electrolyte imbalances & types of IVF

signs and symptoms of hyponatremia

• Increased ICP → seizures, confusion

• Weak pulse, hypotension

• Muscle cramps

• Weakness, fatigue

Signs and symptoms of hypernatremia

• Edema

• Bounding pulses, hypertension

• muscle twitching

• Dizziness, weakness

• Decreased urine output, dry mucus membranes

nclex tip for hyponatremia

Monitor near status and correct imbalance slowly to decrease risk for cerebral edema

Signs and symptoms of hypo/hyperchloremia

• Same as hyponatremia or hypernatremia!

• Direct relationship, so if sodium is high then chloride will be high and vice versa

Treatment for hyperchloremia

Bicarb, d/c meds containing sodium- give lactated ringers

Signs and symptoms of hyperkalemia

• Muscle weakness, numbness, cramping

• Shallow respirations

• Hyperactive BS, diarrhea

• Decreased cardiac output → weak pulses, bradycardia, hypotension, tall peaked T waves

Treatment of hyperkalemia

• Drive K+ into cells → D5W, albuterol, bicarb

• Reduce total body of K+ → kayexelate, diuretics, dialysis

• IV calcium gluconate or chloride for cardiac protection

• Potassium diet restriction

Signs and symptoms of hypokalemia

• Weakness, fatigue

• Muscle cramps, decreased deep tendon reflexes, flaccidity

• Shallow respirations

• Decreased BS, constipation, abdominal distenstion

Treatment for hypokalemia

• K+ supplements

• Diet rich in K+

• Prevent dysrhythmias → hold digoxin

Calcium has an inverse relationship with… and a direct relationship with…

• Phosphorus (if calcium is low phos is high)

• PTH (if calcium is low parathyroid hormone is also low)

Signs and symptoms of hypercalcemia

• Decreased LOC, fatigue

• wx, flaccidity, decreased deep tendon reflexes

• bradycardia, cyanosis, DVT

• decreased peristalsis, decreased BS, abdominal pain, N/V, constipation, kidney stones

signs and symptoms of hypocalcemia

• irritability, hallucinations

• Paresthesias, tetany, seizures, muscle spasms

• Increased BS, cramping, diarrhea

• weak bones (risk of fox), weak/ brittle nails

what vitamin increases the absorption of calcium

vitamin D

isotonic fluids

• DOES NOT CAUSE A SHIFT IN FLUID… used to increase intravascular volume, blood loss, surgery, NPO

• 0.9% NS

• LR

• D5W

hypotonic fluids

• MOVES FLUID OUT OF VESSELS AND INTO CELLS… used when cells are dry and shriveled up: DKA, HHNS, hypernatremia

• 0.45% NS

• 0.33% NS

• 0.2% NS

• D2.5W

hypertonic fluids

• MOVES FLUID OUT OF CELLS AND INTO BLOOD VESSELS… for hyponatremia and cerebral edema

• 1.5% NS

• 3% NS

• 5% NS

• D5NS

• D5LR

• D10W

signs and symptoms of hypermagnesemia

• weakness

• shallow RR, bradycardia, hypotension

• vasodilation → flushed skin, warm

• drowsy, lethargic, coma

s/s of hypomagnesemia

• n/t, cramping, seizures, tetany, increased DTRs

• torsades de pointes (rapidly push IV Mg)

• psychosis, confusion