Electrolytes Med Surg Final

sodium levels

135-145

hyponatremia

less than 135

hyponatremia symptoms (7)

malaise, anorexia, decreased LOC, lethargy, confusion, coma, could have seizures

hyponatremia interventions (4)

increase sodium intake (table salt), monitor I and O’s, fluid restriction (1500-2000ml), IV hypertonic solution

hypernatremia

greater than 145

hypernatremia symptoms (5)

thirst, decreased LOC, lethargy, confusion, coma

hypernatremia interventions (4)

increase fluids, IV hypotonic solution, diuretics (furosemide or bumetanide), avoid sodium

calcium levels

8.5-10.5

hypocalcemia

less than 8.5

hypocalcemia symptoms (8)

positive chvostek sign, positive trousseau, neuromuscular excitability (muscles, and reflexes hyperactive), seizures, laryngospasms, numbness, tingling of extremities, muscle cramps

hypocalcemia interventions (5)

vitals, ECG, labs, supplemental nutrition, fall and seizure precautions

calcium food sources

non-dairy spinach, rhubarb, tofu; dairy, ice cream, milk, cheese, yogurt; orange juice with calcium (not given to diabetic)

hypercalcemia

greater than 10.5

hypercalcemia causes

hyperparathyroidism, cancer, vitamin D toxicity

how does vitamin D toxicity cause hypercalcemia

increase in vitamin D causes calcium absorption, increase calcium release from bones

hypercalcemia symptoms (11)

muscle weakness (decrease neuromuscular excitability), anorexia (not digesting well), nausea, vomiting, lethargy, stupor, coma, constipation, personality change, decrease muscle strength, and tone

hypercalcemia interventions (9)

ECG, vitals, labs, decrease calcium, increase oral intake by 3L, IV fluids, diuretics, bisphosphonate, calcitonin (binds to calcium)

potassium levels

3.5-5

hypokalemia

less than 3.5

hypokalemia causes (9)

decrease potassium in diet, diuretics (furosemide), NPO, persistent vomiting, NG tube, persistent IV fluids with no supplementation, corticosteroids, insulin, chemotherapies

hypokalemia symptoms (4)

dysrhythmias, bilateral muscle weakness, constipation, respiratory depression

hypokalemia interventions (4)

EKG for possible dysrhythmias, monitor labs and vitals, supplementation oral or IV

hyperkalemia

greater than 5

hyperkalemia causes (5)

excess potassium intake, diuretics (spironolactone), kidney failure, excessive tissue damage (trauma or burns), severe infection causing release of intracellular potassium

hyperkalemia symptoms (6)

dysrhythmias, bilateral weakness, transient abdominal cramping, cardiac arrest, flaccid paralysis, no respiratory issues

hyperkalemia interventions (6)

IV fluids including insulin and glucose, oral med patiromer, avoid potassium, ECG, vitals, labs