Electrolytes

Question 0

Name the causes for Hyponatremia.

Answer 0

Increased sodium excretion
(N/D/V, diuretics, wound drainage, kidney disease, or decreased secretion of aldosterone)

Inadequate sodium intake

Dilution of serum sodium
(Excessive hypotonic fluids, kidney disease, freshwater drowning, hyperglycemia, or Heart Failure)

Question 1

Normal Range for serum sodium?

Answer 1

135-145mEq/L

Question 2

Name the causes for Hypernatremia.

Answer 2

Decreased sodium excretion
(Cushings, corticosteroids, kidney disease, hyperaldosteroism)

Increased sodium intake

Decreased water intake

Increased water loss

Question 3

Name common food sources for Sodium.

Answer 3

Bacon
Butter
Canned food
Cheese
Ketchup and Mustard 
Lunch meat
Milk 
Processed foods
Soy sauce
Table salt 
White and whole wheat bread

Question 4

Hyponatremia signs and symptoms

*think Neurological

Answer 4

Skeletal muscle weakness

Increased urinary output and GI motility

Mental Changes

Question 5

Hypernatremia signs and symptoms

*think neurological

Answer 5

Extreme thirst

Decreased urinary output

Muscle twitching and/or weakness

Question 6

Interventions for Hyponatremia

Answer 6

Monitor electrolytes

IV sodium chloride infusion (if both fluid & sodium are decreased)

Osmotic diuretic administered (if sodium is low and fluid volume is high)

Increase oral sodium intake

Monitor closely if taking Lithium (Hyponatremia can cause lithium toxicity)

Question 7

Interventions for Hypernatremia

Answer 7

Monitor electrolytes

Prepare to administer IV infusions if the cause is fluid loss

If caused by inadequate renal excretion than administer diuretics that promote sodium loss

Restrict sodium & fluid intake as prescribed

Question 8

Normal range for serum Potassium

Answer 8

3.5-5.0

Question 9

Name the causes for Hypokalemia

Answer 9

Excessive potassium intake

Decreased potassium excretion
(Kidney disease, potassium retaining diuretics, or adrenal insufficiency like Addisons)

Potassium shifting from intercellular fluid to extracellular fluid
(Tissue damage, acidosis, hyperuricemia, or hypercatabloism)

Question 10

Name Common Foods rich in Potassium

Answer 10

Avocado 
Bananas
Cantaloupe 
Carrots 
Fish
Mushrooms 
Oranges
Potatoes 
Pork, beef, veal
Raisins
Spinach 
Strawberries 
Tomatoes

Question 11

Name the signs & symptoms of Hypokalemia

*think Cardiac

Answer 11

Thready, weak irregular heart rate

Muscle cramps

Arrhythmias that can be life threatening

Question 12

Name the signs & symptoms of Hyperkalemia

*think Cardiac

Answer 12

Slow, weak irregular heart rate

Muscle twitching initially then followed by flaccid paralysis

Arrhythmias that can be life threatening

Question 13

Aldosterone increases when……..

Answer 13

Blood Volume goes down

Question 14

Where is aldosterone found?

Name the diseases the result from too much aldosterone being secreted and too little being secreted.

Answer 14

Aldosterone is found in the adrenal glands

Too Much: cushings and hyperaldosteroism

Too Little: Addisons

Question 15

Where is ANP found and what is it’s function?

Answer 15

ANP is found in the atria of the heart and is a hormone that works on the kidneys to reduce blood volume.

Question 16

Where is ADH found and what is its function?

What are some common causes?

Answer 16

ADH is found in the pituitary and makes your body retain water.

Causes can include Increased ICP, head injury, craniotomy, or transphenoidal hypophysectomy.

Question 17

Name the disease caused by too much ADH and some common signs and symptoms.

Answer 17

SIADH (makes you go into FVE)

Urine decreases and is concentrated
Blood is diluted (low electrolyte levels)
S/S of FVE

Question 18

Name the disease caused by not enough ADH and common sign and symptoms.

Answer 18

Diabetes Insipidus (which causes FVD)

Urine is diluted and blood is concentrated (high electrolyte levels)

Watch for shock!
Has NOTHING to do with blood sugar!

Question 19

The Removal of the pituitary gland through the sinuses is called:

Answer 19

Transphenoidal Hypophysectomy

Question 20

Treatment for FVE:

Answer 20

Low Na diet/restrict fluids as ordered
Weights daily
Bed rest
Physical assessments

Diuretics

Question 21

Name the treatments for FVD:

Answer 21

Prevent further fluid loss
Replace fluid loss by PO and/or IV fluids

Monitor for fluid overload
At higher risk for falls r/t vitals and LOC

Question 22

Isotonic solutions and contradiction uses:

Answer 22

Normal Saline (0.9%)
LR
d5W
D5 1/2 NS

Contradiction w/clients with HTN, cardiac disease, or renal disease because these solutions can cause FVE

Question 23

Name examples of hypotonic solutions and contradictions.

Answer 23

D2.5W, 1/2NS. 0.33%NS

*rehydrates cells but does not cause HTN

Contradictions: watch for cellular edema and FVD, which would cause decreased B/P

Question 24

Name hypertonic solutions and contradictions:

Answer 24

D10W, 3%NS, 5%NS, D5LR, D5 1/2NS, TPN, and Albumin Used for patients who have developed 3rd spacing, severe edema, burns, and/or ascites. *watch for FVE!

Question 25

Normal lab value for Calcium

Answer 25

8.6-10.5mg/dl

Question 26

Name 3 causes of Hypercalcemia 6 Signs & Symptoms 6 Treatments

Answer 26

Hyperparathyroidism, thiazides, immobilization S/S: brittle bones, kidney stones, ^b/p, muscle weakness, decreased DTRs, and decreased pulse Tx: bear weight(move!), push fluids as ordered (prevent kidney stones), Pospho Soda Fleet Enema, Steroids, add phosphorus diet, and/or Calcitonin

Question 27

Normal Lab Value for Magnesium

Answer 27

1.2-2.6mg/dl

Question 28

Name 3 causes for HyperMagnesium Identify 6 Signs & Symptoms Name 4 Treatments

Answer 28

Causes: Renal Failure, Antacids, Overdose of Mg S/S: flushing~warmth, vasodilation, decreased DTRs, decreased LOC, muscle weakness, and drowsiness Tx: Ventilator (if RR<12rpm) Dialysis (if kidneys not working properly) Calcium Gluconate IV slowly (antidote to Mg toxicity) Safety Precautions

Question 29

Name 3 causes of HypoCalcemia Name 6 signs & symptoms Name 3 treatments

Answer 29

Causes: Hypoparathyroidism, Radical Neck, and Thyroidectomy S/S: Mind changes, rigid/tight muscle tone, possible seizures, +chovstek's(cheek tap), +Trousseau's( b/p cuff, increased DTRs, & swallowing problems Tx: Vitamin D Phosphate Binders IV Ca (given slowly) w/heart monitor

Question 30

Name 3 causes for HypoMagnesia Name 6 signs & symptoms Name 4 Treatments

Answer 30

Causes: Diarrhea, Alcoholism, Starvation or Drinking S/S: mind changes, tight/rigid muscle tone, increased DTRs, +Chovstek's, +Trousseau's, and possible seizures. Tx: IV Mg Check kidney function Seizure Precautions Eat Magnesium

Question 31

Name the Causes of Respiratory Acidosis Name the S/S List some treatments

Answer 31

Causes: pneumonia, narcotics, sleeping pills, collapsed lung, or mid abd incision S/S: H/A, confusion, sleepy Restlessness & Tachycardia Tx: treat the cause Post-Op: turn, cough, and deep breathe

Question 32

Name causes for Respiratory Alkalosis Name S/S List Treatments

Answer 32

Causes: Hyperventilating, Hysteria, Acute Aspirin Overdose S/S: light headed, numbness/tingling in fingers and toes, Peri-oral numbness Tx: breathe into bag Calm client Treat the cause Monitor ABGs

Question 33

Name 5 foods that contain high amounts of Calcium

Answer 33

``` Milk and Soy Milk Cheese Collard Greens Yogurt Tofu ```

Question 34

Nam 5 foods that contain high amount of Magnesium:

Answer 34

``` Avocados Green leafy vegetables Oatmeal Pork, beef,chicken, and soy beans Peanut Butter ```

Question 35

Name 5 foods with high amounts of Phosphorus:

Answer 35

``` Fish Nuts Pork, beef, chicken, organ meats Dairy products Whole grain breads and cereals ```

Question 36

Name the causes of Metabolic Acidosis Signs & Symptoms Treatments

Answer 36

Causes: DKA, Starvation, Renal Failure, Severe Diarrhea, High fat diet, Excessive ASA ingestion S/S: depends on cause, Hyperkalemia, increased RR (Kussmaul Respirations) Tx: treat the cause (like insulin for DKA) Monitor Respiratory, I&Os, LOC, Safety/seizure precautions Watch K+ levels (tx may cause Hypokalemia) IV sodium bicarb push as ordered

Question 37

Name the Causes of Metabolic Alkalosis Signs & Symptoms Treatments

Answer 37

Causes: loss of GI contents(like excessive suctioning or vomiting), diuretics,too many Antacids, and too much bicarb S/S: depends on cause K+ goes down (watch LOC, cramping, arrhythmias) Tx: fix the cause Replace K+ Prepare to administer meds to promote excretion of bicarb through kidneys

Question 38

Normal HCO3 level

Answer 38

22-27mEq/L

Question 39

Normal pCO2 level

Answer 39

35-45mm Hg

Question 40

Normal Po2 level

Answer 40

80-100mmHg