electrolytes

Hyponatremia s/sx

headache, nausea, Muscle cramps, confusion, cerebral edema, coma, hyperactive bowel sounds, nausea,

Hyponatremia levels

less than 135 mEq/L

Hyponatremia food

pizza soup tomato juice pretzel and chips

Hyponatremia management

Water and sodium restriction (FVE), Na replacement 3 or 5% NaCl IV with nero signs, LR or NS isotonic ferlose of NA and water

Hypernatremia s/sx

Thirst, poor skin tugor, hypotension, tachycardia, confusion, restlessness

Hypernatremia levels

greater than 145mEq/L

Hypernatremia Food

rinse canned vegetables before eating, limit high sodium foods

Hypernatremia

½ NS, D5W,  slow correction of water deficient over 2 to 3 days initially,  identify cause, encourage fluids, decrease sodium in diet,  daily weight and I&O

Hypokalemia s/sx

Generalized muscle weakness, cardiac dysrhythmias, GI upset, lethargy, anorexia, n/v

Hypokalemia levels

below 3.5 mEq/L

Hypokalemia Foods

Spinach, baked potatoes and skin, sweet potato, banana, oranges

Hypokalemia management

Potassium in diet, supplement or mixed in IV fluid, given with IV fluids as IV piggyback, never IV push, Assessment, EKG/ telemetry unit, Flomide and digoxin toxicity risk 

Hyperkalemia s/sx:

Muscle weakness, Tremors, heart rhythm (EKG) changes, cardiac arrest, nausea, diarrhea

Hyperkalemia levels

greater than 5.3 mEq/L

Hyperkalemia management

monitor EKG, limit dietary potassium, give Loop Diuretics and fluids, caution-exchange resign, insulin + dextrose is given

Hypocalcemia s/sx

Anxious, confusion, irritable, painful muscle spasms, hypotension, Airway problems, bradycardia, Tetany, paresthesias, Muscle aches,  seizures,  positive trousseau and kowarski signs, laryngeal spasm

Hypocalcemia level

less than 9mg/dL

Hypocalcemia management

Calcium gluconate (IVor po), Infuse via IV slowl/painful, Calcium/ vitamin D supplements, Take with full glass of water or orange juice, not with meal or milk, not with other meds 

Hypocalcemia food

Dairy products, broccoli, tofu, green leafy vegetables, baked beans, salmon, sardines 

Hyperkalemia s/sx

decreased DTR, muscle weakness, fatigue, n/v, abd discomfort, constipation, confusion, lethargy, coma, dysrhythmias, hypertension, bracardia, cardiac arrest

Hypercalcemia level

 > 11 mg/dL

Hypercalcemia management

Dilate with fluids 1/2 NS or NS, increase oral fluids, flomide, calcitronin, biophosphates, surgery for hyperparathyroidism, assess, hyperkalemic crisis, fluids of 3 to 4 L/d, ambulate patient, injury prevention

Hypomagnesemia s/sx

confusion, hyperactive DTRs, tremors, seizures, pscyhosis, +Chvostek’s, +Trousseau’s, dysrthmias, depressed, dysphagia

Hypomagnesemia level

 less than 1.5mg/dL

Hypomagnesemia management

diet, oral Mg, Mg sulfate IV, ensure safety, alcohol use, and care related to IV Mg sulfate (monitor heart rhythm, beware resp emergency)

Hypomagnesemia food

halibut, cashews, oatmeals, whole grain

Hypermagnesemia s/sx

interfered neuromuscular transmission, depressed CNS, hypotension, facial flushing, sweating, resp depression, DTRs decreased

Hypermagnesemia level

more than 2.5 mg/dL

Hypermagnesemia management

loop diuretics, hemodialysis, NS IV, calcium gluconate antidote, for mg OD, assessment, don’t administer meds containing Mg, OTC meds, monitor resp status, and cardiac rhythm

Hypochloremia s/sx

Irritability,  hypotension, tetany, shallow respirations, and Hyperexcitability of muscles and nerves

Hypochloremia levels

Less than 97mEq/L

Hypochloremia management

Monitor patients Consciousness, respiratory effort, and muscle control notifying provider if there are any changes. educating patients on chloride High Foods and replacing fluid loss with electrolyte fluids

Hypochloremia foods

tomatoes, meats, and potatoes

Hyperchloremia s/sx

Deep and Rapid respirations, lethargy, tachypnea, decreased cognitive ability and elevated blood pressure

Hyperchloremia level

Greater than 107mEq/L

Hyperchloremia management

Monitor patient for changes in neurological cardiac and respiratory status. Educate patient on adequate hydration and hyperchloremia

Hypophosphatemia s/sx

Confusion, apprehension, seizures, coma, skeletal or general smooth muscle weakness, respiratory insufficiency, resulting from diaphoric dysfunction

Hypophosphatemia level

Less than 2.5mg/dL

Hypophosphatemia management

Monitoring for patients at risk for hypo phosphatemia monitor for signs of patient status such as confusion and increased muscle weakness in myocardial irritability. Educate pt and family regarding dietary sources to ensure adequate and take phosphorus.

Hypophosphatemia food

meat, cheese, and nuts

Hyperphosphatemia s/sx

Positive chvostek or Trousseau sign, hyperreflexia, soft tissue calcification, tetany bone and joint pain, muscle weakness, anorexia paresthesias, delirium, convulsion, seizures, coma  hypotension, heart failure and a prolonged QT interval on ECG

Hyperphosphatemia levels

Greater than 4.5mg/dL

Hyperphosphatemia management

Monitoring and identifying patients at risk for developing hyperphosphatemia. Educate  patient and family Dietary management Focus Foods to avoid meat nuts, high protein foods cheese and other dairy products