Electrolyte Imbalances and Their Symptoms

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Questions and Answers

What are the symptoms associated with dumping syndrome?

Severe constipation and dehydration

Acute fatigue and low energy

Increased gastric acid production

Staggering gait and impaired judgment (correct)

Which of the following is a recommended treatment for dumping syndrome?

Lower the head of the bed during meals (correct)

Increase the intake of carbohydrates during meals

Eat larger meals less frequently

Increase fluid consumption before meals

How does protein impact gastric emptying in relation to dumping syndrome?

Protein slows down gastric emptying (correct)

Protein has no effect on gastric emptying

Protein causes an increase in gastric acid secretion

Protein speeds up gastric emptying

Which statement correctly describes the relationship between 'kalemias' and heart rate?

Kalemias affect heart rate in the opposite direction as the prefix Signup and view all the answers

What does the combination of symptoms referred to as 'Drunk + Shock' indicate?

Dumping syndrome Signup and view all the answers

What is the therapeutic level of Digoxin?

1 to 2 Signup and view all the answers

What is typically associated with hypernatremia?

Dehydration Signup and view all the answers

What is a common cardiovascular symptom associated with hyperkalemia?

Bradycardia Signup and view all the answers

What bilirubin level in newborns typically indicates a need for hospitalization?

14 to 15 Signup and view all the answers

Which sign is universally indicated for all electrolyte imbalances?

Muscle weakness Signup and view all the answers

Which of the following symptoms is indicative of hypokalemia?

Constipation Signup and view all the answers

What is a primary symptom of hiatal hernia that can also indicate GERD?

Heartburn when lying down Signup and view all the answers

What is a long-term solution for lowering potassium levels?

Kayexalate Signup and view all the answers

Which condition is associated with hyponatremia?

SIADH Signup and view all the answers

Which condition refers to excess bilirubin in the brain?

Kernicterus Signup and view all the answers

In cases of hypocalcemia, which symptom would likely be present?

Muscle spasticity Signup and view all the answers

What effect does hypercalcemia have on heart rate?

Decreases heart rate Signup and view all the answers

What therapeutic level is considered toxic for Aminophylline?

<blockquote> 20 </blockquote> Signup and view all the answers

What are the potential signs of dehydration?

Flushed, dry skin and rapid heart rate Signup and view all the answers

What distinguishes pathological jaundice from physiological jaundice in newborns?

Pathological jaundice is present at birth. Signup and view all the answers

Which electrolyte imbalance is commonly associated with diarrhea?

Hyperkalemia Signup and view all the answers

Which treatment should never be administered through pushing IV?

Potassium Signup and view all the answers

What direction do symptoms go in hypomagnesemia?

Decrease with hyper Signup and view all the answers

In which position should an opisthotonic newborn be placed?

On the side Signup and view all the answers

How do D5W and regular insulin work to lower potassium levels?

By driving potassium into the cells Signup and view all the answers

Which of the following statements is true regarding the therapeutic levels of Bilirubin in adults?

Normal level ranges from 0.2 to 1.2. Signup and view all the answers

What reflects a typical symptom of hyperkalemia related to neurological function?

Seizures Signup and view all the answers

What should be monitored in a patient with suspected fluid overload?

Crackles in the lungs Signup and view all the answers

Hypomagnesemia can cause which of the following symptoms?

Increased muscle tone Signup and view all the answers

What is a significant risk associated with prolonged low calcium levels?

Tetany causing airway obstruction Signup and view all the answers

Which statement about hypothyroidism is accurate?

Patients exhibit symptoms of hypometabolism. Signup and view all the answers

What is the correct method of administering Levothyroxine?

On an empty stomach with water Signup and view all the answers

What condition could occur if a patient with hypothyroidism does not receive Synthroid before surgery?

Suppressed effects of anesthesia Signup and view all the answers

What is a key characteristic of Addison's disease?

Under secretion of corticosteroids Signup and view all the answers

In the face of stress, what is a primary function of the body's stress response?

To maintain blood pressure and glucose levels Signup and view all the answers

What is a possible consequence for patients with Addison's disease if they cannot adapt to stress?

Danger of adrenal crisis Signup and view all the answers

What symptom is associated with myxedema coma?

Decreased mental status Signup and view all the answers

How should lab results be prioritized when using the ABCD scheme?

A is low priority, B is concerning, C is critical, D is highest priority. Signup and view all the answers

What is the normal range for creatinine levels?

0.6 to 1.2 Signup and view all the answers

What should the nurse's first action be for a potassium level that is over 6?

Prepare to give Insulin/Kayexelate STAT. Signup and view all the answers

At what INR level is it necessary to monitor closely and prepare to take action?

4 and above Signup and view all the answers

Which of the following indicates a low priority for intervention?

A potassium level of 4.0. Signup and view all the answers

What is the order of action for high potassium levels between 5.4 and 5.9?

Hold K+, assess heart (EKG), prepare to give Insulin/Kayexelate, call HCP. Signup and view all the answers

When is potassium considered critical according to the ABCD scheme?

When it is above 5.9. Signup and view all the answers

What immediate action should be taken for a creatinine level if a dye procedure is involved?

Monitor closely but no immediate actions necessary. Signup and view all the answers

Study Notes

Lecture 1 - Acid-Base Balance

Normal values for pH, CO2, and HCO3 (bicarbonate) are crucial for acid-base disorders: pH (7.35-7.45), CO2 (35-45), and HCO3 (22-26).
Acidosis occurs if pH is <7.35, and alkalosis if pH is >7.45.
Determine if the imbalance is metabolic or respiratory by considering if HCO3 moves in the same direction as pH (metabolic) or the opposite (respiratory).

Lecture 2 - Alcoholism

Denial is the primary psychological issue in alcoholism and other abusive situations.
Dependency and codependency have a symbiotic but pathological relationship, with the dependent person relying on the codependent person for decisions.
Manipulation involves the abuser making the codependent person do things that are not in their best interest.

Lecture 3 - Drug Toxicities and Acid-Base Imbalances

Aminoglycosides: Important drugs with potential ototoxicity (ear damage) and nephrotoxicity (kidney damage). Therapeutic levels are between 0.6 to 1.2. Toxic levels are above 2.0.
Calcium channel blockers: Used to treat heart conditions; common side effects include headache, and hypotension.
Monitor blood pressure before administering with calcium channel blockers, if SBP (systolic blood pressure) is below 100, stop administering.
Always monitor electrolytes for levels above and below the normal ranges.

Lecture 4 - Crutches, Canes, Walkers

Crutch length is measured by placing the tip on the ground and having 2-3 fingers widths between the pad and anterior axillary fold.
Using crutches, canes, and walkers is tested for on the Exam, with a focus on measuring and using the devices.
Knowing which gait to use for various levels of impairment is important.

Lecture 5 - Diabetes Mellitus

Diabetes mellitus involves an error in glucose metabolism. Type 1 is insulin-dependent, while Type 2 involves insulin resistance.
Diabetes insipidus (DI): Characterized by excessive urination (polyuria), extreme thirst (polydipsia) and is caused by low ADH (antidiuretic hormone). The opposite condition of DI is SIADH (syndrome of inappropriate antidiuretic hormone).
Insulin acts to lower blood sugar. Several types of insulin (e.g., regular, NPH, lispro) have different onset, peak, and duration times.

Lecture 6 - Drug Toxicities

Lithium: Used in bipolar disorder to treat manic episodes. Therapeutic level is 0.6-1.2mEq/L, toxicity is above 2.0mEq/L.
Lanoxin (digoxin): Used for A-Fib and CHF. Therapeutic level is 1-2 ng/mL. Toxicity is above 2 ng/mL.
Aminophylline: bronchodilator for airway issues. The therapeutic level is 10 to 20 mcg/mL.

Lecture 7 - Thyroid and Adrenals

Hyperthyroidism is a condition with increased metabolism; Symptoms include weight loss, increased heart rate, blood pressure, and heat intolerance.
Hypothyroidism is a condition with decreased metabolism; Symptoms include weight gain, decreased heart rate, blood pressure, and cold intolerance.
Exopthalmos (bulging eyes), is a symptom of Graves disease.

Lecture 8 - Lab Values

Prioritizing patients with abnormal lab values is important. Use the ABCD scheme:
- A = low priority
- B = concerning
- C = critical
- D = highest priority (stay at bedside).
Critical lab values require immediate intervention.
Abnormal lab values should be communicated to the healthcare provider.

Lecture 9 - Blood Cell Counts and Infections

Neutropenic precautions are critical for patients with low neutrophil counts (ANC).
Remember the five "deadly D's": K+, pH, CO2, pO2, and Platelets. Prioritize based on value-danger combination.
The study material includes how to identify which blood counts are abnormal, when to intervene and when to document.

Lecture 10 - Maternity and Neonatology

Naegele's rule is used to calculate estimated due dates.
Normal weight gain in pregnancy is an important topic.
Diagnosing and treating complications and conditions of pregnancy (e.g., preeclampsia, gestational diabetes) are covered.

Lecture 11 - Fetal Monitoring

Fetal heart rate patterns (normal range is 120-160 bpm) are critical, and certain abnormal patterns require urgent intervention using the LION acronym (Left Side, IV, Oxygen, and Notify HCP; this needs to be implemented first before anything in the room).
Understanding fetal heart rate abnormalities and recognizing the urgency in those situations are crucial.

Lecture 12 - Prioritization, Delegation, and Staff Management

Prioritizing patients based on the modifying phrase (e.g. unstable BP, fever, hemorrhage, is important in clinical situations). The most important factor will always be the modifying phrase.
Understanding which tasks can be delegated to specific nursing levels is crucial (e.g. LPN, UAP).
Specific knowledge of who does which tasks is a key part of clinical situations.

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Description

This quiz focuses on the symptoms and treatments related to various electrolyte imbalances, including their impacts on conditions like dumping syndrome and cardiovascular health. Test your knowledge on key concepts such as bilirubin levels in newborns and the therapeutic levels of Digoxin.