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NUR151-Ele-CasStd2
Electrolyte Illness Case Studies 2
| Question | Answer |
|---|---|
| Physical examination: apprehension, personality change, postural hypotension, postural dizziness, abdominal cramping, nausea and vomiting, diarrhea, tachycardia, dry mucous membranes, convulsions and coma | Hyponatremia due to GI (vomiting), renal (disease), skin (burns or sweat), polydipsia, or SIADH. |
| Physical examination: extreme thirst, dry and flushed skin, dry and sticky tongue and mucous membranes, postural hypotension, fever, agitation, convulsions, restlessness, and irritability | Hypernatremia due to excessive salt intake, excess aldosterone, Diabetes insipidus, or water deprivation. |
| Physical examination: weakness and fatigue, muscle weakness, nausea and vomiting, intestinal distention, decreased bowel sounds, decreased deep tendon reflexes, ventricular dysrhythmias, paresthesias and weak, irregular pulse | Hypokalemia due to diuretics, GI losses, alkalosis, excess aldosterone, polyuria, sweating, treatment of diabetic ketoacidosis with insulin. |
| Physical examination: anxiety, dysrhythmias, paresthesia, weakness, abdominal cramps, and diarrhea | Hyperkalemia due to renal failure, fluid volume deficit, burns, IV potassium overload, adrenal insufficiency, acidosis. |
| In acidosis, you will see higher __ levels | potassium |
| Physical examination: numbness and tingling of fingers and circumoral (around mouth) region, hyperactive reflexes, positive Trousseau's sign (carpopedal spasm with hypoxia), positive Chvostek's sign (contraction of facial muscles when facial nerve is tapp | Hypocalcemia due to rapid blood transfusion, hypoparathyroidism, alkalosis, renal failure, pancreatitis, alcoholism. |
| Physical examination: anorexia, nausea and vomiting, weakness, hypoactive reflexes, lethargy, flank pain (from kidney stones), decreased level of consciousness, personality changes, and cardiac arrest | Hypercalcemia due to hyperparathyroidism, Paget’s disease, osteoporosis, acidosis, or thiazide diuretics. |
| Physical examination: muscular tremors, hyperactive deep tendon reflexes, confusion and disorientation, tachycardia, hypertension, dysrhythmias, and positive Chvostek's sign and Trousseau's sign. | Hypomagnesemia due to inadequate intake, diarrhea, vomiting, nasogastric drainage, aldosterone excess, polyuria. |
| Physical examination: acute elevations in magnesium levels: hypoactive deep tendon reflexes, decreased depth and rate of respirations, hypotension, and flushing. | Hypermagnesemia due to renal failure or excess intake of magnesium. |
| A patient with ECF excess will experience? | Shortness of breath, irritative cough, and moist crackles on auscultation. |
| A patient with ECF deficit will demonstrate | an increased respiratory rate due to decreased tissue perfusion and resultant hypoxia. |
| ECF excess may result in | cerebral edema as a result of increased hydrostatic pressure in cerebral vessels. |
| Profound volume depletion may cause an alteration in | sensorium secondary to reduced cerebral tissue perfusion. |
| Volume deficit may also cause the skin to appear | dry and wrinkled. |
| Skin that is edematous may feel cool because of | fluid accumulation and a decrease in blood flow secondary to the pressure of the fluid. |
| The patient with nasogastric suction should not be allowed to drink water because | it will increase the loss of electrolytes. |
| A nasogastric tube should always be irrigated with | isotonic saline solution not water because it causes diffusion of electrolytes into the gastric lumen from mucosal cells; the electrolytes are then suctioned away. |
| The primary protection against the development of hyperosmolality is | thirst |
| Irritability, apprehension, confusion, dizziness, personality changes, tremors, seizures, coma | Hyponatremia with Decreased ECF Volume |
| Hyponatremia with Decreased ECF Volume | (blank) |
| Restlessness, agitation, twitching, seizures, coma, Intense thirst; dry, swollen tongue, sticky mucous membranes | Hypernatremia with Decreased ECF Volume |
| jugular venous filling, tachycardia, thready pulse | Hyponatremia with Decreased ECF Volume – also postural hypotension and cold/clammy skin. |
| Headache, apathy, confusion, muscle spasms, seizures, coma, Nausea, vomiting, diarrhea, abdominal cramps | Hyponatremia with Normal/Increased ECF Volume |
| Restlessness, agitation, twitching, seizures, coma, Intense thirst, flushed skin | Hypernatremia with Normal/Increased ECF Volume |
Created by:
Ladystorm