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100 Cards in this Set

  • Front
  • Back
The 6 electrolytes we are concerned with are...
Sodium (Na+)
Potassium (K+)
Calcium (Ca++)
Magnesium (Mg++)
Phosphate (serum phosphorus)
Chloride (Cl-)
Normal Total Calcium (Ca++) is ______.
9-10.5 mg/dl
Normal Ionized (free) serum Ca++ is _____.
4.5-5.6 mg/dl
Normal Potassium (K+)
is _____.
3.5-5 mEq/L
Normal Phosphate
serum phosphorus) is _____.
3-4.5 mg/dl
Normal Magnesium (Mg++)
is _____.
1.3-2.1 mEq/L
Normal Chloride (Cl-)
is _____.
98-106 mEq/L
Normal Sodium (Na+)
is _____.
136-145 mEq/L
Sodium is the most abundant ion in the _____.
ECF
Potassium is the most abundant ion in the _____.
ICF
A shift in which electrolyte triggers a fluid volume change to restore normal solute and water ratios?
Na+
True or False:
Na+ helps maintain acid-base balance
True
Which electrolyte activates nerve and muscle cells involved in muscle contraction?
Na+
Which electrolyte with Cl- influences water distribution?
Na+
Which electrolyte is regulated by the kidney through tubular reabsorption?
Na+
Aldosterone, a hormone secred by the adrenal cortex, works to increase the reabsorption of _____ by the kidney.
Na+
Natriuretic peptides increase _____ and water excretion.
Na+
The 7 causes of HYPOnatremia are:
B urns
R enal disease
A ldosterone (decreased secretion
D iuretics
S weating (excessive)

GI wound drainage
SI adh (SIADH - decreased renal excretion of water

Brads Gisi
The 6 causes of HYPERnatremia are:
D iabetes
I nspipdus
C ushings
S yndrome

H igh protein w/o water
H yperaldosteronism
O smotic diuretics

Dics H2O
Seizures and comas are symptoms of both high and low levels of _____.
Na+
Irritability, restlessness, confusion, and agitation are symptoms of __________.
Hypernatremia (high Na+)
Increased thirst is a symptom of __________.
Hypernatremia (high Na+)
Sleepiness, weakness, and lethargy are symptoms of __________.
Hyponatremia (low Na+)
Headache, decreased tendon reflexes, and N/V or anorexia are symptoms of __________.
Hyponatremia (low Na+)
Behavioral and personality changes are symptoms of __________.
Hyponatremia (low Na+)
The 7 symptoms of low sodium (hyponatremia) are:
Sleepiness, weakness and lethargy
Headache, N/V or anorexia
Decreased tendon reflexes
and Behavioral & personality changes
Treatment for low sodium levels (hyponatremia) is:
Fluid restriction and monitoring of I/O, VS, Wt, lab values, urine Na+, specific gravity
Treatment for high sodium levels (hypernatremia) is:
Push fluids, D5W, inspect for edema, and monitoring of I/O, VS, Wt, lab values, urine Na+, specific gravity
_____ is the main ECF anion.
Chloride (Cl-)
ECF osmolality is affected by
Chloride (Cl-)
Cl- affects body pH by...
combining with H ions to produce HCl
via passive transport, _____ follows Na+
Chloride (Cl-)
The 4 causes of low chloride levels are:
Diuretics
Low sodium diets
Excessive administration of bicarb
Prolonged vomiting, GI suctioning, diarrhea, sweating
The 3 causes of high chloride levels are:
Hypernatremia
Metabolic acidosis
Ingestion of salicylate, ethylene glycol or methanol
4 symptoms of low chloride are:
Tetany
Hypoventilation
Paresthesia of the extremities
Restlessness, confusion, convulsions
The 6 symptoms of high chloride levels are:
Hyperventilation (to blow off excess carbon dioxide)
Hypotension
Decreased cardiac output
Peripheral vasodilation
Headache
Lethargy
The treatment for low chloride includes:
Increase NaCl in the diet
Correct GI symptoms
Seizure precautions
The treatment for high chloride includes:
Give IV fluids to correct fluid imbalance
Give sodium bicarb to correct pH
Monitor level of consciousness and respiratory status
Phosphorus and ______ levels are generally opposite (ie., a patient with high phosphorus will have low _____).
Calcium
The 4 causes of low serum phosphorus are:
Alcohol abuse
Antacid abuse (increased use)
D deficiency (causing decreased absorption)
Intestinal malabsorption
Increased renal excretion
The cause of high serum phosphate levels is:
significant loss of glomerular filtration, cancer with chemotherapy
The 4 symptoms of low serum phosphorus (phosphate) levels are:
Hypoxia and bradycardia caused by reduced oxygen transport on RBCs
Increased risk of infection and bleeding because of dysfunctions in WBCs and platelets
Nerve and muscle malfunctions
Rickets or osteomalacia caused by bone resorption
The 8 symptoms of high serum phosphorus (phosphate) are:
Confusion, convulsions & insomnia
Paresthesias around the mouth and hands
Carpopedal spasm & tetany
Hyperreflexia
Brittle nails, osteoporosis & periodontal disease
Diarrhea
Positive Chvostek's & Trousseau signs
Cardiac arrhythmias
The treatment for low serum phosphorus (phosphate) is:
Treat the underlying cause
A low _________ level is generally not life-threatening, but administration of _________ salts can be.
phosphorus/phosphate
Which electrolyte is a major ICF cation
Mg++
What percent of the body's Mg++ is stored in the bone?
40-60%, with the remainder in the soft tissues and muscles
Which electrolyte aids in protein synthesis and is necessary for the formation and function of healty bones
Mg++
Mg++ is important in _______ ______ transmission.
nerve impulse
Mg++ is regulated by what organ?
kidney
The 8 causes of low mg++ are:
Diuretics
Antibiotics (certain ones)
Alcoholism
Malnutrition
Malabsorption bowel disorders
Hyperaldosteronism
Hypokalemia
Hypoparathyroidism
The 2 causes of low mg++ are:
Renal failure and chronic/excessive use of magnesium-based antacids
The symptoms of low magnesium levels are:
Neuromuscular irritability
Nystagmus
Twitching, tremors & tetany
Disorientation, difficulty swallowing & depression
Hyperreflexia
Positive Chvostek's and Trousseau signs
Monitor for cardiac arrhythmias
The symptoms of high magnesium levels are:
Increased perspiration
Muscle weakness
Decreased deep tendon reflexes
Nausea & vomiting
Hypotension
Caridac arrhythmias
Respiratory compromise
The treatment for low magnesium is:
Give PO or IV mg++
The treatment for high magnesium is:
Give IV fluids, diuretics and calcium gluconate
Monitor cardiac, respiratory, and neurological statuses, I/O and labs
Which electrolyte is the MAIN cation in the ICF
Potassium
Which electrolyte regulates cell excitability and membrane potential for muscle contraction and nerve impulse condution?
Potassium
The cellular pump is the Sodium-_________ pump
Potassium
Which electrolyte affects the cell's electrical status?
Potassium
Which electrolyte influences ICF osmolality?
Potassium
Insulin and which electrolyte are necessary to move glucose into the ICF?
Potassium
Which electrolyte is involved in the metabolism of carbohydrates and proteins?
Potassium
Which electrolyte must be replaced every day?
Potassium
The amount of potassium excreted from the body is determined by which part of the kidney?
the distal tubules
Kidneys excrete what percent of the body's potassium?
80% with the other 20% being lost through the sweat glands and the bowel
What 2 hormones play major role in the regulation of potassium in the body?
Aldosterone & Insulin
Insulin helps regulate which electrolyte by moving it into the liver and muscle cells?
Potassium
The causes of low potassium levels are:
AML & Cushing's Syndrome
Diarrhea & Diuretics
Polyuria
Administering insulin without K+ supplementation
GI suction & drainage
Certain antibiotics
The causes of high potassium levels are:
Burns & renal failure
Stored whole blood
Addison's disease
Interstitial nephritis
Diuretics (potassium sparing)
Excessive intake (especially with renal disease)
ACE inhibitors
The symptoms of low potassium are:
Muscle weakness, cramps, fatigue, decreased tendon reflexes
Postural hypotension
Constipation
EKG changes & arrhythmias
Confusion
The symptoms of high potassium are:
EKG changes & arrhythmias
Nausea, diarrhea, hyperactive bowel sounds with intermittent colic, numbness/tingling of the face, tongue, feet, or hands
Fatigue, drowsiness
Irritability, mental confusion
The treatment for low potassium is:
Give PO or IV K+
Monitor I/O, heart monitor, labs, & mental status
The treatement for high potassium is:
Kayxelate
Insulin, bicarb, and dextrose fluids
Dialysis
Monitor I/O, heart monitor, labs, & mental status
With the goal of increasing excretion and moving potassium into the cells
Which electrolyte is found in equal proportions in the ICF and ECF?
Calcium
Which is the major cation for the development and maintenance of healthy bones and teeth?
Calcium
Which electrolyte is found in cell membranes and helps cells maintain their shape?
Calcium
Which electrolyte is necessary for muscle contraction?
Calcium
Which electrolyte is necessary for the synaptic release of neurotransmitters?
Calcium
The release of which electrolyte initiates muscle contractions?
Calcium
Which four electrolytes help to maintain muscle tone?
Calcium, sodium, potassium, and magnesium
Which electrolyte aids in coagulation?
Calcium
Calbindin is a protein necessary for the absorption of which electrolyte?
Calcium
Absorption of calcium is greatest where?
The ileum, duodenum, and the proximal jejunum where the pH is more acidic and calbindin is present.
What percent of calcium is absorbed?
20-30%
Along with with calbindin, calcium requires __________ for absorption in the intestines, reabsorption in the kidneys, and resorption of calcium through the bone.
Vitamin D
What competes with calcium for absorption?
Zinc, manganese, magnesium, copper, and iron
Calcium is excreted in _______, _______, & ______.
urine, feces & sweat
What four things regulate calcium levels?
Parathyroid hormone (PTH)
Thyrocalcitonin (TCT)
Blood pH
Vitamin D
The 5 causes of low calcium are:
Vitamin D deficiency
Cancer of the bone
Acute pancreatitis
Massive transfusion
Decrease in PTH or removal of the parathyroid gland
Parathyroid hormone makes the kidneys reabsorb ______ and excrete _______.
calcium
phosphorus
Parathyroid hormone makes the kidneys convert _______ to an active form which increases the GI absorption of calcium.
Vitamin D
Parathyroid hormone releases _______ from bone storage to release it into the plasma
Calcium
The causes of hypercalcemia are:
Hyperparathyroidism
Thyrotoxicosis
Adrenal insufficiency
Cancer
Excessive Vitamin D or A
Paget's disease
Hypophosphatemia
Multiple fractures
Prolonged immobilization
Antacids containing aluminum (excessive/chronic use)
Acidosis
Does calcitonin (TCT) raise or lower calcium levels in the body?
lowers
Calcitonin (TCT) is released by the ________ gland in response to high calcium.
Thyroid
Calcitonin's major effects are:
increased bone uptake of calcium, decreased vitamin D GI absorption, and increased urinary excretion of calcium
Why does blood pH affect serum calcium levels?
Because calcium competes with hydrogen for binding sites on albumin. The more calcium is able to bind, the lower the serum levels (the higher the pH because the hydrogen ions are unbound) and vice versa.
Symptoms of low calcium are:
Confusion, convulsions, insomnia
Paresthesias around the mouth and hands
Carpopedal spasm & tetany
Hyperreflexia
Brittle nails, osteoporosis, and periodontal disease
Diarrhea
Positive Chvostek's and Trousseau signs
Cardiac arrhythmias
Symptoms of high calcium are:
Nausea & vomiting
Constipaton
Confusion, weakness & lethargy
Polydipsia, polyuria, dehydration
Decreased tendon reflexes
Bone pain, cardiac arrhythmias or arrest