Fluids & Electrolytes Flashcards
(218 cards)
1
Q
What is a solution composed of?
A
A solvent (fluid) and solutes (particles)
In the context of fluids, the solvent is typically water, and the solutes can include electrolytes and proteins.
2
Q
What percentage of an adult’s body weight is fluid?
A
60%
This percentage can vary based on age, gender, and body fat.
3
Q
What are the two major compartments fluid is distributed in?
A
Intracellular Fluid (ICF) and Extracellular Fluid (ECF)
ICF contains two-thirds of body fluid, while ECF contains one-third and is further divided into intravascular, interstitial, and transcellular fluids.
4
Q
What is third-spacing?
A
Fluid shifts into spaces where it cannot contribute to equilibrium
Examples include ascites and pleural effusion.
5
Q
Name two major cations in the body.
A
- Sodium (Na+)
- Potassium (K+)
- Calcium (Ca2+)
- Magnesium (Mg2+)
These cations play critical roles in physiological functions.
6
Q
How does sodium (Na+) affect extracellular fluid volume?
A
Regulates ECF volume; water follows sodium
Sodium is key for maintaining fluid balance in the body.
7
Q
What is the function of the Sodium-Potassium Pump?
A
Moves 3 Na+ out and 2 K+ into the cell
This active transport helps maintain cellular ion balance.
8
Q
Fill in the blank: Water moves from lower to higher solute concentration through _______.
A
Osmosis
9
Q
What is hydrostatic pressure?
A
Pushes fluid out of capillaries
It contrasts with osmotic pressure, which pulls fluid into capillaries.
10
Q
What are isotonic solutions used for?
A
Volume expansion
An example is 0.9% NaCl.
11
Q
What are the main routes of fluid loss in the body?
A
- Kidneys
- Skin
- Lungs
- GI Tract
Each route contributes to daily fluid loss, with specific volumes varying per individual.
12
Q
What is the normal range for serum osmolality?
A
275-290 mOsm/kg
13
Q
True or False: High hematocrit indicates dehydration.
A
True
14
Q
What role do the kidneys play in fluid balance?
A
Filter 180 L of plasma daily and regulate fluid, electrolytes, and acid-base balance
This is crucial for maintaining homeostasis in the body.
15
Q
What is hypervolemia?
A
Excess fluid retention due to compromised regulatory mechanisms
It can result from organ dysfunction or excessive sodium intake.
16
Q
List two signs of dehydration.
A
- Low blood pressure
- Dizziness
Other signs include increased heart rate and poor skin turgor.
17
Q
What are isotonic solutions typically used for in IV therapy?
A
- Hypovolemia
- Shock
- Resuscitation
- Diabetic ketoacidosis
Examples include Normal Saline and Lactated Ringer’s.
18
Q
Fill in the blank: The normal pH range for blood is _______.
A
7.35 – 7.45
19
Q
What does a high BUN level indicate?
A
Dehydration or kidney dysfunction
20
Q
What is the purpose of IV fluids?
A
- Provide water
- Replace electrolytes
- Administer medications
IV fluids are essential for maintaining hydration and supporting various bodily functions.
21
Q
What can cause fluid overload?
A
- Excessive IV fluid administration
- Kidney failure
- Heart failure
This condition leads to symptoms such as high blood pressure and pulmonary edema.
22
Q
What is the Anion Gap formula?
A
AG = Na⁺ - (Cl⁻ + HCO₃⁻)
23
Q
What are the risks associated with hypotonic solutions?
A
- Cellular overhydration
- Cardiovascular collapse
- Increased intracranial pressure
These risks necessitate careful monitoring during administration.
24
Q
What is the main function of colloid solutions in IV therapy?
A
Increase oncotic pressure and draw fluid into the intravascular space
Examples include Dextran and Albumin.
25
What is the formula for calculating the Anion Gap in metabolic acidosis?
AG = Na⁺ - (Cl⁻ + HCO₃⁻)
## Footnote
Normal AG is 10-14 mmol/L.
26
What are the signs and symptoms of Fluid Overload (Circulatory Overload)?
High BP, distended jugular veins, pulmonary edema, rapid breathing
## Footnote
Caused by excessive IV fluid administration.
27
What is the management for Fluid Overload?
Slow IV rate, monitor vitals, place patient in high Fowler’s position, notify provider
## Footnote
Important to address symptoms promptly.
28
What causes an Air Embolism?
Air enters the central veins, travels to the right ventricle, and blocks blood flow
## Footnote
Can lead to serious complications.
29
What are the signs and symptoms of an Air Embolism?
Palpitations, dyspnea, jugular vein distention, cyanosis
## Footnote
Indicates a serious condition requiring immediate action.
30
What is the management for an Air Embolism?
Clamp IV line, place patient in left Trendelenburg position, administer oxygen
## Footnote
Aims to prevent further complications.
31
What are the signs and symptoms of Infection (Sepsis) related to IV complications?
Fever, chills, nausea, increased heart rate, back pain
## Footnote
Often caused by contaminated IV solutions or poor hand hygiene.
32
How can Infection (Sepsis) be prevented in IV therapy?
Aseptic technique, change IV sets as per protocol, inspect insertion site regularly
## Footnote
Essential for reducing infection risk.
33
What causes Phlebitis?
Irritating medications, large catheter size, poor aseptic technique
## Footnote
Inflammation of the vein is a common complication.
34
What are the signs and symptoms of Phlebitis?
Redness, warmth, pain, swelling along vein
## Footnote
Indicates inflammation and requires intervention.
35
What is the management for Phlebitis?
Discontinue IV, apply warm compress, restart IV at a different site
## Footnote
Aims to relieve symptoms and prevent further issues.
36
What is Infiltration in IV therapy?
Non-vesicant leakage when IV catheter is dislodged or perforates vein wall
## Footnote
Can lead to tissue swelling and discomfort.
37
What are the signs and symptoms of Infiltration?
Cool, swollen, pale IV site, leakage of IV fluid
## Footnote
Indicates fluid is not entering the bloodstream.
38
What is the management for Infiltration?
Stop infusion, remove IV catheter, apply warm compress
## Footnote
Essential to prevent further complications.
39
What is Extravasation in IV therapy?
Vesicant leakage caused by irritating IV medications leaking into tissue
## Footnote
Can cause severe tissue damage.
40
What are the signs and symptoms of Extravasation?
Burning, pain, redness, swelling, blistering, tissue necrosis
## Footnote
Indicates a serious complication requiring immediate action.
41
What is the management for Extravasation?
Stop IV immediately, administer antidote, apply cool compress
## Footnote
Aims to minimize tissue damage.
42
What is Parenteral Nutrition (TPN)?
Used when patients cannot tolerate oral intake, containing glucose, proteins, fats
## Footnote
Essential for patients with feeding difficulties.
43
What types of blood products can be administered via IV?
* Whole blood
* Packed RBCs
* Plasma
* Albumin
* Cryoprecipitate
## Footnote
Used for various medical conditions requiring blood component therapy.
44
How can IV medications be administered?
Given via continuous infusion or intermittent bolus
## Footnote
Requires careful monitoring due to rapid systemic effects.
45
What are the reference ranges for serum sodium?
135 - 145 mEq/L
46
Define electrolytes.
Substances that are dissolved in water and carry a positive or negative charge.
47
What is hypernatremia?
Serum sodium > 145 mEq/L
48
What causes hypernatremia?
* Excess sodium intake
* Hypertonic I.V fluids
* Fluid deprivation
* Heat stroke
* Diabetes Insipidus
49
What are the clinical manifestations of hypernatremia?
* Cellular dehydration
* Thirst triggered by the hypothalamus
* Possible neurological effects
50
What is hyponatremia?
Serum sodium < 135 mEq/L
51
List common causes of hyponatremia.
* SIADH
* Nausea, vomiting, diarrhea
* Adrenal insufficiency
* Excess water intake
52
What is the normal serum potassium range?
3.5 - 5 mEq/L
53
What is hyperkalemia?
Serum potassium > 5 mEq/L
54
What are the causes of hyperkalemia?
* Excess intake of potassium
* Internal shifts (e.g. acidosis)
* Renal injury or disease
* Medications (e.g. ARBs, ACE inhibitors)
55
What are the clinical manifestations of hyperkalemia?
* Changes in cardiac conduction
* Muscle weakness
* Abdominal cramps
* Diarrhea
56
What treatment options are available for hyperkalemia?
* Monitor ECG
* Limit potassium intake
* Potassium wasting diuretics
* Dialysis (if severe)
57
What is hypokalemia?
Serum potassium < 3.5 mEq/L
58
List causes of hypokalemia.
* Increased loss via kidneys
* GI tract losses
* Magnesium deficiency
* Metabolic alkalosis
59
What are the clinical manifestations of hypokalemia?
* ST segment depression
* Skeletal muscle weakness
* Decreased GI motility
* Cardiac dysrhythmias
60
What is the normal serum calcium range?
8.8 - 10.4 mg/dL
61
What are the functions of calcium?
* Formation of teeth and bone
* Blood clotting
* Transmission of nerve impulses
* Myocardial contractions
62
What is hypocalcemia?
Serum calcium < 8.8 mg/dL
63
What are the clinical manifestations of hypocalcemia?
* Tetany
* Laryngeal stridor
* Dysphagia
* Cardiac dysrhythmia
64
What is hypercalcemia?
Serum calcium > 10.5 mg/dL
65
What are the causes of hypercalcemia?
* Hyperparathyroidism
* Malignancy
* Excessive intake
* Prolonged immobilization
66
What is the normal serum phosphate range?
2.7 - 4.5 mg/dL
67
What are the clinical manifestations of hyperphosphatemia?
* Often asymptomatic
* Neuromuscular irritability
* Tetany
68
What is hypophosphatemia?
Serum phosphate < 2.7 mg/dL
69
List causes of hypophosphatemia.
* Malnourishment/malabsorption
* Diarrhea
* ETOH abuse
* Use of phosphate-binding antacids
70
What is the normal serum magnesium range?
1.8 - 2.6 mg/dL
71
What is hypermagnesemia?
Serum magnesium > 2.6 mg/dL
72
What are the clinical manifestations of hypermagnesemia?
* ECG changes
* Hypotension
* Lethargy
* Nausea and vomiting
73
What are the treatment options for hypermagnesemia?
* Restrict magnesium intake
* Emergency treatment: IV calcium gluconate
74
Fill in the blank: Electrolytes help regulate _______.
Cardiac and neurological function, fluid balance, acid-base balance
75
True or False: Sodium is primarily regulated through the liver.
False
76
What are the clinical manifestations of hypermagnesemia?
ECG changes, Hypotension, Lethargy/Somnolence, N/V, Impaired reflexes, Respiratory and cardiac arrest
## Footnote
Hypotension occurs due to magnesium acting like a sedative, leading to decreased heart contractility and blood pressure.
77
What is the serum magnesium level that defines hypomagnesemia?
Serum magnesium < 1.8 mg/dl
## Footnote
This indicates low serum magnesium levels.
78
List the causes of hypomagnesemia.
* Prolonged fasting or starvation
* Chronic alcoholism
* Fluid loss from GI tract
* Prolonged parenteral nutrition without supplementation
* Diuretics
* Large blood transfusion
## Footnote
These causes contribute to magnesium deficiency in the body.
79
What are the clinical manifestations of hypomagnesemia?
* Hyperactive deep tendon reflexes
* Muscle cramps
* Tremors
* Seizures
* Cardiac dysrhythmias (Torsade de pointes, Vfib)
## Footnote
Cardiac dysrhythmias are particularly important to recognize in hypomagnesemia.
80
What is the emergency treatment for hypermagnesemia?
IV calcium gluconate
## Footnote
This treatment is critical in counteracting the effects of high magnesium levels.
81
What treatments are used to promote urinary excretion in cases of hypermagnesemia?
* Fluids
* IV furosemide
## Footnote
These treatments help to reduce magnesium levels in the body.
82
What is the consequence of magnesium acting like a sedative in hypermagnesemia?
Losing contractility of the heart, leading to hypotension
## Footnote
This sedative effect can severely impact cardiovascular function.
83
True or False: Impaired reflexes can indicate magnesium deficiency.
False
## Footnote
Checking reflexes is a method to assess magnesium levels.
84
Fill in the blank: The treatment for severe hypermagnesemia may include _______.
[Dialysis]
## Footnote
Dialysis is considered if magnesium levels are excessively high.
85
What are the primary uses of water in the body?
Metabolic reactions, transport, lubrication, insulator, body temperature regulation (rep & sweating)
## Footnote
Water is essential for various physiological functions including maintaining body temperature and facilitating metabolic reactions.
86
How is water gained by the body?
Through drinking and eating
## Footnote
Daily intake of fluids is crucial for maintaining hydration and overall health.
87
What should the daily input and output of fluids be?
Equal
## Footnote
Maintaining fluid balance is essential for homeostasis.
88
What is the normal fluid loss through the kidneys?
1 ml/kg/hr
## Footnote
This is a standard measurement for renal function in terms of fluid output.
89
List the ways fluid is lost from the body.
* Skin (sweat, insensible loss)
* Lungs
* GI tract
## Footnote
GI tract losses are typically greater than normal fecal matter.
90
What factors affect water loss in the body?
* Age
* Sex
* Temperature
* Disease stages
## Footnote
These factors can influence hydration levels and fluid balance in individuals.
91
How does aging affect fluid loss?
Less lean muscle as we age
## Footnote
Lean muscle tissue holds more water, so a decrease in muscle mass can lead to increased fluid loss.
92
How does sex influence fluid content in the body?
Females have higher fat content, which doesn't hold water like muscle tissue
## Footnote
This biological difference can affect hydration status.
93
What is the typical fluid composition of an adult's body?
60% fluid
## Footnote
Understanding body fluid composition is important for assessing hydration and health.
94
What percentage of body fluid is intracellular and extracellular?
2/3 intracellular, 1/3 extracellular
## Footnote
Intracellular fluid is vital for cellular functions, while extracellular fluid is important for transport and communication between cells.
95
What is osmolality?
Thickness of body fluid, concentration of solute
## Footnote
Normal sodium osmolality levels range from 280-295 for plasma and 100-300 for urine.
96
What are the types of tonicity in relation to cells?
* Isotonic: Same osmolality as surrounding tissue
* Hypotonic: Less concentrated solutes than the cell
* Hypertonic: More concentrated solutes than the cell
## Footnote
These terms describe how fluids move in relation to cells based on solute concentration.
97
Define osmosis.
Water moves from low osmolality to high osmolality
## Footnote
Osmosis is a key process in maintaining fluid balance in the body.
98
What is hydrostatic pressure?
Pressure exerted on blood vessels
## Footnote
Hydrostatic pressure plays a critical role in fluid movement within the circulatory system.
99
What is osmotic pressure?
Volume in plasma
## Footnote
Osmotic pressure is influenced by solutes such as albumin, which attract fluid.
100
How does the heart affect hydrostatic pressure?
It extends on the vessels, pushing fluid from vascular spaces into interstitial spaces and pulling fluid into vascular spaces
## Footnote
The heart's pumping action is essential for maintaining blood pressure and fluid distribution.
101
True or False: Albumin does not attract fluid.
False
## Footnote
Albumin is a key protein that helps maintain osmotic pressure by attracting fluid into the vascular space.
102
How much of the water in our bodies is Intracellular fluid?
2/3
103
What is extracellular fluid further divided into?
Intravascular fluid (plasma)
Interstitial fluid (surrounding cells)
Transcellular fluid (cerebrospinal, synovial, pleural fluid)
104
What does fluid movement between the ICF and ECF maintain?
Homeostasis.
105
what are some signs of third spacing?
Decreased urine output, increased heart rate, decreased blood pressure.
106
Explain third spacing.
Fluid shifts into spaces where it cannot contribute to equilibrium (e.g., ascites, pleural effusion).
107
What are you doing?
Being Awesome
108
What are the major anions (-) in out body?
Chloride (Cl-), Bicarbonate (HCO3-), Phosphate (PO4-).
109
What pulls fluid out of the capillaries?
Osmotic pressure
110
Movement of solutes from high to low concentration is______________?
Diffusion.
111
Fluid movement due to hydrostatic pressure is_______________?
Filtration.
112
What type of IV solution causes no fluid shift?
Isotonic for example 0.9 NaCl
113
What type of IV solution treats dehydration? (moves fluid into the cells)
Hypotonic solution f.ex. 0.45% NaCL
114
What type of IV solution can be used to treat cerebral edema (draws fluid out of the cells)?
Hypertonic, such as 3% NaCl.
115
How much fluid is lost through sweat and insensible loss?
approx. 500ml/day
116
how much fluid is lost through the lungs each day?
approx. 300ml/day
117
how much fluid is lost through the GI tract each day?
100-200 ml/day
118
What does the BUN tell us?
Dehydration & kidney dysfunction.
119
What lab is the best indication for kidney function?
Creatinine.
120
What does it mean if the hematocrit lvl is high?
If the patients hematocrit is high it means that they are dehydrated. Low Hct means that the patient is overhydrates or anemic.
121
What does urine sodium help us assess?
Fluid volume status.
122
What does the Pituitary gland release and what is its purpose?
ADH (antidiuretic hormone), promotes water retention.
123
what does the adrenal gland release and what is its purpose?
Aldosterone, regulates sodium and potassium.
124
What does the RAAS respond to and what does it increase?
Low blood pressure. It increases fluid retention.
125
What is the action of the Natriuretic Peptides ANP & BNP?
It does the opposite of the RAAS. It promotes the excretion of water and sodium. This can happen if the blood pressure is too high.
126
Why would we give a patient ACE inhibitors and what is their action?
We would give a patient ACE-inhibitors (-pril) in response to high blood pressure. They stop the body from converting Angiotensinogen to angiotensin and therefore prevents vasoconstriction.
127
What is dehydration the loss of? And what does it elevate?
Water OR sodium - Elevates sodium concentration.
128
What is another name for Hypovolemia?
Fluid Volume Deficit (FVD)
129
How is FVD different from Dehydration?
Dehydration is loss of Water only, FVD is a proportional loss of water AND electrolytes.
130
What are some clinical manifestations of FVD/Hypovolemia?
* Low BP & increased HR and flattened neck veins
* Dizziness confusion & thirst
* Low urine output & concentrated urine
* Poor skin turgor, sunken eyes, cool/clammy/pale skin
* Nausea, muscle cramps, fever, increased body temp.
131
What looking at the labs of someone who is hypovolemic, which readings would increase and which would decrease?
* Hemoglobin & hematocrit concentration would INCREASE due to plasma volume loss.
* Serum & urine osmolality would INCREASE due to concentrated urine.
* Urine sodium would DECREASE due to the kidneys trying to conserve sodium.
* BUN and Creatinine would INCREASE which is an indication for dehydration.
132
What is the primary focus of the lecture on fluid and electrolytes?
Fluid and electrolyte balance in the body
## Footnote
The lecture specifically concentrates on sodium, potassium, magnesium, calcium, and phosphate.
133
What role does sodium (Na⁺) play in the body?
Fluid balance, nerve transmission, and muscle function
## Footnote
Sodium is regulated by the kidneys.
134
What is the normal range for sodium (Na⁺)?
135-145 mEq/L
135
What is hypernatremia?
Na⁺ > 145 mEq/L
## Footnote
Causes include excess sodium intake, water loss, and heatstroke.
136
List three effects of hypernatremia.
* Cellular dehydration
* Thirst (hypothalamus-driven)
* Neurological changes (confusion, seizures)
## Footnote
Muscle weakness is also a significant effect.
137
What are the treatments for hypernatremia?
* Increase water intake
* IV hypotonic fluids
* Monitor neurological status
138
What is hyponatremia?
Na⁺ < 135 mEq/L
## Footnote
Causes include excess water intake, SIADH, and heart failure.
139
What are the effects of hyponatremia?
* Neurological changes
* Confusion
* Seizures
## Footnote
Muscle weakness is also a notable effect.
140
What are the treatments for hyponatremia?
* Fluid restriction
* Hypertonic saline (if severe)
* Monitoring
141
What is the normal range for potassium (K⁺)?
3.5-5.0 mEq/L
142
What is hyperkalemia?
K⁺ > 5.0 mEq/L
## Footnote
Causes include excess intake, renal failure, and tissue damage.
143
List three effects of hyperkalemia.
* Cardiac arrhythmias
* Muscle weakness
* Paralysis
## Footnote
Diarrhea is also a common effect.
144
What are the treatments for hyperkalemia?
* EKG monitoring
* Insulin/glucose therapy
* Diuretics
* Dialysis (if severe)
145
What is hypokalemia?
K⁺ < 3.5 mEq/L
## Footnote
Causes include diuretics, vomiting, and alkalosis.
146
List three effects of hypokalemia.
* Cardiac dysrhythmias
* Muscle weakness
* Cramps
## Footnote
Constipation is another effect.
147
What are the treatments for hypokalemia?
* Potassium supplements (oral/IV)
* IV potassium must be diluted (no bolus!)
* Monitor urine output
148
What is the normal range for calcium (Ca²⁺)?
8.8-10.4 mg/dL
149
What are the functions of calcium (Ca²⁺)?
* Bone health
* Blood clotting
* Nerve transmission
* Muscle contraction
150
What is hypercalcemia?
Ca²⁺ > 10.4 mg/dL
## Footnote
Causes include hyperparathyroidism and malignancy.
151
List three effects of hypercalcemia.
* Lethargy
* Muscle weakness
* Kidney stones
## Footnote
Cardiac dysrhythmias are also a concern.
152
What are the treatments for hypercalcemia?
* Hydration
* Loop diuretics
* Bisphosphonates
* Calcitonin
153
What is hypocalcemia?
Ca²⁺ < 8.8 mg/dL
## Footnote
Causes include vitamin D deficiency and chronic kidney disease.
154
List three effects of hypocalcemia.
* Tetany (muscle spasms)
* Positive Chvostek’s sign
* Seizures
## Footnote
Cardiac issues may also arise.
155
What are the treatments for hypocalcemia?
* Calcium supplements (IV calcium gluconate)
* Vitamin D supplementation
156
What is the normal range for phosphate (PO₄³⁻)?
2.7-4.5 mg/dL
157
What are the functions of phosphate (PO₄³⁻)?
* Bone/teeth strength
* ATP production
* Acid-base balance
158
What is hyperphosphatemia?
PO₄³⁻ > 4.5 mg/dL
## Footnote
Causes include renal failure and chemotherapy.
159
List three effects of hyperphosphatemia.
* Hypocalcemia symptoms
* Soft tissue calcifications
## Footnote
Symptoms may include tetany and muscle cramps.
160
What are the treatments for hyperphosphatemia?
* Phosphate binders
* Dialysis if severe
161
What is hypophosphatemia?
PO₄³⁻ < 2.7 mg/dL
## Footnote
Causes include malnutrition and chronic alcoholism.
162
List three effects of hypophosphatemia.
* CNS depression
* Cardiomyopathy
* Muscle weakness
163
What are the treatments for hypophosphatemia?
* Phosphate supplementation
* Diet modification
164
What is the normal range for magnesium (Mg²⁺)?
1.8-2.6 mg/dL
165
What are the functions of magnesium (Mg²⁺)?
* Muscle function
* Nerve conduction
* Cardiac function
166
What is hypermagnesemia?
Mg²⁺ > 2.6 mg/dL
## Footnote
Causes include renal failure and excessive intake.
167
List three effects of hypermagnesemia.
* Lethargy
* Hypotension
* Respiratory depression
## Footnote
Cardiac arrest is a severe effect.
168
What are the treatments for hypermagnesemia?
* IV calcium gluconate
* Dialysis if severe
169
What is hypomagnesemia?
Mg²⁺ < 1.8 mg/dL
## Footnote
Causes include malnutrition and prolonged diarrhea.
170
List three effects of hypomagnesemia.
* Hyperactive reflexes
* Tremors
* Cardiac dysrhythmias
## Footnote
Torsades de pointes and V-fib are specific dysrhythmias.
171
What are the treatments for hypomagnesemia?
* Magnesium sulfate IV
* Dietary intake
172
What should be monitored for potassium, magnesium, and calcium imbalances?
Cardiac function (ECG)
173
What should be assessed in sodium disorders?
Neurological changes
174
Before giving IV potassium, what should be checked?
Urine output
175
What is a key nursing consideration regarding electrolyte intake?
Balance electrolyte intake and loss through diet and IV fluids
176
What is the normal range for Sodium (Na⁺)?
135-145 mEq/L
177
What key roles does Sodium (Na⁺) play in the body?
* Maintains extracellular fluid balance
* Nerve impulses
* Muscle function
178
What is hypernatremia?
Na⁺ > 145 mEq/L
179
List two causes of hypernatremia.
* Too much sodium (diet, IV fluids)
* Too little water (dehydration, diabetes insipidus, heatstroke)
180
What are the effects of hypernatremia?
* Neurological issues: confusion, delirium, brain cell dehydration
* Seizures, coma in severe cases
* Thirst mechanism activation (hypothalamus)
181
What is the nursing management for hypernatremia?
* Fluid replacement (oral or IV)
* Hypotonic solutions (e.g., 0.45% saline)
* D5W (5% dextrose in water)
* Diuretics
* Monitor for neurological changes
182
What is hyponatremia?
Na⁺ < 135 mEq/L
183
List two causes of hyponatremia.
* Excess water intake (SIADH, heart failure, excessive IV fluids)
* Sodium loss (vomiting, diarrhea, diuretics)
184
What are the effects of hyponatremia?
* Neurological changes: altered mental status, seizures, coma
* Fluid status variations (hypovolemic, euvolemic, hypervolemic)
185
What is the nursing management for hyponatremia?
* Fluid restriction
* Hypertonic saline (3% NaCl) for severe cases
* Diuretics
* Monitor mental status changes
186
What is the normal range for Potassium (K⁺)?
3.5-5.0 mEq/L
187
What key roles does Potassium (K⁺) play in the body?
* Cardiac function
* Nerve impulses
* Muscle contraction
188
What is hyperkalemia?
K⁺ > 5.0 mEq/L
189
List two causes of hyperkalemia.
* Excess potassium intake (diet, salt substitutes)
* Tissue damage (burns, crush injuries)
190
What are the effects of hyperkalemia?
* ECG changes: tall, peaked T waves; widened QRS complex
* Severe cases → Ventricular fibrillation, asystole
* Muscle weakness, abdominal cramps, diarrhea
191
What is the nursing management for hyperkalemia?
* Telemetry monitoring
* Diuretics
* Sodium polystyrene sulfonate (Kayexalate)
* IV insulin with dextrose
* Calcium gluconate IV
* Dialysis for severe cases
192
What is hypokalemia?
K⁺ < 3.5 mEq/L
193
List two causes of hypokalemia.
* Diuretics (loop & thiazide)
* GI losses (vomiting, diarrhea)
194
What are the effects of hypokalemia?
* ECG changes: flattened T waves, presence of U waves
* Ventricular dysrhythmias
* Muscle weakness, leg cramps, constipation
195
What is the nursing management for hypokalemia?
* Potassium supplementation (oral or IV)
* Monitor ECG changes
* Encourage potassium-rich foods
196
What is the normal range for Calcium (Ca²⁺)?
8.8-10.4 mg/dL
197
What key roles does Calcium (Ca²⁺) play in the body?
* Bone health
* Muscle contraction
* Nerve function
* Blood clotting
198
What is hypercalcemia?
Ca²⁺ > 10.4 mg/dL
199
List two causes of hypercalcemia.
* Hyperparathyroidism
* Malignancies (cancer-related bone destruction)
200
What are the effects of hypercalcemia?
* Fatigue, muscle weakness, kidney stones
* ECG changes (shortened QT interval)
201
What is the nursing management for hypercalcemia?
* Increase fluid intake
* Loop diuretics
* Bisphosphonates
202
What is hypocalcemia?
Ca²⁺ < 8.8 mg/dL
203
List two causes of hypocalcemia.
* Vitamin D deficiency
* Chronic renal disease
204
What are the effects of hypocalcemia?
* Neuromuscular excitability (tetany, muscle spasms)
* Positive Chvostek’s sign
* Positive Trousseau’s sign
205
What is the nursing management for hypocalcemia?
* IV calcium gluconate for acute cases
* Calcium and vitamin D supplements
* Seizure precautions
206
What is the normal range for Phosphate (PO₄³⁻)?
2.7-4.5 mg/dL
207
What is hyperphosphatemia?
PO₄³⁻ > 4.5 mg/dL
208
List two causes of hyperphosphatemia.
* Kidney disease
* Tumor lysis syndrome
209
What are the effects of hyperphosphatemia?
* Soft tissue calcifications
* Hypocalcemia symptoms
210
What is the nursing management for hyperphosphatemia?
* Phosphate binders (calcium acetate)
* Dialysis
211
What is hypophosphatemia?
PO₄³⁻ < 2.7 mg/dL
212
List two causes of hypophosphatemia.
* Malnutrition
* Chronic alcoholism
213
What are the effects of hypophosphatemia?
* Muscle weakness
* Respiratory failure
214
What is the nursing management for hypophosphatemia?
* Phosphate supplements
* Dietary changes
215
What is the normal range for Magnesium (Mg²⁺)?
1.8-2.6 mg/dL
216
What are the effects of hypermagnesemia?
* Lethargy
* Hypotension
* Cardiac arrest
217
What are the effects of hypomagnesemia?
* Hyperactive reflexes
* Torsades de pointes (life-threatening arrhythmia)
218
What are the final takeaways regarding electrolytes?
* Electrolytes affect cardiac, neurological, and muscular functions
* Nurses must anticipate interventions & monitor patients closely
* Key nursing actions include ECG monitoring, IV management, dietary education
