Question | Answer |
Potassium level | 3.5-5 |
Sodium level | 135-145 (Na and K generally go in opposite directions) |
Chloride level | 98-106 (Cl goes with Na) |
Potassium | Regulates metabolic activities, Important for nerve conduction. Important for muscle contraction (smooth, skeletal, cardiac) |
Hypokalemia | K is not stored in body. Must have 40-60 meq ingested in diet daily. EKG changes, fatigue, weakness, leg cramps, abd. distention, confusion. Caused by: vomiting, diarrhea, gastric suctioning, K wasting drugs (Lasix, Dig) |
Foods high in K | Bananas, oranges, baked potatoes, spinach, chocolate, coffee, dried fruits (apricots, raisins, dates), canteloupe. |
K+ IV guidelines | Diluted at no more than 1meq/10mL. Delivered via pump or controller. Give at rate of 5-10 meq/hr or 40 meq/2-3 hrs. Pt must have adequate renal function. Monitor cardiac and labs. NEVER GIVE IV PUSH! |
Hyperkalemia | Most common cause is renal dysfunction (also: K conserving diuretics and aged blood). EKG changes, muscle weakness, nausea, diarrhea, parethesia. Monitor labs and cardiac status, avoid foods high in K+, Kayexelate, or insulin/glucose. |
Hyponatremia | Less than 135. Muscle cramps, headache, weakness, fatigue, anorexia, N&V, drowsiness, confusion, coma, seizure. Caused by <3 failure, renal disease, excessive H2O intake or hypotonic IV's. Tx: oral sodium, IV fld. replacement, fld. restriction, diuretics |
Foods high in Na | Bacon, lunch meat, cheese, canned soups, snack foods, condiments. |
Hypernatremia | Greater than 145. Thirst, ^ temp, dry mouth, restlessness, weakness, altered level of consciousness, seizures. Caused by: H2O deprivation, excessive Na intake or H2O loss. Tx: depends on cause; low Na diet, monitor I&O, diuretics as indicated. |
Too much SALT | Skin- flushed. Aggitated (neurological). Low grade temp. Thirsty. |
Calcium | Needed for bone and teeth formation, blood clotting, nerve transmission, cardiac function. |
Hypocalcemia | Tetany (impending seizures), paresthesia, positive Chvostek's (facial spasm), positive Trousseas's, increased deep tendon reflexes, arrhythmias, bleeding tendencies. |
Hypocalcemia causes and Tx | Caused by post op thyroidectomy, radical neck Sx, Vit D deficiency, hypomagnesmia. Tx: oral calcium supplements, Vit D supplements, IV management: calcium and gluconate. |
Foods high in calcium | Cheese, milk, yogurt, ice cream, sardines, broccoli, spinach. |
Hypercalcemia | Muscle weakness, fatigue, decreased deep tendon reflexes, renal stones, EKG changes |