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Fluid & Electrolytes

Hyponatremia (Causes) Adrenal insufficiency (aldosterone deficiency), SIADH, vomiting, diarrhea, sweating, diuretics
Hyponatremia (Symptoms) Headache, lethargy, confusion, muscle twitching, weakness, dry skin/mucous membranes, tremor, convulsions, N/V, cramps, Seizure precaution
Hyponatremia (Treatment) Slow increase of NA. Hypertonic (3% or 5%) solutions. Water restriction (800ml/day)
Hypernatremia (Causes) Fluid deprivation, Diabetes Insipidus, heat stroke, Hypertonic feedings
Hypernatremia (Symptoms) Restlessness, weakness, agitation, coma (r/t cerebral deprivation), elevated body temp, hallucinations
Hypernatremia (Treatment) Gradual reduction of NA with hypotonic solution (0.2% or 0.4%), Diuretic therapy, low NA diet, increase fluid intake
Hypokalemia (Causes) GI losses, alterations in acid-base balance, hyperaldosterism, Lasix, Mag depletion causes renal K loss, insulin promotes entry of K into cell
Hypokalemia (Symptoms) Flat T wave, present U wave, Dysrhythmias, decreased muscle strength, leg cramps, Cardiac or respiratory arrest, paresthesia, polyuria, glucose intolerancethirst, slow, weak pulse, shallow respirations
Hypokalemia (Treatment) K replacement, 40 to 80mEq/day (No IV or IM) with glass of water, monitor for Dig toxicity, ECG, Aldactone
Hyperkalemia (Causes) Impaired renal function, hypoaldosterism, tissue trauma, acidosis
Hyperkalemia (Symptoms) Peaked T, flat P, prolonged QRS,Ventricular Dysrhytmias, tachycardia then bradycardia, hypotension, flaccid quadriplegia, paralysis of speech muscles,
Hyperkalemia (Treatment) IV calcium gloconate, ECG, increase fluids, Sodium bicarb (shifts K into cells), Lasix, Kayexalate, Insulin and hypertonic dextrose (K uptake in cell)
Hypocalcemia (Causes) hypoparathyroidism, pancreatitis, alkalosis, Packed RBC's, renal failure, Cushing's Disease, vitamin D deficiency
Hypocalcemia (Symptoms) Prolonged QT interval, tetany, circumoral numbness, parathesias, Trousseau's, Chovstek's, seizures, hyperactive motor sensory nerves, dyspnea, hypotension, prolonged bleeding time, hyperactive bowel sounds, dry brittle hair and nails
Hypocalcemia (Treatment) IV calcium gluconate, ECG, high calcium and Vitamin D diet, low phosphate, antacids (for phosphorous), weight-bearing exercises, airway status monitored, assess for Dig toxicity
Hypercalcemia (Causes) Malignancy, immobility, hyperparathyroidism
Hypercalcemia (Symptoms) Cardiac arrest, dysrhythmias, muscle weakness, incooridnation, abdominal distention, constipation, bone pain, polyuria,
Hypercalcemia (Treatment) IV NS, Lasix, calcitonin (IM) BIphosphates (Inhibit osteoclast activity), excessive hydration
Hypomagnesemia (Causes) Alcoholism, GI losses, enteral/parenteral feeding, packed RBC's, DKA (from insulin), Addison's disease, sepsis, burns, alkalosis, excess antacid intake
Hypomagnesemia (Symptoms) Prolonged QRS, depressed ST segment, dysrthmias, Tetany, tremores, irratibility, muscle weakness, vasospasm, depression, confusion, physhosis
Hypomagnesemia (Treatment) Mag sulfate, ECG, high mag diet, monitor for dig toxicity
Hypermagnesemia (Causes) Renal failure, DKA (cellular release of mag), excessive mag administration
Hypermagnesemia (Symptoms) {rolonged PR interval, tall T waves, widened QRS, prolonged QT interval, flushing, hypotension, hypoactive reflexes, muscle weakness, depressed respirations, dysrhythmias,
Hypermagnesemia (Treatment) IV calcium gluconate, Lasix, IV NS, hemodialysis, watch for decreased patellar reflex
Created by: maggardba