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Imbalances

Sodium (Na+) Imbalance

SIGNS & SYMPTOMSRISK FACTORS TREATMENT
HYPONATREMIA “salt loss” < 135 mEq/L = 1. Stupor/coma 2. Anorexia (nausea/vomiting) 3. Lethargy (weakness/fatigue) 4. Tachycardia (Thready pulse) 5. Limp muscles (Muscle weakness) 6. Orthostatic hypotension 7. Seizures/headache 8. Stomach cramping (hyperactive bowels) LOSS OF SODIUM from: • Diaphoresis • Diarrhea & vomiting • Drains (NGT suction) • Diuretics • SIADH (dilution) Administer Hypertonic solution • Initiate NPO status, seizure precautions, and never give food or H2O to a patient who is lethargic, confused in comatose state • Implement fluid restriction for patients with SIADH-related fluid volume overload
HYPERNATREMIA “fried salt” > 145 mEq/L 1. Flushed skin 2. Restless, anxious, confused, irritable 3. Increased BP & fluid retention 4. Edema (pitting) 5. Decreased urine output 6. Skin is dry 7. Agitation 8. Low-grade fever 9. Thirst (dry mucous membranes) ↑ Sodium intake • Oral ingestion • Administer of IV fluids with sodium (hypertonic IV fluids) LOSS OF FLUIDS from: • Fever • Burns • Diabetes insipidus (DI) ↓ water = ↑ salt (hemoconcentration) • Limit sodium intake • Administer IV fluids if due to fluid loss • Isotonic or hypotonic solutions
HYPOKALEMIA “NED Has Many Strange Symptoms” < 3.5 mEq/L 1. Nausea, vomiting 2. EKG changes - Flattened T-waves or inversion of the T-wave 3. Decreased reflexes 4. Hypotension 5. Muscle weakness 6. Shallow breathing 7. Slowing of GI system (constipation) • Low potassium intake (not eating, NPO) • Vomiting & diarrhea • Gastric suction • Alkalosis • Potassium-wasting diuretics (loop or thiazide)
HYPERKALEMIA “murder” > 5 mEq/L 1. Muscle cramps & weakness 2. Urine abnormalities 3. Decreased cardiac contractility (↓ HR, ↓ BP) 4. EKG changes -Tall, peaked T-waves 5. Reflexes (↓ DTR ) • Excess potassium intake (IV fluids with K+ ) • Adrenal gland issues (insufficiency) • High levels of acid in blood (acidosis) • Nonsteroidal anti-inflammatory drugs (NSAIDs) (ibuprofen, naproxen) • Potassium-sparing diuretics (spironolactone)
Created by: alno26
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