Electrolytes and Fluid Balance Lecture Review

Vocabulary flashcards generated directly from the lecture notes covering sodium, potassium, calcium, and magnesium balance, manifestations, mnemonics, nursing care, and dietary recommendations.

Sodium Extracellular Location

The major electrolyte found in extracellular fluid, outside of the cell.

Sodium Key Functions

Maintains acid-base balance, keeps fluid balance, and causes irritability and conduction of nerve and vessel tissue.

Dietary Sources of Sodium

Salt, soy sauce, and packaged meats.

Hypernatremia Assessment Findings

Dry and sticky mucus membranes, intense thirst, dry mouth, flushed skin, elevated body temperature, irritability, restlessness, agitation, and altered neurological status.

Hyponatremia (Sodium Deficit)

Occurs with water excess or excessive sodium loss (such as from vomiting, diarrhea, or diuretics); characterized by cellular swelling, headache, confusion, muscle weakness, thready pulse, seizures, or respiratory arrest.

General Sodium Nursing Interventions & Safety

Implement seizure precautions and fall precautions, track intake and output closely, perform comprehensive neurological assessments, monitor daily weights using the same scale/clothing/time, provide frequent mouth care, and enforce fluid restrictions or controlled hypertonic saline orders.

Patient Education for Hypernatremia Indicators

Brain thirst, sticky mouth, flushed skin, and restlessness.

Patient Education for Hyponatremia Indicators

Headache, confusion, muscle weakness, and generalized tiredness.

Potassium Intracellular Location

The major electrolyte found inside the cell, maintaining cell volume and electrical neutrality.

Potassium Primary Assessment Focus

The heart, because potassium controls electrical impulses and excitable tissue contraction.

Hyperkalemia Mnemonic

MURDER: includes changes in cardiac rhythm, severe ventricular arrhythmias, muscle weakness, hyperactive bowel sounds, abdominal cramping, and diarrhea.

Hypokalemia Mnemonic

6 L's: Lethargy, Leg cramps, Limp muscles, Low shallow breathing, Lethal heart arrhythmias, and Lots of urine (excess urine).

Rule for IV Potassium Administration

NEVER give potassium IV push; it must ALWAYS be diluted and given over an infusion pump.

Minimum Urine Output During Potassium Replacement

Must be at least $30\text{ mL/h}$.

Dietary Sources of Potassium

Bananas, oranges, spinach, potatoes, tomatoes, avocados, and dark leafy greens.

Oral Potassium Supplement Nursing Care

Take with a full glass of water or food to minimize gastric irritation, and NEVER crush or chew extended-release potassium tablets/capsules.

Calcium Primary Functions

Regulates nerve conduction, prevents systemic muscle excitability, supports heart contraction and circulation, facilitates hormone secretion, forms the matrix for bone and teeth, and aids blood clotting.

Hypocalcemia Mnemonic and Signs

CRAMPS (Convulsions, Reflexes increased, Arrhythmias, Muscle spasms, Positive Chvostek and Trousseau signs, Numbness and tingling). Also presents with increased neuromuscular excitability and tetany.

Hypercalcemia Mnemonic

Stones (kidney stones), Bones (bone pain), Abdominal groans (constipation, nausea, vomiting, GI upset), and Psychiatric overtones (confusion, lethargy, altered mental status).

Chvostek Sign

A sign of tetany and latent neuromuscular excitability seen in hypocalcemia and hypomagnesemia.

Trousseau Sign Assessment Technique

Inflation of a blood pressure cuff on the upper arm to $20\text{ mmHg}$ above systolic pressure to test for carpopedal spasm associated with hypocalcemia or hypomagnesemia.

Vitamin D Function in Calcium Balance

Essential for the absorption of calcium in the body.

Calcium Supplement Dosing Limit

Best absorbed in maximum increments of $500\text{ mg}$ at a time.

Magnesium Body Location

Skeletal reservoir primarily stored in the bone, with a small amount in extracellular fluid.

Hypomagnesemia Mnemonic

LOMAG: Low intake, Other electrolyte monitoring (calcium/potassium), Diuretics wasting magnesium, Malabsorption (Crohn's, celiac, gastric sleeve), Alcoholism, and Glycemic issues (DKA, insulin overuse).

Hypomagnesemia Manifestations

Neuromuscular irritability, positive Chvostek and Trousseau signs, muscle twitching, increased heart rate, increased blood pressure, and arrhythmias.

Hypermagnesemia Manifestations

Depressed deep tendon reflexes, decreased heart rate, decreased blood pressure, lethargy, muscle weakness, respiratory depression, and potential cardiac arrest.

Antidote for Magnesium Cardiotoxicity

Calcium gluconate.

Dietary Sources of Magnesium

Almonds, cashews, pumpkin seeds, spinach, kale, leafy greens, and seafood such as salmon, mackerel, and halibut.