med surg electrolytes and fluids

Hypovolemia

Cause- severe loss of fluids in body such as GI loss, DI, and decreased intake.

hypovolemia

SXS-tenting, decreased blood pressure, increased pulse, nausea, weakness, cool, clammy, skin. Low Na & K and increased Hct

hypovolemia

treatment- fluids PO or IV LR

hypervolemia

Causes- Fluid overload, heart failure, kidney dysfunction, cirrhosis.

hypervolemia

SXS- edema, crackles, acute weight gain, SoB, bounding heart, increased RR, increased BP

hypervolemia

treatment- diuretic, low-sodium diet, lifestyle ( not sodium)

sodium

Muscle contraction and nerve impulses

hyponatremia

cause- primary imbalance of water, diuretic, GI, gain of water (dilution) meds

hyponatremia

SXS- poor skin turgor, dry mucosa, headache, hypotension, muscle cramps, seizures

hyponatremia

treatment- sodium replacement, water restriction,

hypernatremia

cause- fluid deprivation, watery diarrhea, water loss, tube feeding, DI, heatstroke, drowning.

hypernatremia

SXS- thirst, elevated body temp, sticky mucous membranes, hallucinations, restlessness, irritability, seizures, pulmonary edema, n, v, twitching.

hypernatremia

treatment- hypotonic solutions, diuretic

potassium

controls skeletal and cardiac muscles

hypokalemia

cause- potassium losing diuretics, GI loss, abnormal diet, hyperaldosteronism, hypersecretion of insulin

hypokalemia

SXS- fatigue, muscle weakness, polyuria, ventricle asystole or fibrillation, ileus, abd distension, hypoactive reflexes

hypokalemia

ECG- flatten T waves, prominent U waves, prolonged PR interval

hypokalemia

treat- diet, IV slowly maybe with lidocaine to help the burning pain

hyperkalemia

cause- decreased excretion, decreased aldosterone, meds, potassium sparing diuretics, salt substitutes, lysis of malignant cells after chemo

hyperkalemia

SXS- myocardium, muscle weakness, tachycardia→ bradycardia, paralysis, abd distension, irritability, anxiety, intestinal colic

hyperkalemia

ECG- peaked t waves

hyperkalemia

Treatment- give three meds 1. IV calcium gluconate pushed slow to protect heart 2. sodium bicarb to fix acidosis 3. regular insulin to put K back into cell

calcium

regulates nerve impulses and muscle contractions + relaxation

hypocalcemia

cause-hypoparathyroidism, receiving blood, acute kidney injury, inadeqate vitamin d, antacids

hypocalcemia

tetany, chvostek sign, trousseau sign, seizures , dry nails and skin, torsades de pointes

hypocalcemia

ECG- prolonges QT and ST intervals

hypocalcemia

treat-IV calcium, oral supplements, diet

hypercalcemia

Cause- malignancies, hyperparathyroidism, immobilization, thiazides, lithium use, vitamin a & d intoxication

hypercalcemia

SXS- muscle weakness, incoordination, n, v, polyuria, polydipsia, hypoactive deep tendon reflexes, deep bone pain, flank pain, hypertension, deep bone pain

hypercalcemia

treat- calcitonin, underlying cause, fluids, diuretics, phosphorus

magnesium

carb + protein metabolism & neuromuscular function

hypomagnesemia

causes- loss of GI , alcohol abuse, tube feedings, digoxin, PPIs diabetic ketoacidosis

hypomagnesemia

SXS- chvostek and trousseau signs, change in psychological status

hypomagnesemia

ECG- PVC, flat t waves prolonged PR interval

hypomagnesemia

treat- replace orally, IV over 4 hours to prevent overdose, chvostek and trousseau→ calcium gluconate, avoid alcohol

hypermagnesemia

causes, kidney injury, adrenocortical insufficiency, hypothermia, antacids or laxatives

hypermagnesemia

SXS- depressed CNS & peripheral neuromuscular, AV heart block, muscle weakness, sweating,

hypermagnesemia

ECG- prolonged PR and QRS. Peaked t waves

hypermagnesemia

treatment diuretics, ventilator, elemental Ca, dialysis, saline

hypotonic

to hydrate

hypertonic

to dehydrate