/vomiting
Excessive insensible loss-Perspiration
Administration of isotonic, hypertonic saline solutions, or sodium bicarbonate IV
Renal dysfunction-Nephritis

Question 25

Signs and symptoms of Hypernatremia?

Answer 25

``` Nervous System: Short attention span/confused/agitated Lethargic, drowsy or comatose in late stages Skeletal Muscle changes: Twitching Deep tendon responses absent in late stages Cardiovascular: Decreased contractility Hypotension ```

Question 26

What does FRIED mean for hypernatremia?

Answer 26

F: Fever (low grade) and flushed, dry skin R: Restlessness, irritability, and confusion I: Increased fluid retention and BP E: Edema (Peripheral and Pitting) D: Decreased urinary output, dry mouth, and increased thirst.

Question 27

7 areas to assess with hypernatremia?

Answer 27

``` 24-hour I & O record Look for bounding pulses and distended neck veins. Check for tachycardia and tachypnea Look for changes in sensorium Check and compare daily weights Check skin turgor and mucous membranes ```