Fluid and Electrolytes Flashcards by Josh Engel

What is hyponatremia?

Na+<135mEq/L

Normal range: 135-145mEq/L

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Signs and Symptoms of Hyponatremia

abdominal cramps

nausea

headache

altered mental status

muscle twitching, tremors, weakness

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Cause of Hyponatremia

excessive sweating

loop diuretics

low salt diet

hyperglycemia

wound drainage

hyperlipidemia

kidney disease

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Treatment for Hyponatremia

Monitor sodium

increase oral sodium intake

administer IV saline solutions

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What is Hypernatremia?

Na+>145mEq/L

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What causes hypernatremia?

water deficit

excess sodium intake with foods

medications (antiacids, IV solutions normal saline, antibiotics)

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Signs and Symptoms of Hypernatremia

SALT

Skin is flushed

Agitation

Low grade fever

Thirst

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Treatment for Hypernatremia

Oral fluids

IV fluids that do not contain sodium (dextrose)

Restrict sodium in diet

Increase water intake

Beware of hidden salt

Monitor I&O

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What is hypokalemia?

K+<3.5mEq/L

potassium deficit

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Signs and Symptoms of Hypokalemia

Fatigue

Anorexia

Nausea

Vomitting

Muscle weakness

Decreased GI motility

Dysrhythmias

Paresthesia (tinglying)

Flat T wave on ECG

Increased sensitivity to digitalis

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Causes of Hypokalemia

Diuretics

GI fluid loss through vomiiting, gastric suctioning and diarrhea

steroid administration

hyperaldosteronism

anorexia/bulimia

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Treatment of Hypokalemia

Monitor I&O

Monitor pottasium levels

If pt it taking digoxin, monitor pulse and observe for toxicity

intake of foods with pottasium

potassium supplements

IV potassium must be dilute and into central vein slowly

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What is Hyperkalemia?

K+>5.0mEq/l

normal is 3.5-5.0

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Signs and Symptoms of Hyperkalemia

muscle waekness

dysrhythmias

flaccid paralysis

intestinal collic

tall T-waves of ECG

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Causes of Hyperkalemia

renal failure

potassium sparing diuretics

hypoaldosterone

high potassium intake couples with renal insufficiency

acidosis

major trauma

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Treatment of Hyperkalemia

Monitor I&O

Monitor potassium levels

caution about potassium rich food intake win pt with elevated creatinine

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What is hypocalcemia?

Ca<8.5mq/dL

normal 8.5-10.5

Signs and Symptoms Hypocalcemia

Diarrhea

numbness and tingly of extremities

muscle cramps

tetany (stiff)

convulsions

laryngeal spasms

cardiac irritability

positive trousseau’s and chvostek’s tests

Causes of Hypocalcemia

hypoparathyroidism

malabsorption of calcium

pancreitis

alkolosis

Vit. D deficiency

Treatment of Hypocalcemia

Monitor I&O

Monitor calcium levels

encourgage icreased calcium intake

calcium supplements

if severe monitor patency of air way, institute seizure and administer saftey precautions and administer paraenteral calcium

What is hypercalcemia?

Ca>10.5mq/dL

normal 8.5-10.5

Signs and Symptoms of Hypercalcemia

muscle weakness

constipation

anorexia, nausea, vomitting

polyuria and polydipsia

kidney stones

bizarre behavior

bradycardia

Causes of Hypercalcemia

hyperparathyroidism

malignant bone disease

prolonged immobalization

excessive calcium supplementation

thiazide diuretics

Treatment of Hypercalcemia

monitor I&O

encourage fluid intake to prevent stone formation

encourage fiber to prevent constipation

eliminate calcium intake

avoid calcium based antacids

renal dialysis required

What is hypomagnesemia

Mg\<1.3mEq/L normal 1.3-2.1

Signs and symptoms of hypomagnesemia

neuromuscular irritability disorientation mood changes dysrhthmias increased sensitivity to digitalis

Causes of hypomagnesemia

chronic alcoholism malabsorption of magnesium diabetic ketoacidosis prolonged gastric suction

Treatment of hypomagnesemia

monitor I&O encourage foods high in magnesium avoid alcohol intake if the client is taking digoxin, observe sign of toxicity

What is hypermagnesemia?

Mg\>2.1mEq/L normal 1.3-2.1

Signs and Symptoms Hypermagnesemia

flushing and warmth of skin hypotension drawsyness and lathargy hypoactive reflexes depressed respirations bradycardia

Causes of Hypermagnesemia

renal failure adrenal insufficiency excess replacement

Treatment of Hypermagnesemia

monitor vital signs and airway monitor reflexes avoid magnesium based antacids and laxatives restrict foods high in Mg

What is hypophosphatemia

PO\<1.7mEq/L normal 1.7-2.6

Signs and Symptoms of Hypophosphatemia

Paresthesia (tingling) joint stiffness seizures cardiomyopathy impaired tissue oxygenation

Causes of Hypophosphatemia

refeeding after startvation alcohol withdrawl diabetic ketoacidosis respiratory acidosis

Treatment of Hypophosphatemia

monitor phosphorus levels monitor calcium levels as phosphate is replaced start TPN (total perentrial nutrition) slowly to avoid drops in phosphate

What is Hyperphosphatemia?

PO\>1.7-2.6mEq/L normal 1.7-2.6

Signs and Symptoms of Hyperphosphatemia

short term; tetany symptoms-tinglying of extremities and cramping long term; calcification of soft tissue

Causes of Hyperphosphatemia

renal failure hyperthyroidism chemotherapy excessive used of phosphate laxitive

Treatment of Hyperphosphatemia

monitor phosphate levels monitor for tetany if severe, administer aluminum hydroxide with meals to bind to phosphorus.