NUR 242 Med/Surg Exam 2 With 100% correct answers 2025-2026 already graded A+

Hypocalcemia s/s

- serum level below 9

- painful muscle spasms in calf/foot during rest or sleep

- positive Chvostek's and Trousseau's signs

- parethesias, tingling, numbness

- WEAK THREADY HEART RATE that may be slower or faster than normal

Hypocalcemia causes

- inadequate oral intake of calcium and Vitamin D

- kidney failure

- malabsorption syndrome (Chrohn's disease)

- lactose intolerance

- ESKD

Hypocalcemia treatment

- oral or IV calcium supplements

- seizure precautions

- Vitamin D to help with the absorption of calcium from the GI tract

Hypercalcemia s/s

- serum level higher than 10.5

- severe muscle weakness and decreased deep tendon reflexes

- confusion

- lethargy

- INCREASED HR & BP

- severe prolonged - electrical conduction depression

- cyanosis, pallor

- blood clots

Hypercalcemia causes

- excessive oral intake of calcium and Vitamin D

- kidney failure

- use of thiazide diuretics

Hypercalcemia treatment

- D/C thiazide diuretics and replace with diuretics that enhance excretion of calcium (lasix/furosemide)

- administer IV fluids (0.9% NS)

- sodium increases kidney excretion of calcium

Hypokalemia s/s

- serum level less than 3.5

- THREADY, WEAK, IRREGULAR PULSE

- orthostatic hypotension

- lethargy

- skeletal muscle weakness

- CARDIAC DYSRHYTHMIAS

Hypokalemia causes

- Excessive use of diuretics, digitalis, corticosteroids

- diarrhea & vomiting

- kidney disease

- wound drainage

- prolonged gastric suctioning

Hypokalemia treatment

- increase serum potassium levels - oral of IV potassium

- NEVER GIVE VIA IV PUSH

- hold diuretics

- fall prevention

- use potassium-sparing diuretics if NEEDED

Hyperkalemia s/s

- serum level greater than 5.0

- SLOW, WEAK, IRREGULAR HEART RATE

- decreased BP

- profound skeletal muscle weakness

- CARDIAC DYSRHYTHMIA - TALL PEAKED T WAVES AND WIDE QRS COMPLEXES

Hyperkalemia causes

- potassium-sparing diuretics

- salt substitutes

ACE inhibitors

- kidney failure

-rapid infusion of potassium containing IV solutions

Hyperkaelmia treatment

- assess cardiac complications

- fall prevention

- Kayexalate

- hold oral potassium supplements

- potassium restricted diet

- tele montior

Hypovolemia (dehydration) s/s

- INCREASED AND THREADY PULSE RATE

- dyspnea

- orthostatic hypotension

- flat neck veins and hand veins

- tenting of the skin

- diminished peripheral pulses

- decreased urine output

Hypovolemia causes

- occurs when fluid intake is not sufficient to meet the fluid needs of the body

- hemorrhage

- vomiting/diarrhea

- severe wounds

- diuretic therapy

- GI suctioning

- long-term NPO status

- fistulas

- ileostomy

- profuse diaphoresis

hypovolemia treatment

- replace fluid volume and electrolytes, either oral or IV

- monitor for orthostatic hypotension

- fall precautions

Hypervolemia s/s

- fluid intake EXCEEDS the fluid needs of the body

- bounding/increased pulse rate

- shallow rapid respirations

- distended neck veins and hand veins

- moist crackles

- pitting edema in dependent areas

- shortness of breath

Hypervolemia causes

- excessive fluid replacement

- heart failure

- kidney failure

- long-term corticosteroid therapy

Hypervolemia treatment

- restore normal fluid balance - administer diuretics as ordered

- restrict fluid and sodium intake

- daily weights

- maintain skin integrity

- assess lung sounds

Hyponatremia s/s

- serum level less than 135

- confusion

- personality changes

- generalized skeletal muscle weakness

- rapid weak thready pulse

- orthostatic hypotension

- increased GI motility

Hyponatremia causes

- excessive diaphoresis

- wound drainage

- low-salt diet

- NPO status

Hyponatremia treatment

- restore serum sodium levels and monitor for signs for fluid overload

- severe hyponatremia can be treated with hypertonic saline (3% saline solution) in small amounts

- prevent falls due to decreased blood pressure

- increase oral sodium intake and restrict oral fluid intake

Hypernatremia s/s

- muscle twitches

- skeletal muscle weakness

- extreme thirst

- decreased urinary output

- presence or absence of edema (depending on fluid volume changes)

- decreased or absent deep tendon reflexes (late)

Hypernatremia causes

- serum level greater than 145

- corticosteroids

- excessive intake of sodium

- kidney failure

- watery diarrhea

- excessive IV solution containing sodium

Hypernatremia treatment

- patient education regarding limiting daily sodium intake (processed foods, bacon, ham, hot dogs, condiments, etc.)

Hypomagnesemia s/s

- serum level less than 1.5

- anorexia

- nausea

- positive Chvostek's and Trousseau's sign

- tetany

- seizures

Hypomagnesemia causes

- malnutrition

- diarrhea

- Crohn's disease

- ethanol ingestion

- diuretics

Hypomagnesemia treatment

- seizure precautions

- instruct patient to increase intake of magnesium-rich foods (avocados, milk, peanut butter, raisins)

- Administer magnesium sulfate

hypermagnesemia s/s

- serum level greater than 2.5

- bradycardia

- respiratory depression

- peripheral vasodilation

- hypotension

- EKG changes

- lethargy

- decreased or absent deep tendon reflexes

Hypermagnesemia causes

- increased magnesium-containing antacids and laxatives

- increased magnesium replacement

- decreased kidney excretion of magnesium due to kidney disease

Hypermagnesemia treatment

- goal is to reduce magnesium levels and correct the underlying problem that caused the imbalance