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33 Cards in this Set

  • Front
  • Back

What is the normal level of serum sodium?

135 to 145 mEq/L.

What is hyponatremia? And what is the lab level for this condition?

This is when the serum sodium level is less than 135 mEq/L.

What are signs and symptoms of hyponatremia?

With severe sodium deficit the patient experiences mental status changes such as disorientation confusion and personality changes.

How do you treat hyponatremia?

By replacing lost sodium. HCP orders IV saline for patients with hyponatremia without fluid excess.

What is hypernatremia? What is the lab level for this condition?

This is when the PT receives excess sodium and unable to excrete sodium as this is seen in renal failure. This is when the serum sodium level is above 145mEq/L.

What are the signs and symptoms of hypernatremia?

Thirst is one of the first Symptoms. Mental status changes such as agitation, confusion and personality changes. This may be caused by too little fluid in the brain tissues. Seizures may also occur.

What are some treatments for hypernatremia?

If it is accompanied by a fluid imbalance, that is treated first. If kidneys are not excreting the sodium, diuretics may help if the kidneys are functional. If they are not functioning, dialysis may be ordered.

What is the normal level for potassium?

3.5 t 5 mEq/L.

What is hypokalemia? What are the lab levels for hypokalemia?

Hypokalemia is inadequate intake of potassium or excessive loss from the kidneys. Hypokalemia occurs when the serum potassium level falls below 3.5mEq/L.

What are some causes of hypokalemia?

Potassium-losing diuretics (i.e.) Furosemide (Lasix), digitali preparations-digoxin (lanoxin), and corticosteroids.)

What are the signs and symptoms of hypokalemia?

Muscle cramping or muscle fatigue (this can occur with muscle deficit or excess potassium). Pulse is typically weak, irregular and thready. Dysrhythmias can occur leading to cardiac arrest. Orthostatic hypotension can be present.

What are some treatment/therapeutic levels for hypokalemia?

IV potassium supplements. This should be given after the pt has voided.

What is hyperkalemia and what are the lab levels associated with this condition?

This is when the serum potassium level exceeds 5 mEq/L.

What causes hyperkalemia?

Overuse of potassium-based salt substitutes of excessive intake of oral or IV potassium supplements. PT's with renal failure are at risk for hyperkalemia because the kidneys cannot excrete excess potassium.

What are they signs and symptoms of hyperkalemia?

Classic manifestations are: muscle twitches and cramps, later followed by profound muscular weakness; diarrhea, slow irregular heart rate and decreased blood pressure.

What are some therapeutic measures to treat hyperkalemia?

Potassium supplements are discontinued and potassium losing diuretics are given to patients with healthy kidneys. Those with renal failure will be given polystyren sulfoate (kayexalate) either orally or rectally.

What is the normal value for serum calcium? Why is calcium necessary?

9 to 1 mg/dL or 4.5-5.5 mEq/L. It is needed for proper function of excitable tissues, especially cardiac muscle.

When does hypocalcemia occur?

When the serum calcium level falls below 9 mg/dL or 4.5 mEq/L.

What causes hypocalcemia?

This occurs from a result of chronic disease or poor intake of calcium. Post-menopausal women are at risk for hypocalcemia as calcium intake typically declines during aging. This also can occur from inadequate absorption of of calcium from the intestines as seen from Crohn's disease or chronic IBD. Insufficient about of Vitamin D prevents calcium absorption as well.

What are some signs and symptoms of hypocalcemia?

Irregular heart rate, mental status changes, hyperactive deep tendon reflexes, and increased GI motiity such as diarrhea and abdominal cramping. This can be assessed by using Trousseau's sign and Chvostek's sign.

What are some therapeutic measures for hypocalcemia?

For mild cases, oral calcium supplements with or without vitamin D are given. It should be given 1 to 2 hours after meals to increase intestinal absorption. Severe cases of hypocalcemia, especially after thyroid or parathyroid surgery, IV calcium should be readily available.

What is hypercalcemia and what are the labs when this occurs?

Hypercalcemia is an excess of serum calcium. This occurs when serium calcium is above 11mg/dL or 5.5 mEq/L.

What can cause hypercalcemia?

This can result from excessive intake of calcium or vitamin D, renal failure, hyperparathyroidism, cancers and overuse or prolonged use of thiazide diuretics such as hydrochlorothiazide.

What are the signs and symptoms of hypercalcemia?

Acute hypercalceia is associated with increased heart rate and blood pressure, skeletal muscle weakness and decreased GI motility.

What are some therapeutic measures for hypercalcemia?

PT with severe hypercalemia should be hospitalized and and placed on a cardiac monitor. Unless contraindicated, primary treatment is to give large amounts of fluids to promote diuresis. Saline infusions are most useful to promote renal excretion of calcium. Lasix maybe prescribed and in severe cases dialysis may be necessary.

What is the normal values for serum magnesium?

The normal value for serum magnesium is 1.5 to 2.5 mEq/L.

When does hypomagnesemia occur?

This occurs when the serum magnesium level falls below 1.5 mEq/L.

What are some causes for hypomagnesemia?

Malnutrition and starvation diets. Patients with severe diarrhea and Crohn's disease are unable to absorb magnesium in the intestines. One major cause is alcoholism which causes both decreased intake and increased renal excretion of magnesium. Certain drugs such as loop diuretics and osmotic diuretics, aminoglycosides (gentamicin) and some anticancer agens (cisplatin) can increase renal excretion of magnesium.

What are the signs and symptoms of hypomagnesemia?

It is similar to those for hypocalcemia such as positive Trousseau' and Chvostek's signs. Life threatening dysrhythmias can lead to cardiac failure and arrest.

What is the serum magnesium level that causes Hypermagnesemia?

Hypermagnesemia occurs when the serum magnesium level increases above 2.5 mEq/L.

What are the causes of hypermagnesemia?

The most common cause of hypermagnesemia is increased intake coupled with decreased renal excretion caused by renal failure.

What are the signs and symptoms of hypermagnesemia?

Symptoms are not apparent until serum level exceeds 4mEq/L. Some of the signs and symptoms include bradycardia, other dysrhythmias, hypotension, lethargy or drowsiness, and skeletal muscle weakness. If not treated, patient experiences coma, respiratory failure or cardiac failure.

What are some treatments for Hypermagnesemia?

If kidneys are functioning properly, loop diuretics such as furosemide (lasix) and IV fluids can help increase magnesium excretion. For patients with renal failure, dialysis may be the only option.