Electrolytes

normal sodium level

135-145

Normal potassium level

3.5-5

sodium function in the body

influences water distribution between intra and extracellular fluid, generates and transmits nerve impulses, muscle contraction, acid/base balance

hyponatremia causes

gi loss, diuretics, burns, draining wounds, fasting, excessive hypotonic IV fluid, polydipsia

hypernatremia causes

hypertonic or excessive isotonic fluid, hypertonic tube feeding without enough water, insufficient water intake, and near drowning in salt water

hyponatremia symptoms

confusion, fatigue, seizures, weakness, coma, and low BP

hypernatremia symptoms

FRIED SALT

what does FRIED SALT stand for?

flushed skin and fever, restless and irritable, increase BP and fluid retention, edema peripheral and pitting, decreased urine output, skin flushed, agitation, low grade fever, thirst

treatment for hyponatremia

fluid restrictions, oral intake of Na, isotonic sodium containing IV fluids

hypernatremia treatment

mild treat with isotonic iv solution, severe hypotonic d5 water, restrict Na in diet, and diuretics

at what rate should Na insufficiencies be corrected?

slowly to prevent neurological damage

potassium function

resting potential of nerve and muscle cells, impact on neuromuscular and cardiac function, acid base balance

how is K+ obtained in the body

diet is the main source, excreted via urine

hypokalemia causes

gi loss, skin loss (diaphoresis), renal loss/retention, dialysis, inadequate diet

hypokalemia medication treatments

diuretics (furosemide), insulin in large amounts

hyperkalemia causes

excessive intake, rapid administration of iv fluids, renal/kidney disease, adrenal insufficiency, lack of insulin

hyperkalemia medication treatments

ACE inhibitor (-pril medications), K+ sparing diuretics (spironolactone), insulin

hypokalemia symptoms

fatigue, irritability, leg cramps, muscle weakness/ decreased tone, confusion, EKG changes, and shallow respirations

what are the EKG changes during hypokalemia

flattened t wave, prolonged QRS

hyperkalemia symptoms

MURDER

what does "MURDER" stand for

muscle cramps, urine abnormalities, respiratory distress, decreased cardiac contractility, EKG changes, hyper/hypo reflexes

EKG changes in hyper

tall T waves, wide QRS

hypokalemia treatment

IV K+ 10 meq/hr given slowly due to being a vesicant

hyperkalemia treatment

insulin IV push, calcium gluconate to protect cardiac cells, beta agonists (albuterol)

high K+ foods

bananas, oranges, avocado, spinach, tomatoes, potatoes, nuts

sodium polystyrene and lokelma use

exchanges K+ ions for Na in the intestine, excreting K+ by way of the gi tract

side effects of SPS

patient will poop, abdominal cramping, diarrhea, hypernatremia, loss of Mg and Ca