Nurse Mike - Fluid & Electrolyte Tricks

Question 1

Potassium Function

Answer 1

Heart and Muscle Contraction

Question 2

HYPERKalemia

Answer 2

Heart - Tight and Contracted
1 ST elevation and Peaked T waves
2 Severe = V fib or cardiac standstill
3 HYPOtension and Bradycardia

GI Tract - Tight and Contracted
1 Diarrhea
2 Hyperactive bowel sounds

Neuromuscular - Tight and Contracted
Paralysis in extremities
Increased DTR
Profound muscle weakness (general feeling of heaviness)

Remember: EVERYTHING IN THE HEART IS SO CONTRACTED

Question 3

HYPOkalemia

Answer 3

LOW AND SLOW

Heart - Low and Slow
1 flat t waves, ST depression, & prominent U wave

Muscular - Low and Slow
1 Decreased DTR
2 Muscle cramping
3 Flaccid paralysis

GI - Low and Slow
Decreased motility, hypoactive to absent bowel sounds
Constipation
Abdominal distention
paralytic ileum, paralyzed intestines
- PRIORITY FOR SBO

Question 4

What is the function of sodium?

Answer 4

Maintain
- Blood pressure
- Blood volume
- pH balance

Question 5

HYPERnatremia

Answer 5

BIG AND BLOATED

SKin
- Flush : Red & Rosy
- Edema : waterbed skin
- Low grade fever

Polydipsia
- excess thirst

Late Serious Signs:
- SWOLLEN dry tongue
- GI - nausea and vomiting
- INCREASED muscle tone

Question 6

HYPOnatremia

Answer 6

DEPRESSED AND DEFLATED

Neuro = Seizures and Coma
Heart = tachycardia, weak & thready pulses
Respiratory Arrest

Question 7

What is the function of chloride?

Answer 7

Follows sister sodium around and does the same thing

Maintain:
-Blood volume
-Blood pressure
- pH balance

Question 8

HYPERchloremia

Answer 8

GI: nausea and vomiting
Swollen dry tongue
confusion

Question 9

HYPOchloremia

Answer 9

nearly same as low sodium

Excessive diarrhea, vomiting, sweating

FEVER - only difference

Question 10

What is the function of magnesium?

Answer 10

To maintain law and order in the muscles by calming them down and keeping the peace

Mainly in the heart, uterus, and deep tendon reflexes (DTR)

Required for calcium and vitamin D absorption

Question 11

HYPERmagnesemia

Answer 11

CALM AND QUIET

Cardiac - Calm & Quiet
- heart block
- prolonged PR intervals
- Vitals - bradycardia, hypotension

Deep Tendon Reflexes - Calm & Quiet
- HYPOreflexia - decreased DTR

Lungs- Calm & Quiet
- depressed shallow respirations

GI - Calm & Quiet
- hypoactive bowel sounds

Question 12

HYPOmagnesemia

Answer 12

NO sheriff in town, NO law and order

Cardiac - BUCK WILD
- EKG: ST depression, T wave inversion
- Torsades de pointed
- Severe: V fib
- Vitals - tachycardia

Deep Tendon Reflexes - BUCK WILD
-Hyporeflexia - increased DTR

Eyes - BUCK WILD
- abnormal eye movements (nystagmus)

GI - BUCK WILD
-Diarrhea

Question 13

What is the function of calcium?

Answer 13

Keep the 3’Bs strong:

Bones
Blood - clotting factors
Beats - heart beats

Question 14

HYPERcalcemia

Answer 14

SWOLLEN AND SLOW - Moans, groans, and stones

• Constipation
• Bone Pain
• Stones: Renal Calculi (kidney stones)
• Deep Tendon Reflexes: decreased DTR, severe muscle weakness

Question 15

HYPOcalcemia

Answer 15

learns two new dance moves

Trousseau’s Signs
Chvostek’s Sign
Diarrhea
Circumoral tingling

Risk for factors
Risk for bleeding
Cardiac Dysrhythmias

Question 16

What is phosphate’s function?

Answer 16

Calciums worse enemy; always work inversely with calcium

• Essential for bone and teeth formation
• Helps regulate calcium

Question 17

HYPERphosphatemia

Answer 17

Think low calcium s/s

Trousseau’s Signs
Chvostek’s Sign
Diarrhea
Weak B’s: weak bones (fractures), risk for bleeding, cardiac dysrhythmias

Question 18

HYPOPhosphate

Answer 18

think high calcium s/s
SWOLLEN & SLOW - Moans and Groans and Stones

• Constipation
• Decreased DTR and Severe muscle weakness
• Decreased HR, RR
• Increased BP