Looks like no one added any tags here yet for you.
What is sodium largely responsible for?
regulating fluid balance
What is a common cause of hypernatremia in young children?
diarrhea
symptoms of hypernatremia (4)
1. thirst, dry mucous membranes
2. signs of dehydration
3. oliguria
4. disorientation, altered neuro status
What can too rapid of a correction of hypernatremia result in?
cerebral edema
normal potassium range
3.5-5.0
What is the main electrolyte in extracellular fluid?
sodium
sodium level
135-145
What should be assessed while infusing hypertonic solutions?
sodium levels
major sodium food sources (2)
1. processed foods and meats
2. snack foods (cookies and crackers)
causes of hyponatremia (3)
1. loss of GI fluids
2. diuretics
3. gain of water
sodium levels in hyponatremia
< 135
What electrolyte imbalance would be seen in athletes that compete in endurance events and are drinking a lot of water?
hyponatremia
cause of hypernatremia
water deficiency
Who is hypernatremia most commonly seen in?
older adults and young children
How should correction of hypernatremia be done?
do not want to treat to fast/rapid -> correction should be slow
What is the main intracellular electrolyte?
potassium
What is recommended daily intake of potassium?
4.7 g/day
What does potassium do?
lowers blood pressure
What is the number one cause of hypokalemia?
use of diuretics
sodium levels in hypernatremia
> 145
potassium levels in hypokalemia
< 3.5
What should patient be careful of if they are taking potassium sparing diuretics?
be careful with salt substitutes (they are high in potassium)
How should oral potassium supplements be given?
given with a full glass of water
What should be done if patient is receiving IV potassium?
patient should be put on telemetry
causes of hypokalemia (4)
1. diarrhea
2. gastric suction
3. vomiting
4. diuretics
complications of hypokalemia (2)
1. arrhythmias
2. muscle weakness, muscle cramps
What should never be done with administering IV potassium?
should NEVER be given IV push
If patient is receiving peripheral IV potassium, what concentration should they be receiving?
no more than 40 mEq
What should nurse do if patient reports that infusion site is burning if they are receiving IV potassium?
slow the infusion
If a patient is on a medsurg floor and doctor ordered for patient to receive 40 mEq IV potassium, what should be done?
patient should be moved off the unit to a cardiac unit to be on telemetry/cardiac monitor
potassium levels in hyperkalemia
> 5.0
causes of hyperkalemia (4)
1. decreased aldosterone
2. renal failure
3. tissue injury and burns
4. medications (ACE-I, beta blockers, NSAIDS)
What can give false potassium results?
hemolyzed blood specimens
What should nurse tell patient not to do when getting hemolyzed blood specimens?
don't clench hands
complication of hyperkalemia
arrhythmias
medications for hyperkalemia (4)
1. IV insulin and glucose
2. IV calcium gluconate
3. sodium polystyrene sulfonate (Kayexalate)
4. loop diuretics
normal calcium levels
8.6-10
How is calcium balance in the blood achieved?
through Vit D and hormones (PTH)
What should be taken with calcium to enhance absorption?
Vitamin D
causes of hypocalcemia (3)
1. hypoparathyroidism
2. acute pancreatitis, alcoholism
3. chronic kidney disease
What can hypocalcemia lead to?
osteoporosis
calcium levels in hypocalcemia
< 8.5
nursing considerations of patient taking oral calcium (2)
1. take with meals
2. may require Vitamin D supplementation to help with absorption
nursing care for hypocalcemia (3)
1. seizure precautions
2. reduce alcohol/caffeine intake
3. monitor phosphorus level
if calcium is high, phosphorus is ______
low
if calcium is low, phosphorus is ______
high
symptoms of hypocalcemia (3)
1. tetany
2. Troussaeu and Chvostek's sign
3. arrhythmias
What is Chvostek's sign?
push the cheek and it spasms and eye will close
What is Trousseau's sign?
BP cuff inflated and causes a carpal spasm (hand will contract)
causes of hypercalcemia (2)
1. hyperparathyroidism
2. breast and lung malignancies
calcium levels in hypercalcemia
> 10.5
What can be done to treat hypercalcemia? (3)
1. loop diuretics
2. hydrate with isotonic fluids
3. increase physical activity
What should be done to reduce renal calculi stones?
increase fluid intake
symptoms of hypercalcemia (3)
1. muscle weakness and decreased DTR
2. confusion
3. arrhythmias
normal magnesium levels
1.6-2.6
symptoms of hypomagnesium (3)
1. twitching
2. muscle weakness
3. convulsions
magnesium levels in hypomagnesium
< 1.5
What should not be done in administration of IV magnesium? Why?
do NOT push to fast, because it can lead to cardiac arrest
magnesium levels in hypermagnesium
> 2.1
What is treatment for eeclampsia?
magnesium sulfate
Who is at high risk for hypermagnesium? Why?
older adults because they are obsessed with regulation of bowel movements
normal phosphorus levels
2.7-4.5
What works inversely with calcium?
phosphorus
If kidneys are not working, then what can build up?
phosphorus
phosphorus levels in hypophosphatemia
< 2.5
phosphorus levels in hyperphosphatemia
> 4.5
What is hyperphosphatemia mostly related to?
hypocalcemia
symptoms of hyperphosphatemia (3)
1. numbness, tingling to mouth and fingers
2. muscle spasms
3. nausea and vomiting
What should patient on dialysis take to prevent hyperphosphatemia?
phosphate binders
nursing education for patient taking liquid iron supplements
they can stain teeth so rinse mouth and brush teeth after
What is iron best absorbed with?
Vitamin C
for best absorption, do not give iron with ________
milk
What may children with high lead levels benefit from?
iron supplementation
What is zinc used for?
wound healing
What causes a goiter?
iodine deficiency
What does fluoride do?
helps prevent tooth decay by developing tooth enamel
What does chromium do?
helps regulate blood glucose levels
What does ROME acronym mean?
respiratory opposite, metabolic equal
normal blood pH
7.35-7.45
normal PCO2
35-45
normal PO2
80-100
normal HCO3
22-26
low pH, high CO2
respiratory acidosis
What should be done to treat respiratory acidosis?
hyperventilation
What should be monitored in respiratory acidosis?
monitor for hyperkalemia
high pH, low CO2
respiratory alkalosis
What should be done to treat respiratory alkalosis?
hypoventilation
What should be monitored in respiratory alkalosis?
monitor for hypocalcemia and hypokalemia
low pH, low HCO3
metabolic acidosis
high pH, high HCO3
metabolic alkalosis
treatment for metabolic alkalosis (2)
1. isotonic fluid replacement (NS)
2. replace potassium
What is SIADH caused by?
increased ADH production
What does SIADH result in?
hyponatremia
manifestations of SIADH (4)
1. decreased UO
2. increased urine SG (> 1.030)
3. hyponatremia
4. increased body weight
nursing management of SIADH (3)
1. hypertonic solutions
2. restriction of electrolyte-free fluids
3. high salt, high protein diet
What causes diabetes insipidus?
insufficient ADH production
What does diabetes insipidus result in?
increased fluid loss and hypernatremia
manifestations of diabetes insipidus (4)
1. polyuria and polydipsia
2. dilute urine SG (< 1.010)
3. decreased body weight
4. hypernatremia
nursing management of diabetes insipidus (3)
1. fluid replacement
2. vasopressin
3. low salt diet and thiazide diuretics
A nurse is conducting a nutritional class on minerals and electrolytes. The nurse should include which of the following foods as a major source of magnesium?:
A. Tuna
B. Tomatoes
C. Eggs
D. Oranges
A. Tuna