Electrolyte imbalances

Hyponatremia S&S (signs & symptoms)
Tachycardia, Hypotension, seizures, Headache, AMS (altered Mental Status),personality changes/irritability, muscular weaknes, abdominal cramping/hyperactive BS (bowel sounds), muscle cramps, specific gravity <1.010

Hyponatremia Causes
Heart failure, Renal failure,increased Na excretion, excessive diaphoresis, diuretics, wound drainage, vomiting/diarrhea/GI suctioning, inadequate Na intake

Hypernatremia S&S
Tachycardia, restlessness, thirst, flushed skin, dry sticky mucous membranes, rough dry tongue, specific gravity > 1.030

Hypernatremia Causes
Fever, Hyperventillation (not same as rpid RR), decreased excretion, increased intake, hepatic failure, renal failure, fever, hyperventilation, watery diarrhea, diaphoresis, excessive aldosterone secretion, cushing syndrome

Hypokalemia S&S
Tachydysrhythmia, “U” waves on EKG, Orthostatic Hypotention, lethargy, fatigue, decreased bowel sounds, nausea vomiting, diarrhea, abdominal distention, constipation, anorexia, muscle weakness, “U” waves on EKG

Hypokalemia Causes
insufficient intake, constipation (book states diarrhea p 349) , vomiting, loop diuretics, lasix, increased NGT drainage, renal disease

Hyperkalemia S&S
Bradycardia (slow pulse), peaked “T” waves on EKG, cardiac arrest, increased bowel sounds, diarrhea

Hyperkalemia Causes
Increased intake, decreased excretion, rapid IV infusion, Addisons disease, renal failure, K sparing diuretics (aldactone, spirololactone), ACE inhibitors

Hypocalcemia S&S
Hypotension, bradycardia, tetany (muscle spasm), laryngospasm (noted by stridor), increased DTR (Deep Tendon reflexes), Trousseaus sign (hand), Chvosteks sign (cheek)

Hypocalcemia Causes
Indadequate Calcium or Vitamin D intake, Lactose intolerant, Crohn’s disease, malabsorption syndrome (intestines), ESRD (end stage renal disease), diarrhea, acute pancreatitis, hyperphosphatemia

Hypercalcemia S&S
Dysrhythmia, lethargy, muscle weakness, nausea, vomiting, bradycardia, decreased LOC, constipation, decreased BS, decresed DTR

Hypercalcemia Causes
Hypoparathyroidism, immobilization, Increased antacid intake (Tums, Maalox, Mylanta), Renal failure

Hypomagnesemia S&S
Seizures, tetany, anorexia, tachycardia, HTN, mood changes

Hypomagnesemia Causes
hypokalemia, hypocalcemia, protein malnutrition, malabsorption, cirrhosis of liver, alcoholism, chronic diarrhea, dehydration

Hypermagnesemia S&S
Decreased DTR, flushing, warmth, diaphoresis, muscular weakness, respiratory distress, bradycardia, hypotension, coma, insulin

Hypermagnesemia Causes
Severe dehydration, renal failure, Increased laxative or antacid intake (Tums, Maalox, Mylanta),

Hypophosphatemia S&S
Muscle pain, weakness, bone pain, confusion

Hyperphosphatemia S&S
Circumoral (circling the mouth) Paresthesias (tingling), muscle spasms, tetany

D10W, D5.45NS, D5.9NS, D5RL. An environment with more solutes, less solvent, and higher osmotic (water pulling) pressure than ings on other side of plasma membrane. Water leaves the cell causing cells to shrink & die.

0.9%NS, RL, D5W. An environment with no net movement of water across the plasma membrane (water flows at the same rate in both directions)

.45NS. An area with more solvent, less solutes and higher hydrostatic (water pushing) pressure than surroundings on other side of plasma membrane. Water will enter the cell faster than it leaves, and will cause the cell to swell and burst.

Normal Saline
0.9% NaCl has 155 mEq sodium per 500ml

Isotonic dehydration
Treated with Lactated Ringers: Caused by: hemorrhage, vomiting, diarrhea, burns, severe wounds, frequent enemas, long term NPO, duretics, GI suction, profuse salivation, fistulas, abscesses, ileostomy, cecostomy

First Intervention in fluid overload
Elevate head of bead to ease work of breathing (>30 degrees high fowlers)

Decreased peripheral edema
Indicates responsiveness to treatment for overhydration

digoxin toxicity
can occur with hypokalemia

Feurosemide and potassium
Places client at greater risk for potassium deficit

Which three body systems maintain the acid base balance? Lungs; Kidneys; a chemical buffer system (main one is the bicarbonate-carbonic acid system; others involve phosphate, protein or hemoglobin) What do the lungs do? Control CO2 content thru respirations; control to …

Respiratory Acidosis – Hypoventilation Respiratory Acidosis – Hypoventilation If Resp Acidosis Results From: Respiratory depression from poisons, anesthetics, trauma or neuro dz (myasthenia gravis, Guillain-Barre or inadequate ches exansion d/t muscle ewakness pneumothroax/hemothroax, flail chest, obesity, tumors or deformities Results …

what is important about maintaining fluid and electrolyte balance? maintaining hemostasis What are electrolytes? ionized substances that perform their functions within a fluid environment WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE …

Who has greater proportions of body water? adults or children children Infants/Toddlers have more ________ fluid so water loss occurs more rapidly. extracellular WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write …

The nurse is caring for a client with congestive heart failure. On assessment, the nurse notes that the client is dyspneic and that crackles are audible on auscultation. The nurse suspects excess fluid volume. What additional signs would the nurse …

Compare body water to total weight in infants and adults. The total body water is about 80% of body weight at birth, gradually decreasing with age to 60-65 % in adults. Identify patients more susceptible to fluid imbalance. patients with …

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