Electrolytes

Question 1

Mg and Ca act like what?**

Answer 1

sedatives

Question 2

Hypermagnesium causes:

Answer 2

renal failure

antacids

Question 3

with Mg and Ca think what first?

Answer 3

muscles

Question 4

S/S hypermagnesium

Answer 4

flushing
warmth
vasodilation 
decreased DTRs
Muscle tone is weak and flaccid
possible arrhythmias 
decreased LOC
decreased pulse
decreased respirations

Question 5

Mg given to PIH pt why

Answer 5

to decrease bp and prevent seizures (because acts like sedative)

Question 6

hypermagnesium treatment

Answer 6

ventilator - if respirations less than 12
dialysis - because kidneys not working
calcium gluconate - antidote for mg toxicity
safety precautions because sedated

Question 7

hypercalcium s/s

Answer 7

brittle bones
kidney stones
decreased DTRs
Muscle tone is weak and flaccid
possible arrhythmias 
decreased LOC
decreased pulse
decreased respirations

Question 8

phosphorous and what have inverse relationship

Answer 8

calcium

Question 9

hypercalcemia causes

Answer 9

too much PTH (parathormone) - increases Ca
thiazides- retains calcium
immobilization - have to bear weight to keep ca in bones

Question 10

hypercalcemia treatment

Answer 10

Moving
fluids to prevent kidney stones
sodium phosphate (phosphosoda and fleet) - have phosphorus - inverse relationship with ca
steroids - decrease ca by excreting it through the GI tract
add phosphorus to diet (anything with protein)
safety precautions because sedated
vitamin D to use Ca
calcitonin - decreases ca

Question 11

hypomagnesmia and hypocalcemia means

Answer 11

not enough sedative

Question 12

hypomagnesmia causes

Answer 12

diarrhea - lots of mg in intestines

alcoholism - not eating so no mg coming in and diuresising because alcohol suppresses ADH and it’s hypertonic

Question 13

hypomagnesmia s/s

Answer 13

muscle tone rigid and tight
possible seizure
stridor/larngospasm - airway smooth muscle
chvosteks and trousseaus
arrhythmia’s - heart is muscle
increased DTR
mind changes - might be psychotic or depressed
swallowing problems - esophagus smooth muscle - risk for aspiration

Question 14

hypomagnesmia treatment

Answer 14

give some Mg - check renal function before giving IV mg
seizure precations
eat magnesium

Question 15

hypocalcemia s/s

Answer 15

muscle tone rigid and tight
possible seizure
stridor/larngospasm - airway smooth muscle
chvosteks and trousseaus
arrhythmia’s - heart is muscle
increased DTR
mind changes - might be psychotic or depressed
swallowing problems - esophagus smooth muscle - risk for aspiration

Question 16

what do you do if your pt reports flushing and sweating when you start IV mg?

Answer 16

STOP IT!

Mg will decrease respirations

Question 17

foods high in mg:

Answer 17

spinach, mustard greens, summer squash, broccoli, hailbut, turnip greens, pumpkin seeds, peppermint, cucumber, green beans, celery, kale, sunflower seeds, sesame seeds and flax seeds

Question 18

hypocalcemia causes

Answer 18

hypoarathyroidism
radical neck
thyroidectomy
(all have not enough PTH so decreases serum Ca)

Question 19

hypocalcemia treatment

Answer 19

Vitamin D - to help utilize Ca
Phosphate binders (sevelamer hydocholoride (renagel) and calcium acetate (phoslo) - bind to phos and decrease it to increase ca
IV calcium - give slowly

Question 20

Your Na level is totally dependent on what

Answer 20

how much water is in your body

Question 21

hypernatremia =

Answer 21

dehydration

too much Na, not enough water

Question 22

hypernatremia causes

Answer 22

hyperventilation - lose water when exhale
heat stroke
DI
V/D

Question 23

hypernatremia s/s

Answer 23

dry mouth
thirsty
swollen tongue

Question 24

the brain doesn’t like it when what electrolyte is messed up

Answer 24

sodium so think neuro changes*

Question 25

hypernatremia treatment

Answer 25

restrict sodium dilute pt with fluids - diluting makes Na go down daily weights and I&O - if Na problem then fluid problem Lab work

Question 26

Feeding tube pts tend to get

Answer 26

dehydrated = hypernatremia important to check serum sodium ask MD if can give more water with feeding

Question 27

hyponatremia =

Answer 27

dilution | too much water, not enough Na

Question 28

hyponatremia causes

Answer 28

drinking water for fluid replacement - only replaces water and dilutes the blood Psychogenic polydipsia - loves to drink water D5W (sugar and water) SIADH - retaining water

Question 29

hyponatremia s/s

Answer 29

H/A Seizures Coma

Question 30

hyponatremia treatment

Answer 30

pt needs Na and doesn't need water If having neuro problems needs hypertonic saline - packed with particles - 3% NS or 5% NS - worry about FVE because pulling fluid into vascular space - give slowly

Question 31

Potassium excreted by

Answer 31

the kidneys, so if kidneys not working well potassium will go up

Question 32

Hyperkalemia causes

Answer 32

kidney trouble | spirnolactone (aldactone) - makes you retiain potassium

Question 33

Hyperkalemia s/s

Answer 33

begins with muscle twitching then proceeds to weakness then flaccid paralysis also life threatening arrhythmias

Question 34

Hyperkalemia treatment

Answer 34

dialysis - kidneys aren't working calcium gluconate - decreases arrhythmia's insulin to carry glucose and potassium into the cell sodium polystyrene sulfonate (kayexalate) - Na and K have inverse relationship

Question 35

Hyperkalemia ECG changes

Answer 35

bradycardia, tall and peaked T waves, prolonged PR intervals, flat or absent P waves, widened QRS, conduction blocks, v fib

Question 36

Hypokalemia causes

Answer 36

vomiting NG suction (lots of K in stomach) Diuretics Not eating

Question 37

Hypokalemia s/s

Answer 37

muscle cramps weakness life threatening arrhythmias

Question 38

Hypokalemia ECG changes

Answer 38

U waves, PVCs, V tachy

Question 39

Hypokalemia treatment

Answer 39

give potassium spironolactone (aldactone) - makes them retain potassium eat more potassium

Question 40

major problem with PO K+

Answer 40

GI upset - so give with food

Question 41

what to assess prior to giving IV K+ **

Answer 41

urine output | if it drops will cause them to retain potassium and can kill them

Question 42

Never give IV K+

Answer 42

push - lethal injection - has to be diluted

Question 43

Does K+ burn during infusion?

Answer 43

yes, K can eat up peripheral veins

Question 44

Foods high in potassium

Answer 44

spinach, kale, mustard greens, brussel sprouts, broccoli, eggplant, cantaloupe, parsley, cucumber, bell pepper, apricots, ginger root, strawberries, avocado, banana, tuna, cauliflower, kiwi, oranges, lima beans, potatoes, and cabbage

Question 45

electrolyte imbalance with burns

Answer 45

hyperkalemia - potassium is inside the cells and with burns they lyse open and K is released into the blood

Question 46

hyperparathyriodism =

Answer 46

hypercalcium = hypophosphatemia pt will be sedated TX: partial parathyroidectomy

Question 47

hypoparathyroidism =

Answer 47

hypocalcium = hyperphosphatemia pt not sedated TX: IV calcium (give slow causes bradycardia), phosphate binding drugs (Renagel, PhosLo)

Question 48

electrolytes lost when detoxing

Answer 48

mg and k - when drink diuresis and then lose them