Final Exam lab values

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What constitutes Hyponatremia?

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<135MEq/L

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What constitutes Hypernatremia?

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>145 mEqL

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34 Terms

1
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What constitutes Hyponatremia?

<135MEq/L

2
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What constitutes Hypernatremia?

>145 mEqL

3
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What are some causes of hyponatremia?

  • Hypovolemic hyponatremia

  • Diuretics

  • GI fluid loss (vomiting, diarrhea)

  • Profuse diaphoresis

  • Water intoxication

  • Prolonged use of hypotonic IV solutions

  • SIADH

4
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What are some causes of excess sodium? 

Excessive sodium intake

Hypertonic IV solutions

Hypertonic enteral feedings without adequate water

5
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What are some causes of excessive water loss?

Diarrhea

Inadequate intake of water

Insensible loss due to fever

6
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What are some clinical manifestations of hyponatremia?

Lethargy, confusion, weakness

Muscle cramping

Seizures

Anorexia, nausea, vomiting

Serum osmolality <285 mOsm/kg

7
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What are some clinical manifestations of hypernatremia?

Thirst, dry and sticky mucous membranes, weakness, elevated temperature

Severe: confusion and irritability, decreased levels of consciousness, hallucinations, and seizures

Serum osmolality >290 mOsm/kg

8
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What are the interventions for hyponatremia?

Monitor V/S, I&O

Monitor laboratory results

Serum sodium and serum osmolality

Monitor to ensure that Na+ levels increase by only 4 to 6 mEq/L in any 24-hour period. 

Encourage foods high in sodium.

Restrict water intake.

Hypertonic IV saline solutions

9
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What are the interventions for hypernatremia?

Monitor V/S, I&O

Monitor laboratory results

Serum sodium and serum osmolality

Monitor level of consciousness.

Limit salt intake and foods high in sodium.

Increase water intake.

Hypotonic IV solutions.

10
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What is the function of sodium?

  • Responsible for resting membrane potential 

  • Essential in depolarization 

  • Principal cation of the ECF

  • Na-K pump important mechanism

11
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What is homeostasis of sodium ?

  • Moves out of cell by Na-K pump

  • Regulated by aldosterone and ANP

12
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How do obtain sodium in our diet?

  • Breads, cereals, chips, cheese, processed meats such as lunch meats, hot dogs, bacon, ham

  • Commercially canned foods

  • Table salt

13
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What is the function of Potassium?

  • With Na+, produces resting membrane potential 

  • Essential in depolarization 

  • Principal cation of the ICF 

  • Essential component of Na-K pump  

  • Involved in protein synthesis

14
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What is the homeostasis of Potassium?

  • Moves into cell by Na-K pump

  • Regulated by the kidneys 

15
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Where can you get Potassium in your diet?

  • Fish, excluding shellfish; whole grains, nuts, broccoli, cabbage, carrots, celery, cucumbers, potatoes with skins, spinach, tomatoes, apricots, bananas, cantaloupe, nectarines, oranges, tangerines

16
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What are the values of hypokalemia?

<3.5 mEq/L

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What are the values of hyperkalemia?

>5 mEq/L

18
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What are the causes of hypokalemia?

Loss of potassium due to:

Vomiting, gastric suction, diarrhea

Laxative abuse, frequent enemas

Use of potassium-wasting diuretics

Inadequate intake

Hyperaldosteronism

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What are the causes of hyperkalemia?

Renal failure

Massive trauma, crushing injuries, burns

Hemolysis

IV potassium

Potassium-sparing diuretics

Acidosis, especially diabetic ketoacidosis 

20
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What are some clinical manifestations of hypokalemia?

Weak, irregular pulse

Fatigue, lethargy

Anorexia, nausea, vomiting

Muscle weakness and cramping

Decreased peristalsis, hypoactive bowel sounds

Paresthesia

Cardiac dysrhythmias

Increased risk for digitalis toxicity

21
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What are the clinical manifestations of hyperkalemia?

Anxiety, irritability, confusion

Dysrhythmias, including bradycardia and heart block

Muscle weakness, flaccid paralysis

Paresthesia

Abdominal cramping

22
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What are some intervention of hypokalemia?

Monitor V/S, especially HR 

Monitor ECG

Monitor laboratory results

Serum potassium

Assess for signs of digitalis toxicity.

Encourage foods high in potassium.

Administer potassium supplements 

IV potassium:

Diluted & administered slowly

Usually by infusion. 

NEVER administer potassium as an IV bolus or IV push.

23
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What are some interventions for hyperkalemia?

Monitor V/S, especially HR 

Monitor ECG

Monitor laboratory results

Serum potassium

Limit potassium-rich foods.

Administer 

Cation-exchange resins (Kayexalate) 

Glucose and Insulin

24
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What is the function of calcium? 

Primary component of bones and teeth

Role in: 

Blood clotting

Nerve impulse transmission

Cardiac conduction

Muscle contraction

25
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What is it called when there is an imbalance of calcium?

Deficit: PTH and calcitriol 

Excess: Calcitonin 

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Deficit: PTH and calcitriol 

Excess: Calcitonin 

 Cheese, ice cream, milk, yogurt, rhubarb, spinach, tofu

27
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What constitutes hypocalcemia? 

<9 md/dL

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What constitutes hypercalcemia? 

>10.5 mg/dL

29
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What causes hypocalcemia?

Hypoparathyroidism

Pancreatitis

Vitamin D deficiency

Inadequate intake of calcium-rich foods

Hyperphosphatemia

Chronic alcoholism

30
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What causes hypercalcemia?

Prolonged bed rest

Hyperparathyroidism

Bone malignancy

Paget disease

Osteoporosis

31
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Clinical manifestations of hypocalcemia? 

Confusion, anxiety

Numbness and tingling of extremities

Muscle cramps that progress to tetany and seizures

Hyperactive reflexes

Cardiac dysrhythmias

Positive Chvostek and Trousseau signs

32
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Clinical manifestations of hypercalcemia? 

Lethargy, stupor, coma

Decreased muscle strength and tone

Anorexia, nausea, and vomiting

Constipation

Pathologic fractures

Dysrhythmias

Renal calculi

33
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Interventions for hypocalcemia? 

Monitor V/S, especially HR 

Monitor ECG

Institute fall and seizure precautions.

Administer oral and/or IV calcium supplements as ordered.

Encourage calcium-rich foods.

34
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Interventions for hypercalcemia? 

Monitor V/S, especially HR 

Monitor ECG

Encourage increased fluid intake.

Increase patient activity, including active ROM