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Nur356 - Electrolyte
Electrolytes
Question | Answer |
---|---|
How does the gastrointestinal system regulate water balance? | Primarily by oral intake. Reabsorption and secretion accounts for 8,000 mL/day. Diarrhea/vomiting cause losses. |
How does insensible and sensible water loss regulate water balance? | Insensible = lung/skin vaporization (water only) Sensible = sweating, fever (water + electrolytes) |
What are treatments of fluid volume excess? | Treat the cause; give diuretics; limit intake of fluids and sodium |
What are causes of fluid volume excess? | Too much intake with too little output Shift from interstitium to plasma |
What are treatments for fluid volume deficit? | Treat the cause; increase intake; hydrate with IV (lactated ringers, NS, blood) |
What are clinical manifestations of fluid volume deficits? | Lethargy, dry mucous membranes, decreased skin turgor, tachycardia, hypotension, decreased urine output |
What are causes of fluid volume deficit? | Too little intake and too much output Fluid movement from plasma to interstitium (edema) |
What are clinical manifestations of hyperphosphatemia? | Precipitates in joints, arteries, skin, kidneys and cornea Neuromuscular irritability, tetany |
What are treatments of hypomagnesemia? | Mild: Oral supplement Severe: IV or IM supplement |
What are sources of calcium? | Primarily bone and secondary diet |
What are clinical manifestations of fluid volume excess? | Dyspnea, peripheral edema, increased heart rate, JVD, weight gain, lethargy, hypertension, lethargy |
What are clinical manifestations of hypophosphatemia? | Often asymptomatic if mild CNS depression, confusion, muscle weakness, pain, dysrhythmias |
What are causes of hypermagnesemia? | Increased intake with decreased renal function |
What are clinical manifestations of hypermagnesemia? | Lethargy, drowsiness, N/V (early), loss of DTR, somnolence, cardiac arrest |
What are treatments of hypermagnesemia? | Prevention is key; calcium chloride and calcium gluconate oppose the effects of magnesium on cardiac muscle |
What are clinical manifestations of hypomagnesemia? | Confusion, hyperreflexia, tremors, seizure, cardiac dysrhythmias |
What are causes of hypercalcemia? | Hyperparathyroidism, increased vitamin D, malignancy, prolonged immobility |
What are causes of hyperphosphatemia? | Renal failure, chemotherapy, excessive milk ingestion, vitamin D excess |
What are treatments of hypophosphatemia? | Mild: oral supplement, increased intake of dairy products Severe: sodium phosphate or potassium phosphate IV |
What are treatments of hyperphosphatemia? | Identify and treat cause; restrict dairy products, correct hypocalcemia and provide hydration |
What are some clinical manifestations of hypercalcemia? | Depressed reflexes, bone pain, fractures, renal calculi |
What are some treatments of hypercalcemia? | Furosemide (Lasix), hydration by IV and PO, calcitonin |
What are functions of magnesium? | Metabolism of carbohydrates and protein. |
What are sources of magnesium? | Bone is major source. |
How is magnesium balance obtained? | Maintained by GI absorption and renal excretion; similar to calcium balance (PTH) |
What are magnesium levels associated with? | Magnesium levels are associated with potassium and calcium levels. |
What are causes of hypomagnesemia? | Starvation, prolonged fasting, vomiting, diarrhea, NG suction, chronic alcoholism, diabetes mellitus |
What are causes of hypocalcemia? | Insufficient intake, hypoparathyroidism, elevated phosphorus, vitamin D deficiency, acute pancreatitis, chronic renal failure (not reabsorbing) |
How is calcium balance maintained? | Parathyroid hormone, vitamin D, calcitonin |
What are the clinical manifestations of hypocalcemia? | Fatigue, extremity numbness, muscle cramps, hyperreflexia, tetany, Chvostek's sign, Trousseau's sign. |
What are treatments of hypocalcemia? | Identify and treat underlying cause; calcium supplements |
What are functions of phosphorus? | Primary ion in ICF; essential to function of muscles, RBCs, and nervous system; tooth and bone structure; cellular glucose uptake and use, metabolism |
What are sources of phosphorus? | Bone and dietary |
How is balance of phosphorus maintained? | Requires adequate renal function |
With what is the phosphorus level associated? | The phosphorus level has a reciprocal relationship with the calcium level. |
What are causes of hypophosphatemia? | Decreased intake, malabsorption syndrome, alcohol withdrawal, phosphate binding antacids |
What are functions of calcium? | Involved in transmission of nerve impulses, muscle contractions, blood clotting, and teeth and bone formation |