Electrolytes Flashcards
(42 cards)
1
Q
Sodium (Na+): General
A
- Most abundant electrolyte in the ECF
- Important in neuromuscular impulses in the nerve and muscle fibers
- Attracts water; important in water distribution
- Controlled by renal reabsorption and excretion (thirst mechanism, ADH, RAAS, ANF)
2
Q
Sodium Diet Sources
A
Table salt, processed or cured meat, packaged foods, seafood, cheese, junk food
3
Q
Hyponatremia Causes
A
Diaphoresis, wound drainage, diuretic use, dilutional states, SIADH (syndrome of inappropriate ADH secretion)
4
Q
Hyponatremia Manifestations
A
- Decreased urinary output
- Sleepiness
- Muscle weakness/spasm
- Lethargy, confusion, seizures, coma
- N/V, anorexia
5
Q
Hyponatremia Tx
A
- Treat cause
- IV fluids: hypertonic or isotonic
- Oral sodium supplements
- Restrict fluids
6
Q
Hyponatremia Nursing Interventions
A
- Monitor I&O
- Daily weight
- Monitor labs
- Fluid restriction
- Increased dietary intake
- Monitor fluid status
7
Q
Hypernatremia Causes
A
- Increase in sodium intake
- Excess loss of water or inadequate intake of water
8
Q
Hypernatremia Manifestations
A
- Irritability, restlessness, confusion, agitation
- Lethargy, muscle weakness, twitching, or seizures
- Thirst
9
Q
Potassium (K+)
A
- Major cation in the ICF
- Important for nerve-cell communication and the initiation of muscle contraction
- Controlled by kidneys (Aldosterone promotes excretion and insulin moves K+ into cells)
10
Q
Potassium Dietary Sources
A
Bananas, cantaloupe, green leafy vegetables, potatoes, avocados
11
Q
Hypokalemia Causes
A
- Diuretics
- Vomiting, diarrhea, NG suction
- Decreased intake
12
Q
Hypokalemia Manifestations
A
- Muscle weakness, fatigue
- Decreased bowel motility, N/V, constipation, ileus
- Cardiac arrhythmias, ortho hypotension, digoxin sensitivity
- Shallow, ineffective respirations
- Decreased deep tendon reflexes, drowsiness, confusion
- Frequent urination
13
Q
Hypokalemia Tx
A
- Potassium supplements: take with food to minimize GI side effects
- IV potassium: must be diluted; max rate of 10mEq/hr (can cause burning at IV site, irritating to veins)
14
Q
Hypokalemia Nursing Interventions
A
- Cardiac monitor
- Monitor resp. status
- Encourage diet intake
- Monitor labs
- Do not crush or chew
15
Q
Hyperkalemia Causes
A
- Renal failure
- K+-sparing diuretics
- Potassium supplements or IV
- Lack of insulin (diabetic ketoacidosis)
- Cell destruction (burns, trauma, infection)
- Hemolysis of cells with extended tourniquet application
16
Q
Hyperkalemia Manifestations
A
- Muscle cramps, weakness
- Nausea, diarrhea
- LOW BP, bradycardia, arrhythmias
- Numbness or tingling of face, tongue, hands, feet
- Fatigue, drowsiness, confusion
17
Q
Hyperkalemia Tx
A
- Insulin: moves K+ into cells
- Diuretics
- Sodium polysterene sulfate (Kayexalate) PO or via retention enema (binds with K+ preventing absorption with fecal excretion)
- Dialysis
- IV calcium to minimize cardiac toxicity
18
Q
Hyperkalemia Nursing Intervention
A
Cardiac monitor
19
Q
Calcium (Ca2+)
A
- Most abundant mineral in the body
- Provides mass and strength to the bones and teeth
- Works closely with phosphorus and magnesium
- Needed for transmission of nerve impulses, normal muscle contraction, regulation of the heart, hormone secretion, and formation of blood clots
- Controlled by vitamin D, PTH, calcitonin, and serum concentration
20
Q
Calcium Dietary Intake
A
Milk, yogurt, cheese, egg yolk, cauliflower, soybeans, green leafy vegetables
21
Q
Hypocalcemia Causes
A
- Renal failure
- Decreased intake or absorption
- Acute pancreatitis
- Hypoparathyroidism
- Vitamin D deficiency
- Low magnesium level
- Low serum albumin
- Increased phosphorus
22
Q
Hypocalcemia Manifestations
A
- Skeletal muscle spasm, cramps, tetany
- Convulsions
- Paresthesias of lips and extremities
- Chvostek’s sign
- Trousseau’s sign
- Cardiac arrhythmias
- Osteoporosis
23
Q
Hypocalcemia Tx
A
- IV calcium gluconate (monitor IV for tissue necrosis)
- Oral supplements with vitamin D with food
- Cardiac monitor
24
Q
Hypercalcemia Causes
A
- Excess intake/absorption
- Hyperparathyroidism
- Bone cancer causing breakdown of bone
- Multiple fractures
- Prolonged immobilization
- Prolonged use of aluminum-containing antacids
25
Hypercalcemia Manifestations
- Anorexia, N/V, constipation
- Muscle weakness, lethargy, decreased deep tendon reflexes
- Polydipsia, polyuria, dehydration
- Impaired concentration, confusion
- Blurred vision
- Bone pain
- Cardiac arrhythmias
26
Hypercalcemia Tx
- Diuretics
- IV hydration with NS to increase renal blood flow and urinary excretion
- IV biphosphonates- obstruct calcium release from bone
- Calcitonin (spray): inhibits release from bone and promotes renal excretion
- Cardiac monitor
- Encourage fluids (3-4L/day)
27
Magnesium (Mg2+)
- Second most abundant cation in ICF
- An activating co-factor with more than 300 enzymes
- Needed for formation and function of bones
- Influences PTH and calcium levels
- Important in blood clotting, DNA and RNA synthesis, cardiovascular regulation
- Increases or decreases with K+
- Increased intake of Ca2+ or P- decreases absorption of Mg2+ (vice versa)
28
Magnesium dietary sources
Vegetables (spinach, broccoli), avocado, potato, whole grains, beef, chicken, tuna, milk, yogurt, raisins
29
Hypomagnesemia Causes
- Occurs in same conditions that lead to decreased K+ and Ca2+ levels
- Inadequate intake
- Alcoholism
- Malabsorption
- Hypothyroidism
- Meds (diuretics, aminoglycoside antibiotics)
30
Hypomagnesemia S/S
* S/S not seen until less than 1 mEq/L
- Cardiac arrhythmias
- Neuromuscular irritability, twitches, tremors, leg and feet cramping
- Restlessness, disorientation
- Anorexia, N/V
31
Hypomagnesemia Tx
Oral supplements, IV magnesium sulfate (max rate 150mg/min)
- Cardiac monitor
- Monitor neuro status
- Monitor for digitalis toxicity
32
Hypermagnesemia Causes
Renal dysfunction, chronic excessive use of laxatives (milk of magnesia, magnesium sulfate) or antacids (Mylanta)
33
Hypermagnesemia S/S
- Flushing, increase perspiration
- Muscle weakness
- Decreased deep tendon reflexes
- N/V
- Cardiac arrhythmias
- Decreased BP
- Lethargy, CNS depression
34
Hypermagnesemia Tx
- IV fluids increases excretion
- Cardiac monitor
- Monitor renal status and resp. status
- Dialysis if needed
35
Phosphorus (P-) or Phosphate (PO4-)
- Most abundant anion in ICF
- Metabolism of protein, calcium, and glucose
- Muscle contractions
- Maintaining acid-base balance
- Found in ATP
- Needs vitamin D for absorption
- When Ca2+ is increased, P- is decreased (vice versa)
- Controlled by PTH hormones: stimulates kidney to excrete P-
36
Phosphorus dietary source
Milk, cheese, egg yolk, meat, nuts
37
Hypophosphatemia Causes
- Hyperventilation (sepsis, anxiety, pain, heatstroke, DKA, alcohol withdrawal)
- Hyperparathyroidism
- Decreased absorption (vomiting, diarrhea, vitamin D deficiency)
- Diuretic use
- Hyperglycemia
38
Hypophosphatemia S/S
- Numbness and tingling (parethesia)
- Staggering gait (ataxia), tremor, weakness
- Disorientation, confusion, seizures, difficulty speaking and swallowing
- Unequal eye movements
- Bruising, GI bleeding
39
Hypophosphatemia Tx
- Oral supplements
| - IV potassium phosphate or sodium phosphate (must dilute; max rate 1-mEq/L)
40
Hyperphosphatemia Causes
- Renal failure
- Increased intake and excess use of laxatives or enemas
- Cell breakdown or injury (rhabdomyolysis, trauma, burns, exhaustive exercise, heat-related illness, severe infection)
- Hypoparathyroidism
41
Hyperphosphatemia S/S
- Usually asymptomatic
- Tetany
- S/S are related to hypocalcemia (lethargy, fatigue, bone or joint pain, sudden seizure, cramps, numbness, tremors, N/V, abdom. distention, constipation, dysrhythmias)
42
Hyperphosphatemia Tx
- Aluminum-based antacids bind with P- in GI tract
- Diuretics
- Glucose and insulin moves P- into ICF
- Correct hypocalcemia
- Dialysis if needed
