Electrolytes

Question 1

Hypernatremia causes

Answer 1

decreased water intake, excessive intake of salt, insensible water loss (ie. heatstroke, high fever), diarrhea, DI

Question 2

Hypernatremia s/s

Answer 2

intense thirst
sticky mucus membranes
dry lips
flushed skin
red, rough, dry tongue
CNS: disorientation, lethergy hallucinations

Question 3

Hypernatremia treatment

Answer 3

PO water, IV infusions w/ salt free (ex/ 5W or 0.9/0.45 NS)

Question 4

Hyponatremia causes

Answer 4

Water intoxication
Excessive loss of sodium (GI, burns, wounds)
Adrenal insufficiency
Incorrect rehydration after profuse sweating/loss of fluid

Question 5

Hyponatremia s/s

Answer 5

Cold, clammy skin
Dry mucous membranes
Rapid, weak, thread pulse
Orthostatic hypotension
n/v, diarrhea, ab cramps
CNS: indifference, confusion, irritability, feeling of doom

Question 6

Hyponatremia treatment

Answer 6

restrict water, loop diuretics, isotonic solution

Question 7

Hyperkalemia causes

Answer 7

Excessive intake
Shift K out of cells: trauma, cell lysing, infection, crush injuries, severe bruns, sepsis, acidosis

Question 8

Hyperkalemia s/s

Answer 8

Hyperactivity of smooth muscles: ab cramps, diarrhea, hyperactive bowel sounds
EKG: irregular, slow HR
Muscle twitching (early) to paralysis (late)
Increase deep tendon reflexes
Lower extremity weakness
CNS: irritability, anxiety

Question 9

Hyperkalemia treatment

Answer 9

increase fluids and diuretics, kayexalate, IV insulin w/ glucose, dialysis

Question 10

Hypokalemia causes

Answer 10

Loss: diarrhea, vomiting, NG suctioning
Inadequate intake: starvation, diet low in potassium
Giving a lot of insulin for DKA

Question 11

Hypokalemia s/s

Answer 11

Paresthesia (pins and needles), decreased reflexes
Weak, thread pulse
Muscle weakness, leg cramps
Fatigue
Abdominal distension, constipation, n/v

Question 12

Hypokalemia treatment

Answer 12

potassium supplement
potassium is NEVER given IV push, IM, or SQ; IV potassium is always diluted and administered using infusion devices

Question 13

Hypercalcemia causes

Answer 13

Hyperparathyroidism (increase PTH)
Malignancies (w/ or w/o bone involvement)
Prolonged immobility (loss of bone density)

Question 14

Hypercalcemia s/s

Answer 14

Lethargy, weakness
Dereased muscle tone
Depressed reflexes
Flank pain d/t kidney stone
Cardiac arrest

Question 15

Hypercalcemia treatment

Answer 15

hydration, loop diuretics, synthetic calcitonin

Question 16

Hypocalcemia causes

Answer 16

Decreased intake, poor absorption
Vitamin D deficiency
Kidney failure
Surgical removal of part of parathyroid

Question 17

Hypocalcemia s/s

Answer 17

Muscle cramps
Hyperactive reflexes
Depression, anxiety, confusion
Tetany, seizures
Positive chvotek’s and trousseau’s

Question 18

Hypocalcemia treatment

Answer 18

calcium replacement, increase dietary intake, calcium gluconate

Question 19

Hypermagnesemia causes

Answer 19

Increase intake and renal insufficiency
Excess IV magnesium (often given for preeclampsia)

Question 20

Hypermagnesemia s/s

Answer 20

Lethargy
Facial flushing
Hypotension
n/v
Impaired reflexes: weakened or delayed, deep tendon reflexes

Question 21

Hypermagnesemia treatment

Answer 21

limiting intake, fluid and diuretics/dialysis, calcium gluconate

Question 22

Hypomagnesemia causes

Answer 22

GI fails to absorb Mg d/t:
Excessive fluid loss from GI
Fasting or starvation
Alcoholism
Medications like PPIs and some diuretics
Uncontrolled BS

Question 23

Hypomagnesemia s/s

Answer 23

(similar to hypocalcemia)
Muscle cramps
Hyperactive reflexes
Depression, anxiety, confusion
Tetany, seizures
Positive Chvostek and Trousseau’s

Question 24

Hypomagnesemia treatment

Answer 24

oral supplement, increase dietary intake, IV Mg sulfate