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61 Cards in this Set
- Front
- Back
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Function of Sodium |
-major extracellular ion -transmits nerve impulses -acid base balance -maintains osmotic pressure |
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Sources of Sodium |
salt and processed food |
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Causes of hyponatremia (low sodium) |
-hypervolemia (gains of water) *liver, heart, kidney failure *inappropriate sodium release -excessive sodium loss *diuretics *V/D/GI suction and excessive sweating |
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causes of hypernatremia (high sodium) |
dehydration, insufficient water intake, cushings disease, diabetes insipidus, primary aldosteronism |
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regulation of sodium |
eat/food and intestines -minimum requirements -excreted
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symptoms of hyponatremia |
-serum sodium of <135mEq/L -muscle cramps, weakness (falls in elderly), fatigue -anorexia, N/V -altered mental status (confusion) |
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symptoms of hypernatremia |
-serum sodium of >145 mEq/L -thirst -weakness, muscle twitching -seizures, coma and death |
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tests results for hyponatremia |
-serum osmolarity less than 280 -serum sodium less than 135 -urine specific gravity less than 1.010 -elevated hematocrit and plasma protein levels |
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tests results for hypernatremia |
-urine specific gravity greater than 1.030 -serum osmolarity greater than 300 -serum sodium level greater than 145 |
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treatment for hyponatremia |
-when both sodium and water have been lost= IV NS, hypertonic solutions such as 3% or 5% NaCl solutions given cautiously for very low sodium levels -when sodium is low but water is normal or excess = give diuretics and initiate fluid restrictions |
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treatment for hypernatremia |
water replacement (o.45% NaCl or D5) -diuretics |
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potassium function |
-major cation -supports many metabolic functions -2% in extracellular, 98% in intracellular fluid *maintains rate and force of heart conduction, nerve conduction, muscle function, acid base balance, osmotic pressure -K+ has a "K"ICK effect on heart (cardiaK), GI tract, skeletal muscle |
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potassium sources |
bananas, apricots, raisins, spinach, milk, chicken, tuna |
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why is potassium important? |
-maintains cells electrical neutrality and osmolarity -aiding neuromuscular transmission of nerve impulsives -assisting skeletal and cardiac muscle contraction and electrical conductivity -affects acid base balance in relationship to hydrogen |
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regulation of potassium |
-normal range is 3.5 to 5mEq/L -ingest daily -recommendation -80% of K is excreted -sources |
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hypoKalemia |
-level drops below 3.5 -moderate 2.5-3 severe less than 2.5 -not enough in -too much out -drugs |
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what to look for with hypoKalemia |
-skeletal muscle weakness, -paresthesia -leg cramps -deep tendon reflexes decrease -tachycardia -arrhythmias -cardiac arrest
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test results for HypoKalemia |
-serum level less than 3.5 -increased 24 hour urine level -elevated pH and bicarb levels -charecteristic ECG changes |
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treatment for hypoKalemia |
-restore normal potassium balance -high potassium low sodium diet -oral vs IV *may give runs of 10mEq of K in 100ml of fluid to run over 1-2 hours (never any faster) |
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HyperKalemia |
-potassium levels rises above 5 -moderate 6.1-7 -severe greater than 7 -less common -kidneys -acidosis -cell injury |
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what to look for with hyperKalemia |
-effects of neuromuscular and cardiac functioning -muscle weakness to flaccid paralysis -hyperactivity in GI track -Decreased heart rate, cardiac output, B/P -ECG changes |
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tests for hyperKalemia |
-serum potassium levels higher than 5 -decreased arterial pH -ECG abnormalities |
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how hyperKalemia is treated |
-loop diuretics -potasssium restricted diet -kayexalate |
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Calcium function |
needed for bone and tooth formation, blood clotting, muscle contraction and nerve impulse conduction -calcium: "ca"lms vessels and heart |
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sources of calcium |
dairy products, spinach, broccoli, tofu |
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regulation of calcium |
-dietary intake -vary per patient -dietary products green leafy vegetable -absorbed by the small intestine -excreted in urine and feces |
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causes of hypocalcemia |
-thyroidectomy with accidental removal of parathryroids; hypoparathyroidism; decreased albumin (liver disease); inadequate intake/absorption; severe respiratory alkalosis; acute pancreatitis, renal failure |
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causes of hypercalcemia |
-hyperparathyroidism -cancer (bone or PTH producing tremors) -pagets disease -prolonged immobilization (breakdown of bone) -hypophospatemia |
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symptoms of hypocalcemia |
-calcium level of <8.5 -tetany (positive chvostek's sign, Trousseaus sign) -laryngospasm (difficulty speaking and breathing) -diarrhea
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symptoms of hypercalcemia |
calcium level of >10mg/dl -muscle weakness -decreased deep tendon reflexes -constipation -EKG changes/hypertension |
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treatment of hypocalcemia |
-oral supplements (TUMS/diet) -IV calcium preparation |
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treatment of hypercalcemia |
-IV fluids (saline) (to promote renal excretion) -diuretics -calcitonin (promotes uptake of calcium into the bone) -Biphosphonates (prevent bone breakdown) |
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Magnesium function |
-regulates muscular contraction and neuromuscular control (calming effect also) -regulates blood clotting -promotes carb metabolism
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sources of magnesiunm |
-green veg, grains, nuts, meats and seafood -about 25mEq daily intake -40% will be absorbed in small intestine |
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causes of hypomagnesemia |
-ETOH (most common cause) -inadequate absorption/intake -renal disease -diuretic abuse
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causes of hypermagnesemia |
renal failure with intake of magnesium containing antacids or laxatives |
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symptoms of hypomagnesemia |
-serum magnesium < than 1.6mg/dl -tremors, hyperreactive reflexes, positive chvosteks sign and Troussseaus sign, tetany -GI- N/V/D, anorexia and abdominal distention |
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symptoms of hypermagnesemia |
-serum magnesium >2.6 mg/dl -weakness, lethargy, loss of deep tendon reflexes -respiratory depression -ECG changes/cardiac arrest |
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treatment of hypomagnesemia |
-dietary/oral replenishment -IV magnesium sulfate -if taking TPN, add magnesium |
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treatment of hypermagnesemia |
-treat underlying cause -withhold drugs with magnesium -dialysis -calcium gluconate to reverse neuromusclular and cardiac effects |
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Phosphorus function |
necessary for use of CHO, proteins and fats -necessary for ATP production -vital for RBC, nervous and muscle cell function |
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sources of phosphorus |
milk, meat, fish, eggs, poultry, legumes, nuts, cereal, bread |
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causes of hypophosphatemia |
-refeeding syndrome -antacids bind with phosphate and lower levels -alcohol intake |
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causes of hyperphospatemia |
renal insufficiency/failure -disease process that lead to hypocalcemia (hypoparathyroidism, hyperhyroidism) |
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symptoms of hypophosphatemia |
-serum phosphorus level <2.5 mg/dl -irritability, weakness, numbness, confusion -hemolytic anemia -respiratory failure -chest pain, dysrhythmias -anorexia, n/v, ileus |
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symptoms of hyperphosphatemia |
-serum phosphorus level of >4.5 mg/dl -symptoms result more from decrease in calcium levels assoc with elevated phosphare -muscle cramps, tetany, tingling around mouth |
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treatment of hypophosphatemia |
increase phosphate in the diet (milk, meat, fish, eggs, poultry, cereal, bread) -oral or IV supplement |
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treatment of hyperphosphatemia |
limit dietary intake, bind phosphorus in the GI tract (TUMS) -dialysis |
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Giving IV electrolytes |
always dilute electolytes -give in large vein or use central line if available -give slowly and use a pump -slow down if causing pain or can place warm pack over IV site |
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fluid volume |
-fluids act as a medium for transport of nutrients and wastes -medium for metabolic reactions within the cells -helps regulate body temp -acts as lubrication and insulation |
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causes of fluid volume deficit |
-loss from GI tract -diuretic therapy, abuse of laxatives -sweating, increased enviornmental temp -hemorrhage -inadequate intake (NPO) -third spacing (loss of vascular fluid into spaces where it is not useful to do its job) --losses into the abdomen, bowel, pleural space |
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symptoms of fluid volume deficit |
-drop in body weight, dry mucous membranes, decreased urine output, altered mental status, diminished skin turgor, decreased capillary refill, increased pulse, decreased BP |
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treatment of fluid volume deficit |
vital signs, administer ordered fluids, assess skin turgor/mucous membranes, daily weight, I/O |
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Causes of fluid volume excess |
conditions that cause retention of sodium and water -heart failure, cirrhosis, renal failure -steroid admin -admin of IV fluids -post op fluid mobilization in patients with heart and kidney issues |
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symptoms of fluid volume excess |
increased body weight, cough, dyspnea, crackles in lungs, edema, full bounding pulse, increased blood pressure |
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treatment/nursing care for fluid volume excess |
-diuretics, fluid restrictions, sodium restricted diet, intake and output, daily weight, lung assessment, vital signs, assess extremities for edema |
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When C02 is elevated think... |
ACIDOSIS |
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when C02 is decreased think... |
ALKALOSIS |
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when HC03 is elevated think.. |
ALKALOSIS |
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when HC03 is decreased think... |
ACIDOIS |
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Compensation |
buffers, lungs, kidneys |
