Stack #27028
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| Hyperkalemia normal value | 3.4-5 mEq/L
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| Hyperkalemia manifestations | Hx of renal failure & oliguria hypotension, bradycardia, nuscle weakness, nausea anuria
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| hyperkalemia interventiuons | initiate saline lock; notifyMD of K level and anuria infuse insulin & glucose to increase K uptake into cells ; IV Ca gluconate infusion dec. antogonistic effect of K excess on myocardium. Put pt on monitor due to possible severe dysrhytmias/arrest
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| hyperkalemai misc. | K levels over 7. mEq. arelikely to cause cardiac distrubances/ arrest
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| hypokalemia systems to assess | CV nueromuscular , GI, mental status (irritability /confusion)
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| hypokalemia manifestations | use of lasix w/out supplemental K; fatique; muscle weakness; depression; nocturia/polyuria, N/V, diarrha ab. distension
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| hypokalemia intervention | intiate saline lock; oral (less severe) IV (more severe) K Cardiac Montor (if pulse is weak/thready)
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| hypokalamia misc. | never push IV K (adminster 10 mEq/hr. diluted in IV fluid)
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| hypokalemia risk pop. | crash dieting, metabolic/ respiratory, alkalosis, diuretic therapy, loss of GI fluids, steroid use, estrogen use, severe burns, decrease K intake, liver disease with ascites, malabsoption, severe catabolism
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| hyperkalemia risk factors | renal failure, excessive K+ intake, cell damage, crushing injuries, K+ sparing diuretics, metablic acidosis, transfusion of old blood, internal hemorrhage
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| hypernatremia level | > 145 mEq/L
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| hypernatremia systems to assess | CV neuromuscualr Renal , CNS, respiratory, skin
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| hypernatremia manifestations | diarrhea, confusion/agitation/nonresponsive; dry mucous membranes; poor skin turgor; increase respirations; tachycardia; hypotension
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| hypernatremia interventions | initate saline lock when caused by fluid loss ; repalce with 1/4 to 1/2 saline.. Whencuased by fluid $ Na loss, replae with isotonic NS-- diuretics can be used to treat when caused by inadquet renal excretion of Na.
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| hypernatremia interventions | assess hourly for S&S of excess flluid loss, hyponatremia or hypokalemia; Monitor mental status; provide good oral hygiene; dialy weights , I&O
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| Hyponatremia | <135mEq/L
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| hyponatremia systems to assess | CV Neuromuscular, GI, Mental Status
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| hyponatremia manifestation | HA, drowsiness, N/V, severe diaphoresis; fatique, muscle cramps in legs; confusion; convulsions; hyporeflexia
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| hyponatremia interventions | IV replacement of Na (NS 1-2L -in more severe cases, give 3% or 5% Saline) monitor for S&S of fluid overload (crackles,edema, neck vein, distension,ascities, increase.BP) I&O daily wt.; other meds (esp. diuretics, MS, chemo)
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| hyponatremia misc. | commonly caused by strenuous activity in high heat
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| hypocalemia levels | <8.7 mg/dL
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| hypocalemia systems to assess | CV, mental status
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| hypocalcemia manifestations | +chvostek's sign(tap side of face) + trousseau's sign ( apply BP cuff for 2-4min) dec.in pulse, numbness/tingling in extremeties; anxiety; irritalbity
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| hypcalcemia interventions | administer prescribed Ca sol. Watch for throbophlepitis/extravasation/clotting/ thrombus formation/CV distrubances/ recurrence of hypocalcemi/overcorrectio of Ca promotorl intake of Ca ( and vit. D when pts. conditiona has improved.
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| hypocalcemia misc. | do NOT give Ca with saline
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