Electrolytes for foundations exam 3

Sodium

135-145 mEq/L

Most abundant cation in ECT, major contributer to affect serum osmolarity

Assists in maintaining blood volume, regulate ECF volume and distribution, assists in transmitting nerve impulses, contracts muscle, regulated by renin-angiotensin-aldosterone system

Elimination and reabsorption regulated by the kidneys, sodium concentrations affected by salt and water intake

Hyponatremia

Causes: diarrhea, vomiting, fistula, excessive sweating, diuretics, tap water enema, kidney disease, burns, HF, Ng suctioning

Symptoms: confusion, muscle cramps, weakness, edema, decreased BP, disorientation, seizures, headache, lethargy, decreased DTR, decreased temperature

Nursing care: Report abnormal lab results to provider, foods high in sodium, fluid restriction, IV saline solutions, monitor vital signs, monitor intake and output, daily weights, monitor level of consciousness

Hypernatremia

Causes: water deprivation, excessive Na+ intake or retention, fluid losses

Symptoms: seizures, increased temperature, increased heart rate, dry mucous membranes, warm flushed skin, restlessness, muscle weakness, muscle twitching, orthostatic hypotension, coma, decreased DTRs

Nursing care: report abnormal lab values to provider, hypo or isotonic IV solutions, encourage water intake, decrease NA+ intake, loop diuretics, monitor LOC, safety, monitor intake and output

Potassium

3.5-5.2 mEq/L

Most abundant cation in ICF, vital for smooth, skeletal, and cardiac function, transmits nerve impulses, regulating acid-base balance

Must be ingested

Hypokalemia

Causes: vomiting, diarrhea, NG suctioning, diarrhea, inappropriate laxative use, diuretics, wound drainage, burns, increased po intake

Symptoms: increased temperature, weak irregular pulse, decreased BP, respiratory distress, weakness, respiratory collapse, paralysis, decreased muscle tone, hypoactive reflexes, paresthesias, EKG changes

Nursing care: report abnormal levels to provider, treat underlying cause, replace K+, watch IV site for phlebitis, monitor intake and output, monitor vital signs, monitor EKG

NEVER BOLUS OR PUSH IV K+

Hyperkalemia

Causes: increased intake, supplementation, crush injury, severe dehydration, NSAIDS, potassium sparing diuretics, inadequate renal excretion

Symptoms: Weakness with ascending paralysis, cardiac arrhythmias, slow irregular pulse, hypotension, restlessness, irritable

Nursing care: report abnormal levels to provider, stop all supplemental K+, decrease K+ in diet, medications such as diuretics, may require dialysis

Calcium

8.6- 10.2 mg/dL

Most abundant electrolyte in the body, mostly stores in skeletal system

Neuromuscular function, muscle contraction and relaxation, blood clotting, major component of bones and teeth, absorbed from foods in teh presence of normal gastric activity and vitamin D

Hypocalcemia

Causes: malabsorption syndrome, end stage renal disease, thyroidectomy

Symptoms: muscle twitching, tetany, frequent painful muscle spasms at rest, increased DTRs, decreased HR, decreased BP, diarrhea, abnormal cramping, seizures

Nursing care: increase calcium food intake or supplements, IV calcium, seizure precautions

Hypercalemia

Causes: cancer, hyperparathyroidism

Symptoms: nausea, vomiting, constipation, bone pain, confusion, lethargy, cardiac arrest (severe cases)

Nursing care: rapid infusion of isotonic saline IV, monitor intake and output, monitor vital signs, monitor level of consciousness, medications

Magnesium

1.6-2.6 mg/dL

Found in skeleton and ICF, maintains intracellular metabolism, regulating cardiac functioning, relaxing muscle contractions, transmit nerve impulses, lost urine with diuretics and eliminated by kidneys, regulated by parathyroid hormone

Transfers and stores energy, regulated parathyroid levels, metabolizes carbohydrates and lipids, regulated BP

Hypomagnesemia

Causes: starvation, hypocalcemia, GI problems, alcoholism, IBS, bariatric surgery

Signs and symptoms: neuromuscular excitement, weak respirations, Torsade’s (cardiac), hypertension, nausea irritability

Nursing interventions: monitor cardiac, GI status, respiratory status, neuro status, give oral supplements wich can cause diarrhea, monitor deep tendon reflexes, seizure precautions, give foods containing magnesium

Hypermagnesemia

Causes: antacids and laxatives (esp for patients in renal failure), addisons disease, renal failure

Signs and symptoms: lethargy, EKG symptoms, weakness, diminished or absent deep tendon reflexes, slow HR, hypotension, GI issues

Nursing interventions: monitor cardiac, respiratory, GI, monitor for safety, watch foods high in magnesium

Chloride

97-107 mEq/L

Major anion of ECF, produces HCL acid, regulates acid-base balance, acts as a buffer in O2-CO2 exchange, excreted and conserved by the kidneys regulated by aldosterone

Hypochloremia

Causes: vomiting, diarrhea, heavy perspirations, diuretics, CHR, renal disease, addisons disease, burns, cystic fibrosis

Symptoms: weakness, muscle cramps, fatigue, dehydration, dizziness, low BP, increased HR, confusion, lethargy

Nursing interventions: medication adjustments, hydration, fluid replacement, dietary changes

Hyperchloremia

Causes: dehydration, kidney disease, excessive saline intake, metabolic acidosis, medications

Symptoms: fatigue, weakness, extreme thirst, dry mucous membranes, high BP, confusion, difficulty concentrating, muscle cramps, twitching, irregular heartbeat

Nursing interventions: rehydration, adjusting medications, reduce salt intake, medical treatment

Phosphate

2.5-4.5 mg/dL

Major ion of ICF, second most abundant mineral in the body

Functioning of nerves, muscles, and RBCs, promotes energy storage, enters GI tract, all animal products, involved in metabolism of CHO, role in acid-base balance as a hydrogen buffer, assists in regulating calcium levels

Hypophosphatemia

Causes: alcohol use disorder, malnutrition or malabsorption, medical conditions, medications, post surgery

Symptoms: muscle weakness, muscle pain, bone pain, confusion, irritability, numbness, trouble breathing, heart failure, fatigue and loss of appetite

Nursing interventions: supplementation, dietary changes, addressing underlying cause