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Flashcards in Electrolytes Deck (38):
1

Sodium (Na+) Levels

135 - 145 mEq/L

2

Sodium (Na+) Facts

1. Most abundant electrolyte in the ECF
2. Important in regulating neuromuscular impulses in the nerve & muscle fibers
3. Attracts water
4. Controlled by renal reabsorption & excretion
5. Dietary sources are:
a. Table salt
b. processed/cured meat
c. packaged food
d. sea food
e. cheese

3

Hyponatremia Levels

1. Low Na+
2. < 135

4

Causes of Hyponatremia

1. Diaphoresis
2. Wound drainage
3. Duiretic
4. Dilutional states

5

Hyponatremia Manifestations

1. Decreased urinary output
2. Sleeplessness
3. Spasm
4. Muscle Weakness
5. Decreased deep tendon reflex
6. Coma
7. N/V
8. Anorexia

6

Hyponatremia Tx

1. Tx cause
2. Hypertonic IV fluid (Severe case)
3. Isotonic IV fluid
4. Oral Na+ supplement
5. Restrict fluids

7

Hyponatremia RN Implication

1. Monitor I & O
2. DW
3. Monitor labs
4. Restrict fluids
5. Increase dietary intake
6. Monitor fluid status

8

Hypernatremia Levels

1. High Na+
2. > 145

9

Causes of Hypernatremia

1. Increase in Na+ intake
2. Excess loss of water or inadequate intake of water
3. Dehydration

10

Hypernatremia Manifestation

1. Irritability
2. Restlessness
3. Aagitation
4. Confusion
5. Lathargy
6. Muscle weakness
7. Twitching or seizure
8. Thirst**

11

Hypernatremia Tx

1. Tx cause
2. Correct fluid imbalance carefully
3. IV fluids for dehydration (Isotonic & Hypertonic)

12

Hypernatremia RN Implication

1. Monitor VS
2. Monitor I & O
3. DW
4. Monitor edema
5. Nutritional assessment

13

Potassium (K+) Levels

3.5 - 5 mEq/L

14

Potassium (K+) Facts

1. Major cation in the ICF
2. Important for nerve --> cell communication & the initiation of muscle contraction
3. Controlled by kidneys
a. Aldosterone(promotes excretion) & insulin (moves K+ into cell.
4. Dietary sources:
a. Bananas
b. Cantaloupe
c. Green leafy vegetables
d. Potatoes
e. Avocados

15

Hypokalemia Level

< 3.5 mEq/L

16

Causes of Hypokalemia

1. Diuretics
2. V/D
3. Nasogastric suction
4. Decreased intake

17

Hypokalemia Manifestation

1. Muscle weakness
2. Fatigue*
3. Decreased bowel motility*
4. N/V/C
5. Ileus (Obstruction)
6. Cardiac arrhythmias
7. Orthostatic Hypotension*
8. Digoxin Sensativity
9. Shallow/Innefective Resp.*
10. Frequent Urination

18

Hypokalemia Tx

1. K+ supplements
a. Take c fd to minimize GI upset
2. IV K+
a. Must be diluted
b. Max rate of 10 mEq/hr
c. Can cause burning sensation @ IV site
d. Irritating to veins

19

Hypokalemia RN Implication

1. Cardiac Monitor
2. Monitor Resp status
3. Encourage dietary intake
4. Monitor labs
5. Do not crush or chew

20

Hyperkalemia Level

> 5

21

Hyperkalemia Causes

1. Renal Failure
2. K+ sparing diuretics
3. K+ supplements or IV replacement
4. Lack of insulin(diabetic ketoacidosis)
5. Cell destruction(burns, trauma, infection)
6. Hemolysis of cells with extended tourniquet application.

22

Hypekalemia Manifestation

1. Muscle cramps, weakness
2. N/D
3. Low BP
4. Bradycardia
5. Arrhythmias
6. Numbness or Tingling of:
a. Face
b. Tongue
c. Hands
d. Feet
7. Fatigue
8. Drowsiness
9. Confusion

23

Hyperkalemia Tx

1. Insulin moves K+ from ECF to ICF (Give dextrose if needed)
2. Diuretics
3. Na+ polystyrene sulfate, binds c K+ preventing absorption c fecal excretion
4. Dialysis
5. IV Ca++ to minimize cardiac toxicity

24

Hyperkalemia RN Implication

1. Monitor Renal Function
2. Monitor intake - FD & Medication
3. Cardiac Mmonitor
4. Dialysis if needed

25

Calcium (Ca++) Level

8.5 - 10.5 mg/dl

26

Calcium (Ca++) Facts

1. Most abundant mineral in body
2. Provides mass & strength to bones & teeth
3. Works closely c Phosphorus & Magnesium
As Phos increases, Ca++ decreases**
As Mg increases, Ca++ increases
4. Necessary for transmission of nerve impulses, Normal muscle contraction, regulation of heart, hormone secretion & formation of blood clots.
5. Controlled by vitamin D, Parathyroid hormone, Calcitonin & serum concentration:
a. Intestinal absorption
b. Renal reabsorption & excretion
c. Bone breakdown & uptake
6. Dietary sources:
a. Milk
b. Yogurt
c. Cheese
d. egg yolk
e. Cauliflower
f. Soybeans
g. Green leafy vegetables

27

Hypocalcemia Level

< 8.5

28

Hypocalcemia Causes

1. Renal failure
2. Decreased intake or absorption
3. Acute pancreatitis
4. Hyperparathyroidism
5. Vitamin D deficiency
6. Low Mg level
7. Low serum albumin
8. Increased Phos

29

Hypocalcemia Manifestation

1. Skeletal muscle spasm, cramps, tetany
2. Convulsions
3. Parasthesias of lips & extremeties
4. Chvostek's sign
5. Trousseau's sign
6. Cardiac arrhythmias
7. Osteoporosis

30

Hypocalcemia Tx

1. Tx cause
2. IV Ca++ gluconate - monitor IV for tissue necrosis
3. Oral supplements c Vitamin D c fd.

31

Hypocalcemia RN Implication

1. Monitor electrolyte levels
2. Cardiac monitor
3. Monitor respiratory status

32

Hypercalcemia Level

> 10.5
Greater than 12 mg/dl is life threatening!

33

Hhypercalcemia Causes

1. Excess intake or absorption
2. Hyperparathyroidism
3. Bone cancer cause breakdown of bone
4. Multiple fractures
5. Prolonged immobilization
6. Prolonged use of aluminum-containing antacids

34

Hypercalcemia Manifestation

1. Anorexia, N/V/C
2. Muscle weakness
3. Decreased deep tendon reflex
4. Lethargy
5. Polydipsia, Polyuria, Dehydration
6. Impaired concentration
7. Confusion
8. Blurred vision
9. Bone pain
10. Cardiac Arrhythmias

35

Hypercalcemia Tx

1. Diuretic**
2. IV hydration c NS to increase renal blood flow & urinary excretion
3. IV bisphophonates - obstruct Ca++ release from bone
4. Calcitonin - inhibits release from bone & promotes renal excretion

36

Hypercalcemia RN Implication

1. Encourage oral fluids (3-4L/day)
2. Monitor VS
3. Cardiac monitor
4. Monitor neuro status
5. Encourage mobility

37

Magnesium (Mg++) Level

1.8 - 2.5 mEq/dl

38

Magnesium (Mg++) Facts

1. 2nd most abundant cation in ICF
2. Activating co-factor c more than 300 enzymes
3. Necessary for formation & function of healthy bones
4. Influences parathyroid hormone & Ca++ levels
5. Important in blood clotting, DNA & RNA synthesis, Cardiovascular regulation
6. Increased/Decreases c K+
7. Dietary sources:
a. Vegetables:
Spinach
Broccoli
Avocado
Potato
Whole Grain
Beef
Chicken
Tuna
Milk
Yogurt
Raisins