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From Flashcardlet > Fluid and Electrolyte (part 2) > Flashcards

Fluid and Electrolyte (part 2) Flashcards

0
Q

What is sodium level vital for?

A 
Skeletal muscle contraction
Cardiac contraction 
Nerve impulse transmission
Normal osmolarity 
Volume of ECF
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1
Q

Normal sodium level

A

135-145 mmol/L

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2
Q

What will cells do with hyponatremia?

A

Swell causing increase intracranial pressure

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3
Q

If the patient is considered hyponatremic, what is the sodium level?

A

Below 136 mEq/L

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4
Q

What can cause dilutional hyponatremia? (Where there is an increase in water and decrease in sodium)

A

Cirrhosis
Kidney failure
Pschgenic polydipsia

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5
Q

What can cause hyponatremia with decrease in water and sodium?

A

Diuretics

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6
Q

What can cause hyponatremia when the water level is normal but decrease in sodium?

A

SIAHS - syndrome of inappropriate hormone secretion

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7
Q

What kind of saline is given when a patient is hyponatremic?

A

3% saline (has higher sodium)

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8
Q

What is psychogenic polydipsia?

A

Excessive drinking

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9
Q

What is the priority for nursing care when a pt has hyponatremia?

A

Monitor response to therapy

Prevent Hypernatremia and fluid overload

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10
Q

What is the serum sodium levels for patients considered Hypernatremia?

A

Levels over 145 mEq/L

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11
Q

What usually keeps us from hypernatria?

A

Thirst

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12
Q

What is Hypernatremia?

A

More sodium that water is the body

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13
Q

Who is at high risk for Hypernatremia?

A 
Older adults
Coma pts
Tube feeding 
Fevers 
Accidental salt ingestion (near drowning is salt water)
Hypotonic IV fluids
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14
Q

What do cells do in Hypernatremia?

A

Shrink because extracellular fluid is hyperosmolar

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15
Q

What does cells shrinking in patients with Hypernatremia cause?

A

causes changes in metal status

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16
Q

What are the skeletal muscle changes in patients with Hypernatremia?

A

Twitching

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17
Q

What are the priorities for nursing care with pts who are Hypernatremic?

A

Preventing hyponatremia and dehydration

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18
Q

What are the normal potassium levels?

A

3.5 to 5.0 mEq/L

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19
Q

What is the serum potassium level for hypokalemia?

A

Below 3.5

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20
Q

What can hypokalemia cause in respiratory changes?

A

Weak muscles so not good breathing

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21
Q

What can hypokalemia cause in musculoskeletal changes?

A

Make them weak and cause cramps

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22
Q

Cardiovascular changes in patients with hypokalemia

A

EKG changes
Dysrhythmias
⬇ in standing BP

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23
Q

CNS changes in patients who are hypokalemic

A

Metal depression
Confusion
Lethargy

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24
Q

What are the nursing priorities when patients are hypokalemic?

A

Adequate oxygen
Patient safety with falls
Preventing injuring from K+ administration

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25
Q

What can potassium rate be given no fast than?

A

20 mEq/hr

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26
Q

How does potassium always need to be given when its through the IV?

A

Always in pump - never IV push

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27
Q

If a patient is NPO what will they need?

A

Potassium supplement

28
Q

What needs to be assessed for at IV site when giving K+?

A

Phlebitis

29
Q

If potassium is given by mouth, what do you need to make sure of?

A

They are hydrated and urinating

30
Q

Gastrointestinal changes in pts with Hypokalemia

A

Anorexia
N/V
Peristalsis

31
Q

Musculoskeletal changes in pts who are hypokalemic

A

Weakness

Respiratory muscle weakness which can lead to resp arrest

32
Q

Serum potassium levels for Hyperkalemia

A

Greater than 5.0

33
Q

What are the most severe problems from Hyperkalemia and the most common cause of death with patients who are Hyperkalemic?

A

Cardiovascular changes

34
Q

Cardiovascular changes in pts with Hyperkalemia?

A

Cardiac arrest

Dysrhythmia

35
Q

Urine changes in pts with Hyperkalemia

A

Oliguria
⬇
Anuria

36
Q

How can excess intake cause Hyperkalemia?

A

Excessive Parenteral administration

37
Q

A decreased loss of what can cause Hyperkalemia?

A

Potassium-sparring diuretics

Renal failure

38
Q

What drugs are used when a patient is Hyperkalemic?

A

Kayexalate
Insulin
Calcium glucinate

39
Q

How is Kayexalate given and what does it do for Hyperkalemia?

A

Liquid by mouth

Pulls K+ into substance and replaces it with sodium

40
Q

How is insulin given and how does it work on patients to treat Hyperkalemia?

A

IV push with D5W (glucose)

K+ sticks to insulin and temporarily takes care of it

41
Q

What does calcium glucinate do for Hyperkalemic patients?

A

Decreases irritability on the heart (dysrhythmias)

42
Q

What is the main reason for hyperkalemia?

A

Kidney failure

Or pt is given too much K+

43
Q

Main symptoms with Hyperkalemia

A 
Muscle cramps ➡weakness ➡paralysis 
Drowsiness 
⬇BP
Eye changes
Dysrhythmias 
Abdominal cramping
Diarrhea
Oliguria
44
Q

What are the normal Calcium levels?

A

9.0 - 10.5mg/dL

45
Q

What is calcium?

A

A mineral with functions closely related to those of phosphorus and magnesium

46
Q

What does absorption of dietary calcium require?

A

Active form of Vit. D

47
Q

Where is calcium stored?

A

In the bones

48
Q

Total serum calcium level below 9.0

A

Hypocalcemia

49
Q

What races are more prone to be lactose intolerant do therefore are hypocalcemic?

A

Native Americans
African Americans
Asians

50
Q

What can hypocalcemia cause in women?

A

Osteoporosis

51
Q

What face test do you do when a patient is hypocalcemic?

A

Chvostek’s sign - tap cheek - nerve will twitch with hypocalcemia

52
Q

What test do you do on the arm when a patient is hypocalcemic?

A

Trousseau’s sign - pump BP cuff 20 mm higher than systolic - muscle will twitch

53
Q

What can cause hypocalcemia?

A

⬇ Parathyroid hormone
⬇ Vit. D
Dietary deficit

54
Q

What cardiovascular changes occur with hypocalcemia?

A

Dysrhythmias

Cardiac arrest

55
Q

What musculoskeletal changes occur with hypocalcemia?

A

Muscle spasms

Tetany

56
Q

What can hypocalcemia cause with bones?

A

Osteoporosis
⬇
Fractures

57
Q

What needs to watched out in patients hypocalcemia?

A

Seizures

58
Q

Total serum levels above 10.5 mg/dL

A

Hypercalcemia

59
Q

Where does Hypercalcemia occur first?

A

In excitable tissues - all systems are affected

60
Q

What are the most serious and life threatening changes with Hypercalcemic patients?

A

Cardiovascular changes - depressed activity
Dysrhythmias
Cardiac arrest

61
Q

Causes of Hypercalcemia

A

⬆ Parathyroid hormone
⬆ Vitamin D
⬆ Steroid therapy

62
Q

What loss in bone can cause Hypercalcemia?

A

Immobilization
Carcinoma with bone metastasis (release calcium)
Multiple myeloma

63
Q

What can Hypercalcemia cause in bones?

A

Bone pain ➡ osteoporosis ➡ fractures

64
Q

What can Hypercalcemia cause with kidneys?

A

Stones

65
Q

What can Hypercalcemia cause with CNS?

A

Lethargy

Coma

66
Q

What cardiovascular system changes can Hypercalcemia cause?

A

Dysrhythmias

Cardiac arrest

67
Q

What are the drug therapy intervention with hypercalcemia?

A

IV 0.9% sodium chloride, furosemide, calcium chelators, phosphorus, calcitonin, bisphosophates, prostaglandin synthesis inhibitors

Dialysis

From Flashcardlet (107 decks)

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