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11 - Hondros - IVII
Electroylte levels, signs, symptoms, and treatments in nursing
| Question | Answer |
|---|---|
| Treatment of hypernatremia | -Sodium level to be lowered GRADUALLY (not more than 15 meq in 8 hours) -Monitor labs, I&O, watch for signs of pulmonary edema |
| Treatment of hyponatremia | -adminster .9 NS or lactated ringers (D5W will worsen effects - do not give!) -Restrict water intake, asses history and risk factors, medications, and lab results |
| 3 factors that cause Sodium imbalance | -Change in sodium content of ECF -Change in chloride content (affects sodium and water levels) -Change in quantity of water in ECF |
| Signs and symptoms of hypokalemia | -Neuro: fatigure, muscle weakness, no deep tendon reflexes, flaccid paralysis -Anorexia, vomiting, ECG changes -Death by cardiac arrest if not treated |
| Treatment of hypokalemia | -Key is slow replacement, and pt should always be on a cardiac monitor -Use caution when exceeding 120 meq per day -NEVER GIVE POTASSIUM IVP |
| Cations | Sodium, Potassium, Calcium, Magnesium |
| Signs and symptoms of hyponatremia | -Anorexia, muscle cramps, feelings of impending doom (especially when level is <115) -Impaired sense of test -Fatigue, Apprehension, FOCAL WEAKNESS |
| Relationship of sodium and pH | Sodium combines with chloride and bicarbonate to alter pH levels |
| Hyponatremia - levels and why it occurs | -Below 136 meq -More water than sodium -Excess loss of sodium OR water (such as vomiting or diarrhea (Serum osmolarity of <280, specific gravity of <1.010) |
| Potassium - levels, %, location, daily requirement | - 3.5 to 5 meq -98% ICF, 2% ECF -Daily requirement 40 meq |
| Anions | Chloride, Phoshporous, Bicarbonate |
| Signs and Symptoms of Hypernatremia | -Marked thirst, elevated body temperature, swollen tongue, dry/sticky mucous membranes SEVERE - disoriented, irritable, hyper |
| Hypokalemia - level, factors/causes | <3.5 meq - GI loss, diarrhea, laxative, gastric suction, vomiting, sweating -Renal impairment, non potassium sparing diuretics -Excessive steroids, or alkalosis |
| Sodium - range, major function, % and location | -136 to 145 meq -Function is to maintain ECF volume -90% of ECF cations |
| Regulation of potassium as it relates to: -Sodium -Hydrogen -Aldosterone | -There must be enough sodium for exchange (sodium/potassium ion pumps) -An increase in aldosterone stimulates an increase in potassium -An increase in hydrogen excretion leads to a decrease of potassium |
| Roles of potassium | -Regulates fluid volume IN cell (ICF -Nerve impulse transmissions -Muscle contractions -Controls H ion, acid/base balance (when potassium moves out of cell, H ions move in, and vice versa) |
| Hypernatremia - level and why it occurs | >145 meq -Gaining sodium w/o an H20 increase, or loss of H20 w/o loss of sodium -Person can no longer respond to thirst -Drowning in seawater -Hypertonic tube feed/parenteral (serum osmolarity of >295, specific gravity of >1.015) |
| Hyperkalemia - level and why it occurs | >5.5 meq -Caused by excessive potassium administration -Renal failure -Burns or crushing injuries |
| Signs and symptoms of hyperkalemia | -ECG changes (wide QRS intervals) -Muscle weakness, flaccid paralysis -Anxiety -Nausea, diarrhea |
| Treatment of hyperkalemia | -Restrict intake of potassium -Adminster IV calcium gluconate -Adminster sodium bicarbonate -Adminster regular insulin -Possible peritoneal dialysis |
| Calcium - levels and functions | 8.5 to 10.5 mg -maintains skeletal and neuromuscular activity -influences enzymes -converts prothrombin to thrombin |
| Hypocalcemia - levels and causes | <8.5 mg -usually caused by inadequate PTH secretion -Also diarrhea, wound exudates, acute pancreatitis |
| Signs and symptoms of hypocalcemia | -Numbness in fingers -Muscle cramps, decreased deep tendon reflexes -Positive Trousseau and Chvostek |
| Treatment of hypocalcemia | -Alleviate underlying cause -Administration (IV or oral) of calcium gluconate |
| Treatment of hypomagnesemia | -Adminstration of oral magnesium salts -Administer mag sulfate IV |
| hypercalcemia - levels, causes | >10.5 mg -Causes include hyperparathyroidism, pagets disease, multiple fractures, overuse of antacids, and those with tumors |
| Signs and symptoms of hypercalcemia | -Muscle weakness/uncoordination -lethargy -deep bone pain -flank pain -can cause dysrythmias |
| Hypermagnesemia - levels and causes | >2.5 meq -Most common cause is renal failure -Also, addisons disease or inadequate excretion by kidneys |
| Treatment of hypermagnesemia | -decreased intake -administer calcium gluconate -support respiratory function -peritoneal dialysis |
| Phosphorous - levels and functions | 3.0 to 4.5 mg -role of metabolism in proteins, carbs, and fats -essential to energy, creation of ATP and ADP -backbone of nucleic acids -delivery of oxygen and red blood enzymes |
| Hypophosphatemia - levels and causes | <2.5 mg -overzealous refeeding malabsorption -alcohol withdrawal -GI losses |
| signs and symptoms of hypocalcemia | -hyperactive reflexes, coarse tremors, muscle cramps -Positive Trousseau and Chvostek -Seizures -Painfully cold hands and feet |
| signs and symptoms of hypophosphatemia | -disorientation, confusion -seizures, parasthesia, muscle weakness, tremors, ataxia, uncoordination (affects ALL blood cells) |
| Treatment of hypophosphatemia | -Oral phosphate supplements such as neutra-phos or phosphor-soda -severe cases, administer IV phosphorous |
| Hyperphosphatemia - levels and causes | >4.5 mg -Results from renal insufficiency, hypoparathyroidism or increased catabolism -Also: leukemia and lymphoma patients |
| Treatment of hyperphosphatemia | -Identify and treat underlying cause -Restrict dietary intake -Administer phosphate binding gels |
| Chloride - normal levels and functions | -95 to 108 meq -regulation of serum osmolarity -regulation of fluid balance -acidity of gastric juice -acid/base balance |
| Hypochloremia - level and causes | <95 meq -severe vomiting and diarrhea, plyoric obstruction -prolonged use of D5W |
| Signs and symptoms of hypochloremia | -Tetany and hyper reflexes -Depressed respirations -Alkalosis |
| Treatment of hypochloremia | -Treat underlying cause -Administer NaCl solutions |
| Hyperchloremia - level and causes | -trauma from head injury -excessive secretion of adrenal cortical hormone -severe dehydration |
| Signs and symptoms of hyperchloremia | -drowsiness, lethargy, weakness -headache, tremors -Dyspnea, tachypnea, kussmaul respirations, hyperventilation |
| treatment of hyperchloremia | -Correct underlying disorder |
| treatment of hypercalcemia | -Treat the patients underlying disease -saline diuresis, furosemide, calcitonin, and biphosphates to inhibit bone reabsorption |
| Magnesium - normal levels and function | 1.5 to 2.5 meq -Enzyme action -Regulation of neuromuscular activity -regulation of electrolyte balance |
| hypomagnesemia - level and causes | <1.5 meq -can result from alcoholism, malabsorption, prolonged malnutrition, diarrhea, or acute pancreatitis |
| Signs and symptoms of hypermagnesemia | -Flushing/skin warmth -Lethargy, sedation -Decreased deep tendon reflexes -Depressed respirations |
Created by:
sskatygirl
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