Electrolyte Imbalance Quiz
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Questions and Answers

What characterizes dilutional hyponatremia?

  • Na+ depletion with water loss
  • Increased Na+ concentration in the blood
  • Na+ loss with water retention (correct)
  • Excessive Na+ intake

    • Which symptom is most commonly associated with hypovolemic hyponatremia?

  • Hypertension
  • Seizures (correct)
  • Increased skin turgor
  • Weight gain

    • What is a common physical sign of hypervolemic hyponatremia?

  • Bounding tachycardia (correct)
  • Low blood pressure
  • Dehydration
  • Decreased heart rate

    • What constitutes depletional hyponatremia?

    <p>Insufficient Na+ intake</p> Signup and view all the answers

    In the case of hypernatremia, what is the main body defense mechanism?

    <p>Thirst response</p> Signup and view all the answers

    What can cause hypernatremia?

    <p>Water deficit</p> Signup and view all the answers

    What would NOT be a typical treatment for mild hypernatremia?

    <p>Increased Na+ intake</p> Signup and view all the answers

    Which of the following symptoms indicates severe neurological impairment from hyponatremia?

    <p>Altered mental status</p> Signup and view all the answers

    What condition is indicated by a serum phosphorus level greater than 4.5 mg/dl?

    <p>Hyperphosphatemia</p> Signup and view all the answers

    Which treatment is appropriate for severe hyperphosphatemia in patients with good kidney function?

    <p>IV saline</p> Signup and view all the answers

    Which major extracellular anion is secreted in the stomach as hydrochloric acid?

    <p>Chloride</p> Signup and view all the answers

    What is the primary cause of hypochloremia?

    <p>Decreased intake or absorption</p> Signup and view all the answers

    Which condition is NOT associated with hyperphosphatemia?

    <p>Dehydration</p> Signup and view all the answers

    Which electrolyte imbalance is characterized by a serum chloride level greater than 106 mEq/L?

    <p>Hyperchloemia</p> Signup and view all the answers

    What is a common treatment for hypochloremia?

    <p>Oral or IV chloride replacement</p> Signup and view all the answers

    Which underlying condition is associated with respiratory acidosis that may contribute to hyperphosphatemia?

    <p>Chronic obstructive pulmonary disease (COPD)</p> Signup and view all the answers

    What is the normal range for PaCO2?

    <p>35 - 45 mmHg</p> Signup and view all the answers

    Which condition is indicated by a pH value lower than 7.35?

    <p>Acidosis</p> Signup and view all the answers

    Which buffer system is most effective in the renal tubules?

    <p>Phosphate buffer</p> Signup and view all the answers

    What occurs when the body's pH rises above 7.45?

    <p>Loss of acids or accumulation of bases</p> Signup and view all the answers

    How do the lungs respond to high levels of CO2 in the blood?

    <p>Decrease respiratory rate</p> Signup and view all the answers

    What role do kidneys play in maintaining acid-base balance?

    <p>Reabsorb or excrete excess acids or bases</p> Signup and view all the answers

    What is the purpose of chemical buffers in the blood?

    <p>To neutralize acids or bases temporarily</p> Signup and view all the answers

    What is the expected action of the body when pH is low due to acidosis?

    <p>Increase bicarbonate production</p> Signup and view all the answers

    Which IV therapy is considered a volume expander?

    <p>Colloids</p> Signup and view all the answers

    What is a characteristic of total parenteral nutrition?

    <p>It contains electrolytes and micronutrients.</p> Signup and view all the answers

    Which option is a potential sign of hypovolemia related to IV ammonium chloride use?

    <p>Cyanosis</p> Signup and view all the answers

    Which statement accurately describes the pH level condition indicated?

    <p>The pH level is above 7.45 indicating alkalosis.</p> Signup and view all the answers

    What type of solution is 0.45% NaCl classified as?

    <p>Hypotonic solution</p> Signup and view all the answers

    Which symptom is NOT associated with hypomagnesemia?

    <p>Hallucinations</p> Signup and view all the answers

    What is a common cause of hypomagnesemia?

    <p>Chronic alcoholism</p> Signup and view all the answers

    Which of the following is an effect of magnesium deficiency on the cardiovascular system?

    <p>Tachycardia</p> Signup and view all the answers

    What treatment would be appropriate for a patient with mild hypomagnesemia?

    <p>Oral magnesium supplements</p> Signup and view all the answers

    Which of the following symptoms is classified under gastrointestinal issues related to hypomagnesemia?

    <p>Anorexia</p> Signup and view all the answers

    What sign is commonly seen with magnesium deficiency reflecting neuromuscular excitability?

    <p>Chvostek’s sign</p> Signup and view all the answers

    What electrolyte level is defined as hypomagnesemia?

    <p>Mg++ level below 1.5 mEq/L</p> Signup and view all the answers

    Which of the following is NOT a common risk factor for developing hypomagnesemia?

    <p>Excessive potassium intake</p> Signup and view all the answers

    Study Notes

    Magnesium

    • Plays a critical role in energy production as ATP (adenosine triphosphate)
    • Essential for protein synthesis and carbohydrate metabolism
    • Involved in cardiovascular function, contributing to vasodilation
    • Regulates muscle contractions

    Hypomagnesemia

    • Serum magnesium levels below 1.5 mEq/L
    • Often caused by poor dietary intake, inadequate GI absorption, or excessive loss through the GI or urinary systems
    • High risk clients: chronic alcoholism, malabsorption, GI or urinary disorders, sepsis, burns, or wounds requiring debridement.
    • Symptoms: muscle weakness, leg/foot cramps, hyperactive deep tendon reflexes (DTRs), tetany, Chvostek's and Trousseau's signs, tachycardia, hypertension, EKG changes, dysphagia, anorexia, nausea/vomiting

    Sodium

    • Major extracellular cation
    • Plays a crucial role in water balance
    • Maintains osmotic pressure and nerve impulse transmission

    Hyponatremia

    • Serum sodium levels below 135 mEq/L
    • Types:
      • Dilutional: results from sodium loss and water gain
      • Depletional: insufficient sodium intake
      • Hypovolemic: sodium loss exceeds water loss
      • Hypervolemic: edema, hypertension, weight gain, bounding tachycardia
      • Isovolemic:

    Hypernatremia

    • Excess sodium relative to body water
    • Thirst serves as the body's primary defense
    • Caused by water deficit, overuse, or ingestion of sodium
    • Can also be caused by diabetes insipidus
    • Symptoms:
      • Poor skin turgor
      • Tachycardia
      • Decreased blood pressure (BP)
      • Orthostatic hypotension

    Phosphorus

    • Important for energy metabolism
    • Involved in bone formation, cell signaling, and regulating acid-base balance

    Hyperphosphatemia

    • Serum phosphorus levels above 4.5 mg/dl
    • Caused by impaired kidney function, cell damage, hypoparathyroidism, respiratory acidosis, diabetes ketoacidosis (DKA), or increased dietary intake
    • Symptoms:
      • Anorexia
      • Apathy
      • Confusion
      • Cyanosis
      • Hypotension
      • Loss of reflexes
      • Muscle twitching
      • Nausea
      • Paresthesia
      • Polyuria
      • Vomiting
      • Weakness

    Chloride

    • Major extracellular anion
    • Works with sodium to maintain water balance

    Hypochloremia

    • Serum chloride levels below 96 mEq/L
    • Caused by decreased intake, decreased absorption, metabolic alkalosis, or diuretics
    • Symptoms:
      • Arrhythmias

    Hyperchloremia

    • Serum chloride levels above 106 mEq/L
    • Rarely occurs alone
    • Caused by:
      • Dehydration
      • Kidney disease
      • Excessive sodium intake

    Acid-Base Balance

    • A complex process involving the regulation of hydrogen ion (H+) concentration in the body
    • Normal pH range: 7.35 to 7.45
    • Three main regulatory systems maintain pH:
      • Chemical buffers
      • Respiratory system
      • Kidneys

    Chemical Buffers

    • Act immediately
    • Combine with acids or bases to neutralize harmful effects
    • Types:
      • Bicarbonate buffer system
      • Phosphate buffer system
      • Protein buffer system

    Respiratory System

    • Lungs regulate blood carbon dioxide (CO2) levels
    • CO2 + H2O = Carbonic acid
    • High CO2: slower breathing (holding onto carbonic acid, lowers pH)
    • Low CO2: faster breathing (blowing off carbonic acid, raises pH)
    • More effective than chemical buffers, but effects are temporary

    Kidneys

    • Regulate blood pH over time
    • Reabsorb or excrete acids / bases into the urine
    • Produce bicarbonate

    ABG Results

    • Uncompensated Alkalosis:
      • pH > 7.45
      • PaCO2 Normal
    • Compensated Alkalosis:
      • pH within normal range (7.35-7.45)
      • PaCO2 lower
    • Metabolic Alkalosis:
      • pH > 7.45
      • High HCO3
    • Respiratory Alkalosis:
      • pH > 7.45
      • Low PaCO2

    IV Therapy

    • Crystalloids (volume expanders):
      • Isotonic (D5W, 0.9% NaCl, Lactated Ringers): used to replace fluids and electrolytes
      • Hypotonic (0.45% NaCl): used to hydrate cells
      • Hypertonic (D5/0.9% NaCl, D5/0.45% NaCl): used to increase blood pressure
    • Colloids (plasma expanders): draw fluids into the bloodstream
      • Albumin
      • Plasma protein
      • Dextran

    Total Parenteral Nutrition (TPN)

    • Highly concentrated, hypertonic solution
    • Used for clients with high caloric and nutritional needs
    • Contains electrolytes, vitamins, acetate, micronutrients, and amino acids
    • Lipid emulsions are provided in addition to TPN

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