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51 Cards in this Set
- Front
- Back
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Na+ normal values
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135 mEq/L to 145 mEq/L
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Hyponatremia etiology
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* Extracellular deficit (sweat,vomit,diarrhea)* Burns* Nasogastric suction* CHF, cirrhosis* Thiazide diuretics*Impaired renal function
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Hyponatremia, clinical manifestation
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* Dehydration* Weakness* Confusion* Orthostatic hypotension* Tachycardia* Crackles in lungs
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Hyponatremia, nursing implications
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* Na+ replacement as needed*Restrict Na+ until balance regained
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Hypernatremia, etiology
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* Decreased fluid intake*Physical or chemical restraint from H2O*Fever*Vomiting
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Hypernatremia, clinical manifestation
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* Anorexia, N&V*Restlessness*Muscle weakness*Skin: dry, flushed*Orthostatic hypotension*Tachycardia*S3 gallop
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Hypernatremia, nursing implications
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* Older patients at highest risk*Offer H2O & fluids hourly*Restrict high Na+ foods
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Calcium, normal values
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8.6 to 10 mEq/L
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Hypocalemia, etiology
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* Inadequate Ca intake*Vitamin D deficiency*Hypoparathyroidism*Increase serum protein (albumin)
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Hypocalemia, clinical manifestation
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* Neuromuscular irritability*Tetany*Positive Chvostek sign*Positive Trousseau's sign
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Hypocalemia, nursing implications
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* Monitor IV site
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Hypercalemia, etiology
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* Acidosis*Prolonged immobilization*Hyperparathyroidism*Hypoproteinemia
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Hypercalemia, clinical manifestation
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* Constipation*Dryness of mouth (thirst)*Muscle hypotonicity*Formation of ureteral or kidney stones
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Hypercalemia, nursing implications
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* Monitor ECG*Monitor serum calcium levels
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Phosphate, normal values
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1.2 to 3 mEq/L
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Hypophosphatemia, etiology
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*Long term lack of intake*Increased growth or tissue repair*Chronic respiratory alkalosis*Lead poisoning
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Hypophosphatemia, clinical manifestation
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Disruption of the ATP cycle*Decreased cardiac function*Decreased respiratory function*Fatigue*Brittle bones*Bone pain
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Hypophosphatemia, nursing implications
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Mild imbalance can be treated with diet
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Hyperphosphatemia, etiology
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Excessive intake of high-phosphate foods*Excess of Vitamin D*Impaired colonic motility*Addison's disease
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Hyperphosphatemia, clinical manifestation
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Tachycardia*Palpations*Restlessness*Anorexia*N/V*Hyperreflexia*Tetany
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Potassium, normal values
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3.5 tro 5 mEq/L
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Hypokalemia, etiology
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* Diarrhea, vomiting*Nasogastric suctioning*Diuresi*IV fluid without added potassium
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Hypokalemia, clinical manifestation
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* Prominent "U" wave*Weakness, paralysis*Constipation, ileus*Arrhythmias, and cardiac arrest
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Hypokalemia, nursing implications
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* Body does not conserve K+*Give K+ with glass of juice
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Hyperkalemia, etiology
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* Renal disease*Associated with metabolic acidosis*Transfusion with old donor blood*Crush injuries burns
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Hyperkalemia, clinical manifestation
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* Peaked "T" wave, flat "P" wave*Muscle weakness*Flaccid paralysis*Twitching*Ventricular fibrillation and cardiac arrest
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Hyperkalemia, nursing implications
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* Administer IV fluids as prescribed*Administer insulin (if ordered) to facilitate movement of K+ into cells
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Magnesium, normal values
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?
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Critically ill*Alcoholics*Chronic malnutrition*Chrohn's or celiac disease*Prolonged IV or TPN without Mg replacement
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Hypomagnesium, clinical manifestation
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Myocardial irritability*Positive Chvostek's or Trousseau's sign*Tetany, convulsions*Vasospasms, leading to stroke
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Hypomagnesium, nursing implications
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Rare imbalance
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Hypermagnesemia, etiology
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Renal insufficiency*Use of Mg-containing antacids/laxatives*Administering of K+ sparing diuretics*Severe dehydration from ketoacidosis
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Hypermagnesemia, clinical manifestation
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Decreased muscle cell activity*Peripheral vessel dilation leading to hypotension*Severe muscle weakness*Loss of deep tendon reflexes*Respiratory paralysis
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Fluid Excess, etiology
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Excessive oral intake*Excessive IV infusion (hypotonic fluid)*Congestive Heart Failure (CHF)*Malnutrition
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Fluid Excess, clinical manifestation
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Edema*Moist rales*Slow, bounding pulse*Weight gain*Seizures, coma
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Fluid Excess, nursing implications
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Decrease serum electrolytes*Administer diuretics*Limit fluid intake
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Fluid Deficit, etiology
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Neglect of intake by self / caregiver*Overuse of diuretics*Loss through skin or lungs*Excessive sweating*Febrile states
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Fluid Deficit, clinical manifestation
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Postural hypotension*Dry skin and mucous membranes*Decreased urine output*Weight loss*Tacycardia
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Fluid Deficit, nursing implications
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Causes hyponatremia*Increased hematocrit*Increased BUN*Increased osmolarity
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Respiratory Acidosis, Defining Signs
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Hypoventilation*Increasing PaCO2*Decreasing pH
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Respiratory Acidosis, Commonly Seen
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Dyspnea*Anxiety*Confusion
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Respiratory Acidosis, Signs of Severe Imbalance
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Hypotension*Seizures*Muscle tremors
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Respiratory Alkalosis, Defining Signs
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Hyperventilation*Decreasing PaCO2*Increasing pH
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Respiratory Alkalosis, Commonly Seen
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Confusion*Hypocalcemia*Lightheadness
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Respiratory Alkalosis, Signs of Severe Imbalance
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Dsyrhythmias*Muscle weakness*Chest pain
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Metabolic Acidosis, Defining Signs
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Hyperventilation*(Kussmaul's resp)*Decreasing HCO3*Decreasing pH
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Metabolic Acidosis, Commonly Seen
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Hyperkalemia*Dyspnea*Lethargy
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Metabolic Acidosis, Signs of Severe Imbalance
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Bradycardia*Hypotension
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Metabolic Alkalosis, Defining Signs
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Hypoventilation*Increasing HCO3*Increasing pH
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Metabolic Alkalosis, Commonly Seen
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Confusion*Hypocalemia*Hypotension*Muscle cramping
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Metabolic Alkalosis, Signs of Severe Imbalance
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Dysrhythmias*Hypotension*Hypoxemia
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