Electrolytes

Front 1

Name 6 major electrolytes/minerals

Back 1

Sodium, Chloride, Potassium, Calcium, Phosphate, Magnesium

Front 2

What are 3 functions of Sodium

Back 2

maintains osmotic pressure,
balances acid/base,
transmits nerve impulses

Front 3

What is the most abundant cation

Back 3

Sodium

Front 4

What is the normal range for Na

Back 4

135-145 mEq/L

Front 5

Etiologies of Hyponatremia

Back 5

gain of more water than salt:excess water,
loss of more salt than water,
diuretic usage,
vomiting/diarrhea/burns,
excessive sweating,
renal dz,
excess ADH,
excessive IV infusion,
tap water enemas,
replacement of water after v/d/burns, but not salt

Front 6

Neurological Clinical Manifestations of Hyponatremia

Back 6

neuronal swelling, H/A, confusion, behavioral change, seizures, hallucinations

Front 7

Cardiovascular manifestations of Hyponatremia

Back 7

orthostatic hypotension, weak and/or thready pulse

Front 8

Respiratory manifestations of hyponatremia

Back 8

crackles, tachypnea, dyspnea, orthopnea

Front 9

GI manifestations of hyponatremia

Back 9

N/V, hyperactive bowel sounds, abdominal cramping, diarrhea

Front 10

How to assess for hyponatremia

Back 10

CNS sx, BP, HR (tachy), dry mucous membranes, fluid i/o, sodium below 135, cl below 97

Front 11

Tx Goals for hyponatremia

Back 11

correct body water osmolality,
restore cell volume,
raising ratio of na/h2o

Front 12

Interventions for hyponatremia

Back 12

reduce na loss in high risk patients,
restore sodium imbalance,

Front 13

Etiologies of Hypernatremia

Back 13

gain of more salt than water
loss of more water than salt: excess water loss,
dehydration,
overuse of IV saline solutions,
cushing's syndrome,
uncontrolled dm,
tube feeding
IV hypertonic solution,
inability to respond to thirst,
decreased ADH (diabetes insipidus),
diarrhea or sweating without water replacement,
difficulty swallowing fluids

Front 14

neuro sx of hypernatremia

Back 14

increased osmolality of ECF causes neurons to shrivel because water moves from cells to interstitial fluid causing confusion, seizures, coma and death

Front 15

gi sx of hypernatremia

Back 15

polyuria, nausea, vomiting

Front 16

CV 6 sx of hypernatremia

Back 16

HTN, jugular venous distention, S3 gallop, generalized weight gain and edema, dysrythmias

Front 17

3 respiratory sx of hypernatremia

Back 17

crackles, dyspnea, fluid effusion

Front 18

tx goals for hypernatremia

Back 18

correct body water osmolality,
restore cell volume,
decrease ratio of na/water

Front 19

interventions for hypernatremia

Back 19

monitor i/o,
oral care

Front 20

name elements in extracellular fluid

Back 20

sodium, bicarb HCO3, chloride, calcium

low in K, Mg, Phosphate

Front 21

name elements in intracellular fluid

Back 21

K, Mg, Phosphate, Protein

low in Cl and Na

Front 22

what is major anion found predominantly in extracellular spaces

Back 22

chloride

Front 23

which mineral follows sodium

Back 23

chloride

Front 24

what is the function of chloride

Back 24

maintains cellular integrity

Front 25

What is the normal range for chloride

Back 25

98-107 mEq/L

Front 26

hypochloremia etiologies

Back 26

loss via gi tract,
diuretics

Front 27

clinical manifestations of hypochloremia

Back 27

weakness, muscle cramps, hyperactive reflexes

Front 28

hyperchloremia etiologies

Back 28

increased in na serum levels,
deficit of bicarb

Front 29

clinical manifestations

Back 29

metabolic acidosis

Front 30

what is the principle cation of intracellular fluid and the primary buffer of the cell

Back 30

k

Front 31

what are 5 functions of potassium

Back 31

nerve conduction,
muscle function,
acid/base balance,
osmotic pressure,
controls rate/force of contraction of heart and cardiac output

Front 32

what is the normal range for potassium

Back 32

3.5 - 5 mEq/L

Front 33

hypokalemia: etiologies

Back 33

decreased K intake (anorexia, fasting, NPO),
increased K loss (renal, fecal, sweating),
K redistribution from ECF into cells (excess insulin tx for DM),
hyperaldosteronism,
debilitated patients,
medications,
hypernatremia,
vomiting/diarrhea

Front 34

gi sx of hypokalemia

Back 34

anorexia, n/v, abdominal distention, decreased bowel sounds

Front 35

cv sx of hypokalemia

Back 35

r/t decreased conduction,
ECG/EKG changes,
dysrhythmias, hypotension, weak pulse,
slightly peaked p wave,
prominent u wave

Front 36

neuro sx of hypokalemia

Back 36

postural hypotension,
weakness, fatigue, irritability, confusion, a/v premature beats, v fib

Front 37

respiratory sx of hypokalemia

Back 37

shallow respirations, SOB, apnea

Front 38

interventions for hypokalemia

Back 38

cardiac monitor,
oral or iv potassium,
potassium rich foods,

Front 39

hyperkalemia: etiologies

Back 39

increased K intake (excessive or too rapid IV infusion),
impaired excretion of K (renal dz),
shift of K out of cells into ECF (24-72 hours after trauma, crushing injury, cytotoxic drugs, lack of insulin from untreated DM)

Front 40

gi sx of hyperkalemia

Back 40

abdominal cramps, diarrhea

Front 41

cv sx of hyperkalemia

Back 41

r/t increased conduction,
ecg/ekg changes, dysrythmias, hypotension, tachycardia, arrythmia, death by asystole or V fib, cardiac arrest

Front 42

respiratory sx of hyperkalemia

Back 42

muscle paralysis

Front 43

neuro sx of hyperkalemia

Back 43

nerve and muscle irritability,
paresthesia,
convulsions,
agitation,
weakness

Front 44

renal sx of hyperkalemia

Back 44

oliguria, anuria

Front 45

hyperkalemia ecg changes

Back 45

decreased r wave amplitude (not as high),
widened QRS,
narrow and peaked T wave

Front 46

What is normal range for Calcium

Back 46

4.5 - 5.5 mEq/L

Front 47

what other lab values are affected by calcium

Back 47

decreased albumin = decreased calcium
increased phosphorus = decreased calcium

Front 48

3 types of calcium in the body

Back 48

protein bound 50%,
citrate/salt form,
free/ionized (most active)50%

Front 49

functions of ionized calcium

Back 49

muscular contraction, cardiac function, nerve impulse transmission, blood clotting

Front 50

hypocalcemia: etiologies

Back 50

decreased ca intake or absorption (chronic diarrhea from laxative abuse or pancreatitis),
decreased physiologic availability of ca (hypoparathyroidism, hypomagnesmia),
increased ca excretion via renal or fecal routes,
inadequate vitamin D intake (lactose intolerance, gi disease, liver disease),
NPO status,
medications,
parathyroid disease

Front 51

neuro sx of hypocalcemia

Back 51

paresthesias in hands/feet/toes/lips,
chvostek's sign,
trousseau's sign,
muscular irritability,
muscle twitching,
seizures

Front 52

cv sx of hypocalcemia

Back 52

r/t abnormal conduction,
hypotension, dysrhythmia, prolonged QT interval

Front 53

hematological sx of hypocalcemia

Back 53

prolonged bleeding times

Front 54

musculoskeletal sx of hypocalcemia

Back 54

tetany, laryngospasm, muscle twitching and cramping, pathological fractures

Front 55

interventions for hypocalcemia

Back 55

cardiac monitor and
monitor for bleeding

Front 56

hypercalcemia: etiologies

Back 56

increased ca intake or absorption (antacids, vit. D overdose from shark cartilage),
mobilization of ca from bone into blood (hyperparathyroidism, malignant tumor, leukemia),
decreased ca excretion (thiazide diuretics)

Front 57

gi sx of hypercalcemia

Back 57

n/v, constipation, anorexia

Front 58

neuro sx of hypercalcemia

Back 58

r/t abnormal conduction,
fatigue, muscle weakness, decreased reflexes, h/a, confusion, lethargy, personality change, coma

Front 59

renal sx of hypercalcemia

Back 59

kidney stones

Front 60

cv sx of hypercalcemia

Back 60

r/t abnormal conduction,
shortened QT interval,
Widened T wave,
dysrhythmias,
cardiac arrest

Front 61

interventions for hypercalcemia

Back 61

cardiac monitoring,
increase fluid intake,
safety precautions

Front 62

functions of phosphate

Back 62

generation of bony tissue,
metabolism of glucose and lipids,
maintanance of acid/base balance,
storage and transfer of energy

Front 63

what is normal serum range for phosphate

Back 63

2.7 - 4.5 mg/dL

Front 64

hypophosphatemia: etiologies

Back 64

decreased intake or absorption (alcoholism, chronic diarrhea, malabsorption),
shift from ECF into cells (insulin),
increased excretion through normal renal route (diabetes, ETOH withdrawal),
loss through abnormal route (excessive vomiting),
excessive antacid use,
lead poisoning

Front 65

clinical findings in hypophosphatemia

Back 65

r/t decreased energy source,
anorexia, malaise, paresthesias, hemolysis, decreased reflexes, muscle aches/weakness, confusion, stupor, seizures, coma, respiratory failure, impaired cardiac function

Front 66

interventions for hypophosphatemia

Back 66

mild: treat with diet,
severe: treat with TPN

Front 67

hyperphosphatemia: etiologies

Back 67

increased intake or absorption (iatrogenic),
redistribution from cells into ECF (tumor lysis, crushing injury),
decreased excretion (renal failure with oliguria),
excessive vitamin D,
hypoparathyroidism,
addison's disease

Front 68

gi sx of hyperphosphatemia

Back 68

anorexia, n/v

Front 69

neuro sx of hyperphosphatemia

Back 69

restlessness

Front 70

cv sx of hyperphosphatemia

Back 70

tachycardia, palpitations, dysrhythmia

Front 71

renal sx of hyperphosphatemia

Back 71

kidney obstruction

Front 72

interventions for hyperphosphatemia

Back 72

mild or asymptomatic: diet modification - limit high phosphate foods,
administer calcium or aluminum products

Front 73

what is normal serum magnesium range

Back 73

1.5 - 2.5 mEq/L

Front 74

How is magnesium distributed in body

Back 74

40-60% in bone,
20% in muscle,
30% in cells

Front 75

Functions of magnesium

Back 75

regulates neuromuscular irritability and clotting mechanism,
linked with calcium

Front 76

hypomagnesemia: etiologies

Back 76

decreased intake or absorption (alcoholics, malnutrition),
decreased availability of mg,
increased loss through normal routes,
loss thru abnormal routes

Front 77

cv sx of hypomagnesemia

Back 77

r/t increased neuromuscular activity,
premature ventricular contraction, atrial or ventricular fibrillation, ecg changes

Front 78

neuro sx of hypomagnesemia

Back 78

increased neuromuscular excitability,
insomnia, increased reflexes, muscle cramping/twitching, chvostek sign,
trousseau sign,
tetany,
convulsions,
dysphagia

Front 79

gi sx of hypomagnesemia

Back 79

anorexia, nausea, abdominal distention

Front 80

psychological sx of hypomagnesemia

Back 80

depression, psychosis, confusion

Front 81

hypermagnesemia: etiologies

Back 81

increased intake or absorption (antacid tx, near drowning in salt water),
decreased excretion (renal failure with oliguria, decreased urine output),
severe dehydration,
iv administration,

Front 82

cv sx of hypermagnesemia

Back 82

r/t decreased neuromuscular activity,
ECG changes, heart block, premature ventricular contractions,
hypotension,
arrythmias/bradycardia

Front 83

neuro sx of hypermagnesemia

Back 83

decreased reflexes, lethargy, loss of deep tendon reflexes, respiratory paralysis, loss of consciousness, drowsiness