Electrolytes

Question 1

What is the normal phosphate range?

Answer 1

3-4.5

Question 2

What is the normal Chloride range?

Answer 2

98-106

Question 3

What is the normal calcium range?

Answer 3

9.0-10.5

Question 4

What is the normal Magnesium range?

Answer 4

1.3-2.1

Question 5

What is the normal potassium range?

Answer 5

3.5-5.0

Question 6

What is the normal sodium range?

Answer 6

135-145

Question 7

Both hypo- and hyper- natremia cause alterations in what system?

Severe hypo and hypernatremia can both cause…

Answer 7

Neuro
-LOC, orientation, energy, etc

Coma, seizure

Question 8

both high and low sodium can show signs of what fluid imbalance?

Answer 8

Hypervolemia or hypovolemia symptoms

Question 9

Seizure precautions should be implemented for ___natremia

These consist of…

Answer 9

Hypo and Hyper!

Side rails up, bed low, padded side rails, O2 and suction ready

Question 10

If hyponatremia is caused by fluid loss, what medication class should be held?

Answer 10

Diuretics

Question 11

What is the #1 cause of hyperkalemia?

Answer 11

Renal failure

Question 12

how does hyperkalemia manifest on an ECG?

Answer 12

Peaked T waves (early)

Wide QRS (late)

V.fib: basically dead

Question 13

What should be given first for critically high K+ levels?

Answer 13

Calcium gluconate
-stabilizes myocardium to prevent dysrhythmias

Question 14

How does insulin + glucose help hyperkalemia?

Answer 14

Insulin pulls K+ with it when it moves glucose into the cells, reducing the k+ in the blood

Question 15

What acid-base imbalance can cause hypokalemia?

Answer 15

Alkalosis

Question 16

Why can hypokalemia become an airway risk?

Answer 16

Muscle weakness-respiratory weakness

Question 17

How does hypokalemia manifest on an ECG?

Answer 17

Prominent U waves, flat or inverted T waves

Question 18

What are the principles of K+ supplement administration?

Answer 18

Always dilute
Use infusion pump: 10 mEq max
NEVER use bolus or IV push

Question 19

What electrolyte imbalance can licorice cause?

Answer 19

hypokalemia

Question 20

What lyte imbalance can hyperparathyroidism cause?
(cancers affecting bones can cause this too)

Answer 20

Hypercalcemia

Question 21

How does hypercalcemia manifest?

Answer 21

Fatigue, lethargy, weakness, confusion
Nephrolithiasis
Hallucinations, coma, seizures
Dysrhythmias

-similar to hypermagnesemia and low phosphate

Question 22

What kind of fluid intake should be encouraged for treatment of hypercalcemia?

Answer 22

Increased!
3-4 L/day

Question 23

What medication class are the gold standard for lowering Ca2+, but work slowly?

Answer 23

Biphosphonates

Question 24

How does hypocalcemia manifest?

Answer 24

Chvostek’s or Trousseau’s signs
Tetany
Laryngeal stridor
Dysphagia
paresthesias

Question 25

What is a major cause of high phosphate?

Answer 25

Kidney disease

Question 26

What is a common cause of low phosphate?

Answer 26

Malnourishment/malabsorption

Question 27

How does low phosphate manifest?

Answer 27

Similarly to High calcium/ High Mg -CNS depression, weakness, respiratory failure

Question 28

How does high magnesium manifest?

Answer 28

Hypotension, lethargy, diminished deep tendon reflexes, muscle paralysis, respiratory and cardiac arrest

Question 29

What is a common cause of high magnesium?

Answer 29

Increased Mg intake with renal impairment

Question 30

What med can be given to prevent high magnesium's effects on cardiac muscle?

Answer 30

Calcium gluconate

Question 31

How does low magnesium manifest?

Answer 31

similar to low calcium -muscle cramps, hyperactive deep tendon reflexes, tetany, Chvostek's and Trousseau's signs