Electrolyte Imbalance
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61 Terms
Q: Where is most calcium stored?
A: Bones and teeth.
Q: Where is most magnesium stored?
A: Bones and soft tissues.
Q: Where is most phosphate stored?
A: Bones and teeth.
Q: What is sodium’s main function?
A: Maintains ECF concentration and volume and influences water distribution.
Q: What body functions depend on sodium?
A: Nerve impulses, muscle contraction, and acid-base balance.
Q: Where is most potassium found?
A: Inside the cells.
Q: Normal plasma potassium level?
A: 3.5–5 mEq/L.
Q: Main function of potassium?
A: Maintains resting membrane potential of nerve and muscle cells.
Q: Functions of calcium?
A: Bone and teeth strength, blood clotting, nerve transmission, and muscle contraction.
Q: Functions of phosphate?
A: ATP formation, muscle function, RBC function, and nutrient metabolism.
Q: Functions of magnesium?
A: ATP production, enzyme function, glucose control, BP regulation, and neuromuscular function.
Q: What causes hypernatremia?
A: Water loss, inadequate water intake, or sodium gain.
Q: What happens to cells in hypernatremia?
A: Cellular dehydration occurs.
Q: Symptoms of hypernatremia?
A: Thirst, confusion, lethargy, seizures, and coma.
Q: Causes of hypernatremia?
A: Decreased fluid intake, diarrhea, fever, sodium excess, renal retention, and Cushing syndrome.
Q: Nursing care for water-deficit hypernatremia?
A: Fluid replacement with isotonic solutions.
Q: Nursing care for sodium-excess hypernatremia?
A: Sodium-free fluids (D5W) and diuretics.
Q: Why are seizure precautions used in hypernatremia?
A: Severe sodium imbalance can cause seizures.
Q: Why must sodium correction be gradual?
A: Rapid correction can cause cerebral edema.
Q: What causes hyponatremia?
A: Sodium loss or water excess.
Q: What happens to cells in hyponatremia?
A: Cells swell and may rupture.
Q: Symptoms of hyponatremia?
A: Headache, irritability, confusion, vomiting, seizures, and coma.
Q: Causes of hyponatremia?
A: Overhydration, GI loss, burns, trauma, edema, and diuretics.
Q: Treatment for dilutional hyponatremia?
A: Fluid restriction and diuretics.
Q: Severe treatment for symptomatic hyponatremia?
A: IV hypertonic saline (3% NaCl).
Q: What causes hyperkalemia?
A: Renal failure, potassium-sparing diuretics, burns, sepsis, ACE inhibitors, and acidosis.
Q: ECG changes seen in hyperkalemia?
A: Peaked T waves and wide QRS complexes.
Q: Dangerous dysrhythmias caused by hyperkalemia?
A: Bradycardia, ventricular fibrillation, and asystole.
Q: First medication given for severe hyperkalemia?
A: Calcium gluconate.
Q: Why is calcium gluconate given in hyperkalemia?
A: Stabilizes cardiac cell membranes.
Q: Medications that shift potassium into cells?
A: Insulin with glucose, albuterol, and sodium bicarbonate.
Q: Treatments that remove potassium from the body?
A: Diuretics, Kayexalate, and dialysis.
Q: Causes of hypokalemia?
A: Vomiting, diarrhea, NG suction, diuretics, alkalosis, and insulin use.
Q: Symptoms of hypokalemia?
A: Muscle weakness, ileus, nausea, confusion, and dysrhythmias.
Q: ECG changes seen in hypokalemia?
A: U waves, ST depression, and PVCs.
Q: Safe IV potassium infusion rate?
A: No faster than 10 mEq/hr.
Q: What causes hypercalcemia?
A: Hyperparathyroidism and cancers.
Q: Symptoms of hypercalcemia?
A: Weakness, confusion, fractures, kidney stones, dysrhythmias, and dehydration.
Q: Gold-standard medication for hypercalcemia?
A: Bisphosphonates.
Q: Quick-acting medication for hypercalcemia?
A: Calcitonin.
Q: Fluids recommended for hypercalcemia?
A: Isotonic saline with increased fluid intake.
Q: What causes hypocalcemia?
A: Low PTH, alkalosis, multiple blood transfusions, and calcium loss.
Q: Signs of hypocalcemia?
A: Positive Chvostek’s and Trousseau’s signs.
Q: Symptoms of hypocalcemia?
A: Tetany, numbness, tingling, dysphagia, and dysrhythmias.
Q: Severe treatment for hypocalcemia?
A: IV calcium gluconate.
Q: Why can rebreathing into a paper bag help hypocalcemia?
A: Helps control spasms related to alkalosis.
Q: Calcium-rich foods?
A: Milk, cheese, tofu, fish, almonds, beans, broccoli, kale, spinach, and eggs.
Q: What causes hyperphosphatemia?
A: Kidney disease, tumor lysis syndrome, rhabdomyolysis, and high phosphate intake.
Q: Why do hyperphosphatemia symptoms resemble hypocalcemia?
A: Phosphate and calcium have a reciprocal relationship.
Q: Symptoms of hyperphosphatemia?
A: Tetany, muscle cramps, hypotension, dysrhythmias, and seizures.
Q: Complication of severe hyperphosphatemia?
A: Calcified soft-tissue deposits causing organ dysfunction.
Q: Treatments for hyperphosphatemia?
A: Phosphate binders, dialysis, fluid expansion, and correcting hypocalcemia.
Q: Causes of hypophosphatemia?
A: Malnutrition, diarrhea, antacids, and inadequate parenteral nutrition replacement.
Q: Symptoms of hypophosphatemia?
A: Muscle weakness, CNS depression, dysrhythmias, respiratory failure, and osteomalacia.
Q: Treatments for hypophosphatemia?
A: Dairy intake, supplements, and IV phosphate.
Q: What causes hypermagnesemia?
A: Excess magnesium intake with renal insufficiency or excess IV magnesium.
Q: Symptoms of hypermagnesemia?
A: Hypotension, lethargy, flushing, impaired reflexes, paralysis, and cardiac arrest.
Q: Treatment for hypermagnesemia?
A: Stop magnesium intake, IV calcium gluconate, fluids, diuretics, and dialysis.
Q: What causes hypomagnesemia?
A: Alcoholism, starvation, GI losses, diuretics, PPIs, and hyperglycemia.
Q: Symptoms of hypomagnesemia?
A: Tremors, hyperactive reflexes, Chvostek’s sign, seizures, and dysrhythmias.
Q: Treatment for hypomagnesemia?
A: Oral supplements, dietary intake, and IV magnesium if severe.