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34 Cards in this Set
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- Back
- 3rd side (hint)
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Magnesium:
Normal Value and Use |
1.6-2.6 mg/dl
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Required for :
-Use of Adenosine Triphosphate -Carbohydrate metabolism -Protein Synthesis -Regulates neuromascular activity. |
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Sodium:
Normal Value and Use |
135-145 mEq/dl
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-Maintains Osmotic Pressure
-Transmits nerve impulses |
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Sodium:
Hypernatremia Causes and Treatments |
-Excessive intake of Na
-HYPERaldosteronism/Conn's -Cushing’s Disease -Decreased Water Intake -Diaphoresis -Diabetes Insipidus -Diarrhea |
a. IV Normal Saline for Hypernatremia caused by caused by fluid loss.
b. Furosemide (Lasix) - for Hypernatremia caused by Inadequate Renal Secretion |
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Sodium:
Hyponatremina Causes and Treatments |
-Inadequate Na Intake
-Addison’s -Hypoaldosternonism -Vomiting -Diarrhea -Fever -Renal Failure -Excessive Sweating -Thiazide Diuretics -Low salt diet -SIADH (treated with Declomycin, an ADH Antagonist) -CHF |
a. Hypovolemic Hyponatremia – Little H20 and Na. IV NaCl to restore Na and Fluid.
b. Hypervolemic Hyponatremia – More H20, Lesser Na. Potassium-Sparing Diuretics (Spirinolactone) |
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Calcium:
Normal Value and Use |
8.6-10.0 mg/dl
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-Mineral for bone formation
-Coagulation of blood -Excitation of cardiac and skeletal muscles -Regulation of endocrine and exocrine glands |
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Calcium:
Hypercalcemia Causes and Symptoms |
-Excessive oral intake of Ca and Vit D
-Hyperparathyroidism -Bone Destruction |
- ECG Sign: Short ST, Wide -
- Disorrientation - Lethargy - Coma |
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Calcium:
Hypocalcemia Causes and Symptoms |
-Lactose Intolerance
-Inadequate intake of Calcium and Vit D -Celiac Sprue or Crohn’s Disease -Hyperphosphatemia -Parathyroidectomy |
- ECG Sign: Prolonged ST QT
- TROUSSEAU’S Sign (carpall spasm) - Chvostek Sign (facial spasm) - Twitches - Cramps - Tetany |
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Potassium:
Normal Value and Use |
3.5-5.1 mEq/dl
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- Primary fluid in interstitial compartment
- For blood gas exchange - Nerve conduction and muscle function - 5-10 mEq/h infusion rate. - Needs cardiac monitor - Cannot be administered vua IM, SQ and IV Push - No Pee, No K. |
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Potassium:
Hyperkalemia Causes and Treatment |
- Addison’s
- Excessive Intake of K - Spirinolactone - K Supplements |
- Calcium Gluconate
- Sodium Bicarbonate - Kayexalate - Dialysis |
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Potassium:
Hypokalemia Causes and Symptoms |
- Cushing’s
- Hyperaldosteronism - Inadequate intake of K - Fluid shift from Extra to Intra - Renal Failure - Vomiting - Diarrhea - NG Suction - Corticosteroids - Wound drainage - Sweating |
- Early: Muscle Twitches, Cramps
- Late: Paralysis |
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Phosphorus:
Normal Value and Use |
2.7-4.5 mg/dl
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- Required for bone formation
- Metabolism of glucose and lipids - Maintenance of acid-base balance. |
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Phosphorus:
Hyperphosphatemia Causes and Treatments |
- Excessive intake of Phosphate-containing laxative and enema
- Tumorlysis syndrome caused by chemo - Hypoparathyroidism |
- Oral Phosphate Binders such as Aluminum Hydroxide (Amphojel)
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Phosphorus:
Hypophosphatemia Cause and Treatments |
- Insufficient Phosphorus Intake
- Malnutrition - Starvation - Increased phosphorus excretion caused by Hyperparathyroidism |
- Increased Phosphorus Intake along with Vit D.
- If Serum Phosphorus is <1 mg/dl, administer Phosphorus through Slow IV. |
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IV Fluids:
Isotonic Description and Solutions |
Two solutions separated by permeable membrane with equal concentration.
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a. D5W, 5% Dextrose in H2O
b. NaCl, .9% in Cl c. LR, Lactated Ringer's |
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IV Fluids:
Isotonic, Dextrose 5% in water (D5W) Uses and Considerations |
- Fluid loss
- Dehydration - Hypernatremia |
- Use cautiously in renal and cardiac patients
- Can cause fluid overload |
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IV Fluids:
Isotonic, 9% Sodium in Cl (NaCl) Uses and Considerations |
- Shock
- Hyponatremia - Blood transfusions - Resuscitation - Fluid challenges - DKA |
- Can lead to overload
- Use with caution in patients with heart failure or edema |
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IV Fluids:
Isotonic, LaIV Fluids:ctated Ringers |
- Dehydration
- Burns - Lower GI fluid loss - Acute blood loss - Hypovolemia due to third spacing |
- Contains potassium, don’t use with renal failure patients
- Don’t use with liver disease, can’t metabolize lactate |
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IV Fluids:
Hypotonic Description and Solutions |
Contains lower concentration of
Salt |
0.45% sodium chloride (1/2 normal saline)
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IV Fluids:
Hypotonic, 0.45% sodium chloride (1/2 normal saline) Uses and Considerations |
- Water replacement
- DKA - Gastric fluid loss from NG or vomiting |
- May cause cardiovascular collapse
- May Increase intracranial pressure - Don’t use with liver disease, trauma, or burns |
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IV Fluids:
Hypertonic Description and Solutions |
Have high concentration solutes.
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- Dextrose 5% in ½ normal saline
- Dextrose 5% in normal saline - Dextrose 10% in water |
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IV Fluids:
Hypertonic, Dextrose 5% in ½ normal saline Uses and Consideration |
Later in DKA treatment
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Use only when blood sugar falls below 250 mg/dL
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IV Fluids:
Dextrose 5% in normal saline Uses and Considerations |
Temporary treatment for shock if plasma expanders aren’t available
Addison’s crisis |
Don’t use in cardiac or renal patients
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IV Fluids:
Dextrose 10% in water Uses and Considerations |
Water replacement
Conditions where some nutrition with glucose is required |
Monitor blood sugar levels
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Dehydration and Overhydration:
DEHYDRATION Signs and Interventions |
1.CARDIOVASCULAR SIGNS: Increased Pulse Rate, HTN, Orthostatic Hypotension, Flat Neck Veins
2. SKIN: Poor Skin Turgor, Tenting, Dry Mouth, Dry Skin 3. RENAL: Decreased Urine Output, Increased Urine Specific Gravity 4. LAB FINDINGS: Increased Serum Osmolality, Increased Hematocrit, Increased BUN, Hypernatremia |
a. IV Fluid Infusion
b. Increased Fluid Intake c. ISOTONIC with Isotonic, HYPERTONIC with Hypotonic, HYPOTONIC with HYPERTONIC |
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Dehydration and Overhydration:
OVERDHYDRATION Signs |
1. RESPIRATORY: Crackles, Tachypnia, Dyspnea
2. SKIN: Cool, Pale Skin; Pitting Edema 3. CARDIOVASCULAR: Tachycardia, Jugular Venous Distention, Hypertension |
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Dehydration and Overhydration:
ISOTONIC. Definition and Isotonic Fluid Samples |
Contains equal amount of Water and Electrolytes
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Lactated Ringer’s Solution
5% Dextrose in 0.225% Saline 5% Dextrose in Water |
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Dehydration and Overhydration:
ISOTONIC DEHYDRATION Definition and Causes |
a. Water and Electrolytes are lost at an equal Value
b. HYPOVOLEMIC/Hypovolemia |
Fluid Shift
Inadequate intake of Fluids and Solutes |
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Dehydration and Overhydration:
ISOTONIC Overhydration Definition, Causes and Symptoms |
a. Water and Electrolyte are gained at the same value
b. HYPERVOLEMIC/Hypervolemia c. c. Can cause Circulatory Overload, Peripheral Edema and Pulmonary Edema |
CAUSES
- Corticosteroid Therapy - Renal Failure - Excessive IV Therapy SYMPTOMS - Hepatomegaly - Ascites |
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Dehydration and Overhydration:
HYPOTONIC. Definition and Hypotonic Fluid Samples |
Contains more Water than Na
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- 22% NaCl
- 33% NaCl - 45% NaCl |
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Dehydration and Overhydration:
HYPOTONIC DEHYDRATION Definition and Causes |
Electrolyte loss is greater than Water loss causing HYPONATREMIA
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Excessive fluid replacement with Hypertonic, malnutrition
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Dehydration vs Overhydration:
HYPOTONIC OVERHYDRATION Definition and Causes |
Results from water intoxication
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Excessive Hypotonic Infusion
Renal Failure CHF SIADH secretion |
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Dehydration vs Overhydration:
HYPERTONIC. Definition and Hypertonic Fluid Samples |
Have higher concentration of Solutes than Water
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3% NaCl
5% NaCl 10% Dextrose in Water 5% Dextrose in Ringer’s |
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Dehydration vs Overhydration:
HYPERTONIC DEHYDRATION Definition and Causes |
loss exceeds Electrolytes causing HYPERNATREMIA
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Vomiting
Diarrhea Excessive Sweating Ketoacidosis Diabetes Insipidus. |
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Dehydration vs Overhydration:
HYPERTONIC OVERHYDRATION Causes |
Excessive Na intake
Rapid infusion on IV Saline |
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