Electrolytes Flashcards Preview

Nursing > Electrolytes > Flashcards

Flashcards in Electrolytes Deck (108)
Loading flashcards...
1

HypoNAtremia

Na+ (sodium) level in the blood is <13
The concentration of sodium in the blood drops below normal

2

Causes of HypoNAtremia

-Salt loss from the body is > water loss
ex: diarrhea, NG suctioning, vomiting, sweating, salt-wasting diuretics

-Body retains an excess amount of water compared to overall sodium level (dilution)
ex: water intoxication, CHF, overuse of hypertonic solution

3

What do you observe with HypoNAtremia?

Increased Na+ Excretion vs Diluted Na+ level

Increased Na+: decreased skin turgor, dry mucous membranes, orthostatic HYPOtension, abdominal cramps

Diluted Na+: edema, crackles, distended JVD (chf)

4

If Na+ level continues to DECREASE?

Headaches
Changes in LOC:
-altered mental status
-extreme fatigue
-seizures
-coma
-death
***secondary to increased ICP and cerebral edema

5

How to treat HypoNAtremia


Increased Na+ excretion vs Diluted Na+ vs Extreme Neuro Symptoms

Increased Excretion:
-fluid restriction
-Sodium replacement
-increased salt in diet, salt tabs,LR/ 0.9% NS

Diluted Na+:
-Fluid restriction
-Na+ restriction

Extreme Neuro Symptoms:
-Hypertonic IV Solution (3% NS)

6

HypERNAtremia

Na+ level in the blood is > 145
-The concentration of sodium in the blood is above normal

7

HypERNAtremia causes

1. More salt than water is gained
- excessive intake of Na+
- fluid deprivation
- Diabetes Insipidus (excessive ADH)

2. More water than salt is lost
- watery stools
-Hyperventilation
-Excessive diaphoresis

8

What to observe with HypERNAtremia

*S.A.L.T.*
S-skin flushed
A- agitation
L- low grade fever
T- thirst
-orthostatic hypotension
-Weakness
-delusions/hallucinations

9

How to treat HypERNAtremia

-Hypotonic Fluids ( D5W, 0.45% NS)
-Salt wasting diuretics
-Meds to suppress ADH
-Increase fluid intake
-Na+ restriction

10

NORMAL SODIUM LEVELS

135-145
-Helps to regulate fluid balance in the body

11

HypoKalemia

K+ level in the blood is < 3.5

12

NORMAL POTASSIUM LEVEL

3.5-5
Regulates a little of the fluid balance, but a lot of muscle contractions, and nerve signals

13

Causes of HypoKalemia

-K* wasting diuretic (lasix)
-Diarrhea/ Vomiting
-NG suction
-Inadequate intake (alcoholism, fasting/anorexia)
-Chronic Kidney Disease
-Excessive laxative use
-Increased aldosterone
-Diabetes

14

What to observe in HypoKalemia

**Levels below 3
-Anorexia/ Fatigue
-Muscle weakness/ cramping
-N/V
-Decreased bowl motility
-Numbness/ tingling
-Decreased deep tendon reflexes
- Cardiac Arythmias (U wave)

15

How to treat HypoKalemia

Conservative vs Aggressive

Conservative:
-Increased oral intake
-K+ supplement

Aggressive:
-IV replacement (K+ jumps)
***K+ can ONLY be given as IVPB
-Peripheral Line= 20 mEq over 2 hrs
-Central Line= 40 mEq over 2 hrs

16

HypERKalemia

Serum K+ level is > 5

17

Causes of HypERKalemia

-increased K+ intake
-K+ sparing diuretics
-Crush injuries
-trauma
-burns
-Kidney failure
-Decrease in aldosterone

18

What to observe with HypERKalemia

-Cardiac arythmias with EKG changes ( level > 6) ( T wave)
-muscle weakness/ paralysis
-nausea/ diarrhea

***Can lead to cardiac arrest (levels >8)

19

How to treat HypERKalemia


Conservative vs Aggressive

Conservative:
-restrict K+ intake
-Kayexalate (excretes K+ in stool)

Aggressive:
-IV calcium gluconate (protects cardiac function)
-IV insulin and dextrose solution
-Dialysis w/ kidney failure

20

HypoCALCemia

Serum CA++ levels < 8.5
**Calcium level is opposite of phosphate levels

21

Causes of HypoCALCemia

-limited CA++ in diet
-Poor oral intake (malnutrition, alcoholism)
-Hypoparathyroidism
-Vitamin D deficiency
- Medications (albumin based antacids)

22

What to observe with HypoCALCemia

***Levels < 4.4 (severe symptoms)
- Tetany
- Seizures
- Trousseau Sign
- Chvostek Sign

23

How to treat HypoCALCemia

-increase oral intake of calcium
-Vitamin D therapy
-IV Calcium gluconate
-IV calcium chloride

24

Nursing Management of HypoCALCemia

-watch for patients w/ removed thyroid
-osteoporosis
-Seizure Precaution
-Fall precaution
***Keep trach tray at bedside

25

HyperCALCemia

Serum CA++ levels > 10.2

26

What causes HyperCALCemia

-malignancies
*rapid and complete bone destruction
-Hyperparathyroidism
***Can lead to CARDIAC ARREST

27

What to observe with HyperCALCemia

“Bones, stones, moans, groans”
-bone pain, muscle weakness
-Kidney stones
-Anxiety, impaired memory, confusion, lethargy
-GI pain, N/V, constipation, indigestion

28

How to treat HyperCALCemia

*Treat the Cause
-Chemotherapy
-Partial Parathyroidectomy
-Restrict CA++/ vitamin D intake
*IV therapy- 0.9% NS to dilute CA++ levels and increase excretion
*Ambulation
*Calcitonin (intramuscularly)

29

NORMAL Magnesium Level

1.3-2.3
-Aides in carbohydrate and protein metabolism
-Important for neuromuscular function
-Aides in vasodilation if cardiovascular system

30

HypOmagnesemia Causes

Low levels of magnesium
-Alcohol withdrawal
-NG suction
-Diarrhea