Nur 305 Electrolytes

Front 1

The 6 electrolytes we are concerned with are...

Back 1

Sodium (Na+)
Potassium (K+)
Calcium (Ca++)
Magnesium (Mg++)
Phosphate (serum phosphorus)
Chloride (Cl-)

Front 2

Normal Total Calcium (Ca++) is ______.

Back 2

9-10.5 mg/dl

Front 3

Normal Ionized (free) serum Ca++ is _____.

Back 3

4.5-5.6 mg/dl

Front 4

Normal Potassium (K+)
is _____.

Back 4

3.5-5 mEq/L

Front 5

Normal Phosphate
serum phosphorus) is _____.

Back 5

3-4.5 mg/dl

Front 6

Normal Magnesium (Mg++)
is _____.

Back 6

1.3-2.1 mEq/L

Front 7

Normal Chloride (Cl-)
is _____.

Back 7

98-106 mEq/L

Front 8

Normal Sodium (Na+)
is _____.

Back 8

136-145 mEq/L

Front 9

Sodium is the most abundant ion in the _____.

Back 9

ECF

Front 10

Potassium is the most abundant ion in the _____.

Back 10

ICF

Front 11

A shift in which electrolyte triggers a fluid volume change to restore normal solute and water ratios?

Back 11

Na+

Front 12

True or False:
Na+ helps maintain acid-base balance

Back 12

True

Front 13

Which electrolyte activates nerve and muscle cells involved in muscle contraction?

Back 13

Na+

Front 14

Which electrolyte with Cl- influences water distribution?

Back 14

Na+

Front 15

Which electrolyte is regulated by the kidney through tubular reabsorption?

Back 15

Na+

Front 16

Aldosterone, a hormone secred by the adrenal cortex, works to increase the reabsorption of _____ by the kidney.

Back 16

Na+

Front 17

Natriuretic peptides increase _____ and water excretion.

Back 17

Na+

Front 18

The 7 causes of HYPOnatremia are:

Back 18

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

Front 19

The 6 causes of HYPERnatremia are:

Back 19

D iabetes
I nspipdus
C ushings
S yndrome

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

Dics H2O

Front 20

Seizures and comas are symptoms of both high and low levels of _____.

Back 20

Na+

Front 21

Irritability, restlessness, confusion, and agitation are symptoms of __________.

Back 21

Hypernatremia (high Na+)

Front 22

Increased thirst is a symptom of __________.

Back 22

Hypernatremia (high Na+)

Front 23

Sleepiness, weakness, and lethargy are symptoms of __________.

Back 23

Hyponatremia (low Na+)

Front 24

Headache, decreased tendon reflexes, and N/V or anorexia are symptoms of __________.

Back 24

Hyponatremia (low Na+)

Front 25

Behavioral and personality changes are symptoms of __________.

Back 25

Hyponatremia (low Na+)

Front 26

The 7 symptoms of low sodium (hyponatremia) are:

Back 26

Sleepiness, weakness and lethargy
Headache, N/V or anorexia
Decreased tendon reflexes
and Behavioral & personality changes

Front 27

Treatment for low sodium levels (hyponatremia) is:

Back 27

Fluid restriction and monitoring of I/O, VS, Wt, lab values, urine Na+, specific gravity

Front 28

Treatment for high sodium levels (hypernatremia) is:

Back 28

Push fluids, D5W, inspect for edema, and monitoring of I/O, VS, Wt, lab values, urine Na+, specific gravity

Front 29

_____ is the main ECF anion.

Back 29

Chloride (Cl-)

Front 30

ECF osmolality is affected by

Back 30

Chloride (Cl-)

Front 31

Cl- affects body pH by...

Back 31

combining with H ions to produce HCl

Front 32

via passive transport, _____ follows Na+

Back 32

Chloride (Cl-)

Front 33

The 4 causes of low chloride levels are:

Back 33

Diuretics
Low sodium diets
Excessive administration of bicarb
Prolonged vomiting, GI suctioning, diarrhea, sweating

Front 34

The 3 causes of high chloride levels are:

Back 34

Hypernatremia
Metabolic acidosis
Ingestion of salicylate, ethylene glycol or methanol

Front 35

4 symptoms of low chloride are:

Back 35

Tetany
Hypoventilation
Paresthesia of the extremities
Restlessness, confusion, convulsions

Front 36

The 6 symptoms of high chloride levels are:

Back 36

Hyperventilation (to blow off excess carbon dioxide)
Hypotension
Decreased cardiac output
Peripheral vasodilation
Headache
Lethargy

Front 37

The treatment for low chloride includes:

Back 37

Increase NaCl in the diet
Correct GI symptoms
Seizure precautions

Front 38

The treatment for high chloride includes:

Back 38

Give IV fluids to correct fluid imbalance
Give sodium bicarb to correct pH
Monitor level of consciousness and respiratory status

Front 39

Phosphorus and ______ levels are generally opposite (ie., a patient with high phosphorus will have low _____).

Back 39

Calcium

Front 40

The 4 causes of low serum phosphorus are:

Back 40

Alcohol abuse
Antacid abuse (increased use)
D deficiency (causing decreased absorption)
Intestinal malabsorption
Increased renal excretion

Front 41

The cause of high serum phosphate levels is:

Back 41

significant loss of glomerular filtration, cancer with chemotherapy

Front 42

The 4 symptoms of low serum phosphorus (phosphate) levels are:

Back 42

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

Front 43

The 8 symptoms of high serum phosphorus (phosphate) are:

Back 43

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

Front 44

The treatment for low serum phosphorus (phosphate) is:

Back 44

Treat the underlying cause

Front 45

A low _________ level is generally not life-threatening, but administration of _________ salts can be.

Back 45

phosphorus/phosphate

Front 46

Which electrolyte is a major ICF cation

Back 46

Mg++

Front 47

What percent of the body's Mg++ is stored in the bone?

Back 47

40-60%, with the remainder in the soft tissues and muscles

Front 48

Which electrolyte aids in protein synthesis and is necessary for the formation and function of healty bones

Back 48

Mg++

Front 49

Mg++ is important in _______ ______ transmission.

Back 49

nerve impulse

Front 50

Mg++ is regulated by what organ?

Back 50

kidney

Front 51

The 8 causes of low mg++ are:

Back 51

Diuretics
Antibiotics (certain ones)
Alcoholism
Malnutrition
Malabsorption bowel disorders
Hyperaldosteronism
Hypokalemia
Hypoparathyroidism

Front 52

The 2 causes of low mg++ are:

Back 52

Renal failure and chronic/excessive use of magnesium-based antacids

Front 53

The symptoms of low magnesium levels are:

Back 53

Neuromuscular irritability
Nystagmus
Twitching, tremors & tetany
Disorientation, difficulty swallowing & depression
Hyperreflexia
Positive Chvostek's and Trousseau signs
Monitor for cardiac arrhythmias

Front 54

The symptoms of high magnesium levels are:

Back 54

Increased perspiration
Muscle weakness
Decreased deep tendon reflexes
Nausea & vomiting
Hypotension
Caridac arrhythmias
Respiratory compromise

Front 55

The treatment for low magnesium is:

Back 55

Give PO or IV mg++

Front 56

The treatment for high magnesium is:

Back 56

Give IV fluids, diuretics and calcium gluconate
Monitor cardiac, respiratory, and neurological statuses, I/O and labs

Front 57

Which electrolyte is the MAIN cation in the ICF

Back 57

Potassium

Front 58

Which electrolyte regulates cell excitability and membrane potential for muscle contraction and nerve impulse condution?

Back 58

Potassium

Front 59

The cellular pump is the Sodium-_________ pump

Back 59

Potassium

Front 60

Which electrolyte affects the cell's electrical status?

Back 60

Potassium

Front 61

Which electrolyte influences ICF osmolality?

Back 61

Potassium

Front 62

Insulin and which electrolyte are necessary to move glucose into the ICF?

Back 62

Potassium

Front 63

Which electrolyte is involved in the metabolism of carbohydrates and proteins?

Back 63

Potassium

Front 64

Which electrolyte must be replaced every day?

Back 64

Potassium

Front 65

The amount of potassium excreted from the body is determined by which part of the kidney?

Back 65

the distal tubules

Front 66

Kidneys excrete what percent of the body's potassium?

Back 66

80% with the other 20% being lost through the sweat glands and the bowel

Front 67

What 2 hormones play major role in the regulation of potassium in the body?

Back 67

Aldosterone & Insulin

Front 68

Insulin helps regulate which electrolyte by moving it into the liver and muscle cells?

Back 68

Potassium

Front 69

The causes of low potassium levels are:

Back 69

AML & Cushing's Syndrome
Diarrhea & Diuretics
Polyuria
Administering insulin without K+ supplementation
GI suction & drainage
Certain antibiotics

Front 70

The causes of high potassium levels are:

Back 70

Burns & renal failure
Stored whole blood
Addison's disease
Interstitial nephritis
Diuretics (potassium sparing)
Excessive intake (especially with renal disease)
ACE inhibitors

Front 71

The symptoms of low potassium are:

Back 71

Muscle weakness, cramps, fatigue, decreased tendon reflexes
Postural hypotension
Constipation
EKG changes & arrhythmias
Confusion

Front 72

The symptoms of high potassium are:

Back 72

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

Front 73

The treatment for low potassium is:

Back 73

Give PO or IV K+
Monitor I/O, heart monitor, labs, & mental status

Front 74

The treatement for high potassium is:

Back 74

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

Front 75

Which electrolyte is found in equal proportions in the ICF and ECF?

Back 75

Calcium

Front 76

Which is the major cation for the development and maintenance of healthy bones and teeth?

Back 76

Calcium

Front 77

Which electrolyte is found in cell membranes and helps cells maintain their shape?

Back 77

Calcium

Front 78

Which electrolyte is necessary for muscle contraction?

Back 78

Calcium

Front 79

Which electrolyte is necessary for the synaptic release of neurotransmitters?

Back 79

Calcium

Front 80

The release of which electrolyte initiates muscle contractions?

Back 80

Calcium

Front 81

Which four electrolytes help to maintain muscle tone?

Back 81

Calcium, sodium, potassium, and magnesium

Front 82

Which electrolyte aids in coagulation?

Back 82

Calcium

Front 83

Calbindin is a protein necessary for the absorption of which electrolyte?

Back 83

Calcium

Front 84

Absorption of calcium is greatest where?

Back 84

The ileum, duodenum, and the proximal jejunum where the pH is more acidic and calbindin is present.

Front 85

What percent of calcium is absorbed?

Back 85

20-30%

Front 86

Along with with calbindin, calcium requires __________ for absorption in the intestines, reabsorption in the kidneys, and resorption of calcium through the bone.

Back 86

Vitamin D

Front 87

What competes with calcium for absorption?

Back 87

Zinc, manganese, magnesium, copper, and iron

Front 88

Calcium is excreted in _______, _______, & ______.

Back 88

urine, feces & sweat

Front 89

What four things regulate calcium levels?

Back 89

Parathyroid hormone (PTH)
Thyrocalcitonin (TCT)
Blood pH
Vitamin D

Front 90

The 5 causes of low calcium are:

Back 90

Vitamin D deficiency
Cancer of the bone
Acute pancreatitis
Massive transfusion
Decrease in PTH or removal of the parathyroid gland

Front 91

Parathyroid hormone makes the kidneys reabsorb ______ and excrete _______.

Back 91

calcium
phosphorus

Front 92

Parathyroid hormone makes the kidneys convert _______ to an active form which increases the GI absorption of calcium.

Back 92

Vitamin D

Front 93

Parathyroid hormone releases _______ from bone storage to release it into the plasma

Back 93

Calcium

Front 94

The causes of hypercalcemia are:

Back 94

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

Front 95

Does calcitonin (TCT) raise or lower calcium levels in the body?

Back 95

lowers

Front 96

Calcitonin (TCT) is released by the ________ gland in response to high calcium.

Back 96

Thyroid

Front 97

Calcitonin's major effects are:

Back 97

increased bone uptake of calcium, decreased vitamin D GI absorption, and increased urinary excretion of calcium

Front 98

Why does blood pH affect serum calcium levels?

Back 98

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.

Front 99

Symptoms of low calcium are:

Back 99

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

Front 100

Symptoms of high calcium are:

Back 100

Nausea & vomiting
Constipaton
Confusion, weakness & lethargy
Polydipsia, polyuria, dehydration
Decreased tendon reflexes
Bone pain, cardiac arrhythmias or arrest