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NCLEX > Fluid and Electrolytes 2 > Flashcards

Fluid and Electrolytes 2 Flashcards

1
Q

Magnesium and Calcium act as _____

A

SEDATIVES

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2
Q

Magnesium is excreted by the ____ but it can be lost in other way such as ____/

A

kidneys

Gi tract

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3
Q

NORMAL magnesium lab values

A

1.3-2.1

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4
Q

NORMAL calcium lab values

A

9.0- 10.5

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5
Q

Calcium and _____ have inverse relationship!!

A

Phosphorus

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6
Q

If you want to get mg and ca questions right, think ____ FIRST

A

muscles

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7
Q

causes of hypermagnesemia

A

renal failure

antacids

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8
Q

S/S of hypermagnesemia

A
  1. flushing
  2. warmth
  3. makes you vasodilate
DTR- decrease
Muscle tone- weak, flaccid
arrhythmias- YES
LOC- Decrease
Pulse - Decrease
respirations- Decrease
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9
Q

treatment for hypermagnesemia

A
  • ventilator
  • dialysis
  • calcium gluconate (reverses resp. depression and arrthymias)
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10
Q

How is calcium gluconate administered?

A

IV push very slowly

max rate 1.5-2ml/min

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11
Q

causes for hypercalcemia

A

-hyperparathyroidism (TOO much PTH)
WHYYY?!?
When your serum calcium gets low, PTH kicks in and pulls CA from the BONE and puts it in the blood; therefore, the serum calcium goes UP.
-thiazides (retain calcium)
-immobilization (you have to bear weight to keep CA in the bone)

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12
Q

S/S of hypercalcemia

A
  • bones are brittle

- kidney stones (majority is made of calcium)

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13
Q

Treatment for hypercalcemia

A
  • MOVE
  • Fluids to prevent kidney stones
  • Sodium phosphate
  • Steroids
  • Add phosphorus to diet
  • Must have Vitamin D to use Ca.
  • Calcitonin DECREASES serum Ca
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14
Q

Causes of hypomagnesemia

A
  • diarrhea (lots of Mg in intestines)
  • alcoholism
  • alcohol suppresses ADH & it hypertonic
  • *not eating, drinking
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15
Q

Causes of hypocalcemia

A

-hypoparathyroidism
-radical neck
-thyroidectomy
(NOT ENOUGH PTH for all of these)

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16
Q

s/s of hypo calcemia and hypomagnesemia

A
  • Muscle tone= rigid and tight
  • pt could have seizures
  • stridor/larynogospasm
  • positive chvostek
  • positive trousseau
  • arrhythmias
  • DTR= increase
  • mind changes
  • swallowing problems (esophagus is a smooth muscle)
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17
Q

what is the chvosteks sign?

A

tap check (C is for cheek)

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18
Q

what is trousseaus sign?

A

pump up BP cuff. the hand will hyperflex

if you get a tremor, NOT NORMAL!

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19
Q

treatment for hypomagnesemia?

A
  • give some mg
  • check kidney function (before and during IV mg)
  • seizure precautions
  • eat magnesium
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20
Q

treatment of hypocalcemia?

A
  • vit. d
  • phosphate binder (sevelamer hydrochloride [renagel], calcium acetate [PhosLo]) (makes phos go DOWN, ca go UP)
  • IV ca
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21
Q

What is important to do with IV calcium?

A

GO SLOWLY

make sure patient is on heart monitor!

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22
Q

What do you do if your client reports flushing and sweating when you start IV Mg?

A

STOP THE INFUSION!

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23
Q

Why should you put a patient getting IV calcium on a heart monitor?

A

because it widens the QRS complex.

24
Q

What are some foods that are high in magnesium?

A 
spinach
mustard green
summer squash
broccoli
halibut
turnip greens
pumpkin seeds
peppermint
cucumber
green beans
celery
kale
sunflower seeds
sesame seeds
flax seeds
25
Q

sodium think ____.

A

neuro changes

26
Q

normal sodium lab values

A

135-145 meq/l

27
Q

the sodium level in your blood is totally dependent on __.

A

how much WATER you have in your blood.

28
Q

Hypernatremia =

A

DEHYDRATION

too much sodium; not enough water

29
Q

causes of hypernatremia

A

hyperventilation
heat stroke
diabetes insipidous

30
Q

s/s of hypernatremia

A

dry mouth
thirsty-already dehydrated by the time your thirsty
swollen tongue (when severe)

31
Q

treatment for hypernatremia

A
  • restrict sodium
  • dilute client with fluids (diluting makes sodium go down)
  • daily weight
  • I & O
  • lab work
32
Q

hyponatremia =

A

DILUTION

too much water; not enough sodium

33
Q

causes of hyponatremia

A
  • drinking water for fluid replacement
  • psychogenic polydipsia ( loves to drink water)
  • D5W (sugar and water)
  • SIADH (retaining water)
34
Q

s/s of hyponatremia

A

headache
seizure
coma

35
Q

treatment for hyponatremia

A
  • client needs sodium
  • client doesnt need water
  • if having neuro problems, need HYPERTONIC(packed with particles) saline. (3%NS or 5%NS)
36
Q

with patient taking 3%NS or 5% NS, _____.

A

They will be in an ICU setting!

37
Q

Feeding tube patient tend to get ____.

A

Dehydrated!!

38
Q

normal potassium lab value

A

3.5 - 5.0

39
Q

potassium is excreted by ___

A

the kidneys

40
Q

if the kidneys arent working well, the serum potassium level will go ____ .

A

UP

41
Q

causes of hyperkalemia

A
  • kidney trouble

- spironolactone (makes you retain potassium)

42
Q

s/s of hyperkalemia

A
  • begins with muscle twitching
  • then proceeds to weakness
  • then flaccid paralysis
43
Q

treatment for hyperkalemia

A
  • dialysis; kidneys arent working
  • calcium gluconate (decreases arrhythmias)
  • glucose and insulin (insulin carries glucose and potassium into the cell)
  • sodium polystyrene sulfonate
44
Q

Sodium and potassium are ____.

A

INVERSE

45
Q

anytime you give IV insulin, worry about ____.

A

hypoglycemia and hypokalemia

46
Q

causes of hypokalemia

A
  • vomiting
  • NG suction (we have lots of potassium in our stomach)
  • Diuretics
  • not eating
47
Q

s/s of hypokalemia

A

muscle cramps

weakness

48
Q

life-threatening arrhythmias can happen with __.

A

HYPO and HYPER kalemia

49
Q

treatment for hypokalemia

A
  • give potassium
  • spironolactone (makes pt retain potassium)
  • eat more potassium
50
Q

major problem with oral potassium is?

A

GI UPSET

51
Q

what should you assess before and during IV potassium?

A

urinary output

52
Q

always put IV potassium on ___.

A

a pump

53
Q

never give IV potassium ___.

A

PUSH.

Mix well!

54
Q

does IV potassium burn during infusion?

A

YES

use large bore catheter.

55
Q

foods high in potassium?

A

spinach, fennel, kale, mustard greens, brussels sprouts, broccoli, eggplant, cantaloupe, tomatoes, parsley, cucumber, bell pepper, apricots, ginger root, strawberries, avocado, banana, tuna, halibut, cauliflower, kiwi, oranges, lima beans, potatoes, cabbage.

NCLEX (14 decks)

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