Electrolyte Imbalances Overview
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Questions and Answers

What is the normal range for sodium levels in mEq/L?

  • 135-145 (correct)
  • 120-130
  • 145-155
  • 150-160

Which intervention is appropriate for managing hypernatremia?

  • Increase sodium-rich food intake
  • Replace fluids and monitor serum sodium levels (correct)
  • Fluid restriction
  • Administer IV hypertonic saline

What consequence may arise from the rapid correction of sodium levels?

  • Acute renal failure
  • Cerebral edema (correct)
  • Increased potassium levels
  • Fluid retention

What are common symptoms of hyponatremia?

<p>Seizures and confusion (D)</p> Signup and view all the answers

What is the critical level for potassium that indicates hyperkalemia?

<p>7.0 mEq/L (C)</p> Signup and view all the answers

What is the primary treatment for hyponatremia due to water excess?

<p>Fluid restriction (B)</p> Signup and view all the answers

What is the primary route for potassium loss in the body?

<p>Kidneys (C)</p> Signup and view all the answers

Which of the following functions is potassium necessary for?

<p>Maintenance of cardiac rhythms (C)</p> Signup and view all the answers

Where is sodium primarily regulated in the body?

<p>Kidneys (C)</p> Signup and view all the answers

Which of the following is NOT a known cause of hyperkalemia?

<p>Dehydration (D)</p> Signup and view all the answers

Which symptom is commonly associated with hyperkalemia?

<p>Muscle cramps (A)</p> Signup and view all the answers

What characteristic ECG change is expected in a patient with hyperkalemia?

<p>Peaked T waves (D)</p> Signup and view all the answers

Which nursing intervention is recommended to manage severe hyperkalemia?

<p>Administer loop diuretics (C)</p> Signup and view all the answers

How does acidosis contribute to hyperkalemia?

<p>Causes potassium to leak from cells (A)</p> Signup and view all the answers

Which of the following fluids may be administered to treat hyperkalemia?

<p>IV calcium gluconate (A)</p> Signup and view all the answers

What is the effect of potassium-sparing diuretics on potassium levels?

<p>Help retain potassium (D)</p> Signup and view all the answers

What potassium level indicates hypokalemia?

<p>2.5 mEq/L or less (A)</p> Signup and view all the answers

Which of the following is essential for nerve conduction and cardiac rhythms?

<p>Potassium (A)</p> Signup and view all the answers

What is the term for potassium levels above 5.3 mEq/L?

<p>Hyperkalemia (A)</p> Signup and view all the answers

Which of the following represents the critical value for hyperkalemia?

<p>7.0 mEq/L (A)</p> Signup and view all the answers

Which mechanism primarily maintains the concentration difference of sodium and potassium in cells?

<p>Sodium-potassium pump (B)</p> Signup and view all the answers

Which of the following is a source of potassium?

<p>Fruits and vegetables (C)</p> Signup and view all the answers

What is the critical value for hypokalemia?

<p>2.5 mEq/L or less (C)</p> Signup and view all the answers

What factors can contribute to sodium loss?

<p>Urine, sweat, and feces (C)</p> Signup and view all the answers

What is the normal range for phosphate levels in serum?

<p>2.5 - 4.5 mg/dl (D)</p> Signup and view all the answers

Which hormone regulates calcium concentration in the body?

<p>Parathyroid hormone (PTH) (B)</p> Signup and view all the answers

What role does Vitamin D play in calcium management?

<p>Increases serum calcium levels through dietary absorption (A)</p> Signup and view all the answers

What are severe symptoms associated with hypocalcemia?

<p>Tetany (B)</p> Signup and view all the answers

Which hormone lowers serum calcium levels?

<p>Calcitonin (B)</p> Signup and view all the answers

What condition is characterized by high phosphate levels and low calcium concentrations?

<p>Hyperphosphatemia (D)</p> Signup and view all the answers

Which condition can lead to a decrease in blood volume and pressure?

<p>Fluid Volume Deficit (B)</p> Signup and view all the answers

What is the primary cause of hypokalemia as mentioned in the content?

<p>Increased loss of potassium via kidneys (B)</p> Signup and view all the answers

How is hypoparathyroid tetany typically managed?

<p>IV calcium gluconate (D)</p> Signup and view all the answers

Which condition is NOT associated with factors causing potassium shift from ECF to ICF?

<p>Diarrhea (C)</p> Signup and view all the answers

What is a major role of phosphate in the body?

<p>Cellular uptake of glucose (C)</p> Signup and view all the answers

What is a common symptom of fluid imbalance?

<p>Poor skin turgor (C)</p> Signup and view all the answers

What is the impact of high phosphate levels on calcium concentrations?

<p>It lowers calcium concentrations. (C)</p> Signup and view all the answers

What condition is most commonly associated with hypercalcemia?

<p>Hyperparathyroidism (C)</p> Signup and view all the answers

What serum potassium level indicates hypokalemia in T.M.'s lab results?

<p>2.8 mEq/L (A)</p> Signup and view all the answers

What effect does acidosis have on serum calcium levels?

<p>Increases ionized calcium (D)</p> Signup and view all the answers

What dietary management is suggested for hyperphosphatemia?

<p>Restrict phosphorus intake (A)</p> Signup and view all the answers

What is the typical potassium concentration in muscle cells?

<p>140 mEq/L (D)</p> Signup and view all the answers

What role does potassium play in glycogen metabolism?

<p>It is required for glycogen to be deposited (B)</p> Signup and view all the answers

Which of the following is essential for muscle contractions and blood clotting?

<p>Calcium (B)</p> Signup and view all the answers

What is likely indicated by a hematocrit of 66% in the context provided?

<p>Dehydration (A)</p> Signup and view all the answers

What is the role of cardiac monitoring in electrolyte imbalances?

<p>To provide continuous observation for heart rhythm changes (B)</p> Signup and view all the answers

Which of the following describes a potential risk associated with hyperkalemia?

<p>Lower extremity muscle weakness (A)</p> Signup and view all the answers

Which of the following is true regarding potassium and sodium reabsorption in the kidneys?

<p>There is an inverse relationship between sodium and potassium reabsorption (B)</p> Signup and view all the answers

Flashcards

Sodium Normal Range

135-145 mEq/L

Hypernatremia Cause

Dehydration, excessive sodium intake

Hypernatremia Treatment

Replace fluids, monitor sodium levels

Hyponatremia Cause

Fluid overload, loss of sodium-rich fluids

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Hyponatremia Treatment

Fluid restriction, IV hypertonic saline (severe)

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Potassium Normal Range

3.5-5.3 mEq/L

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Hyperkalemia Level

7.0 mEq/L or higher

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Osmolality Definition

Concentration of solutes in body fluids.

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Hypokalemia

Low potassium levels, below 3.5 mEq/L; critical values are 2.5 mEq/L or less.

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Hyperkalemia

High potassium levels, above 5.3 mEq/L; critical values are 7.0 mEq/L or higher.

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Potassium Functions

Essential for nerve conduction and cardiac rhythms.

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Sodium-potassium pump

A mechanism in cell membranes maintaining sodium and potassium concentration difference, pumping potassium in and sodium out.

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Potassium Sources

Fruits, vegetables (bananas, oranges), salt substitutes (containing potassium), potassium medications, stored blood.

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Electrolyte Imbalances

Imbalances of electrolytes like sodium, potassium, calcium, phosphorus, and magnesium.

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Electrolyte assessment

Monitoring symptoms and lab results (e.g., sodium, potassium, calcium & magnesium etc).

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Nursing Process

Systematic approach to patient care and management, guiding patient-centered, evidence-based care.

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Primary route for potassium loss

Kidneys are the primary organs responsible for eliminating most of the potassium intake (90%).

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Hyperkalemia causes

Conditions like renal failure, medications (ACE inhibitors, potassium-sparing diuretics), acidosis, and cell destruction (e.g., hemolysis, burns, trauma) can lead to elevated potassium levels.

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Cellular excitability

The ability of a cell to respond to a stimulus by generating a rapid change in its membrane potential. Crucial for nerve and muscle function.

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Hyperkalemia symptoms

Muscle cramps, numbness, weakness, respiratory distress, and abdominal cramping are common symptoms. ECG changes like peaked T waves can be present.

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ECG effects of hyperkalemia

ECG changes in hyperkalemia include peaked T waves, decreased cardiac depolarization, flattening of the P wave, widening of the QRS complex, and potential for ventricular fibrillation.

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Hyperkalemia nursing interventions

Interventions include reducing potassium intake, increasing potassium excretion using diuretics, dialysis, and medications like Kayexalate. Supporting measures also include use of insulin, dextrose, calcium, sodium bicarbonate.

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Moderate/Severe hyperkalemia Nursing Interventions

Intensive nursing care for severe cases includes IV insulin and dextrose, IV calcium gluconate/chloride, and sodium bicarbonate for acidosis.

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Potassium loss routes

The main route for potassium loss is through the kidneys, but some is also lost in stool and sweat.

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Potassium Shift

Potassium moving from the blood (extracellular fluid) into cells (intracellular fluid), due to insulin, adrenaline, or high blood pH.

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Hypokalemia Symptoms (TM)

Look for muscle weakness, heart problems, and signs of dehydration in a patient with low potassium.

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Potassium in Muscle Cells

High concentration of potassium inside muscle cells.

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Potassium in Blood (ECF)

Potassium levels in the blood are 3.5-5.0 mEq/L.

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Sodium-Potassium Relationship (Kidney)

Sodium and potassium reabsorption in the kidneys are inversely related.

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Potassium's Role in Glycogen

Potassium is needed for the body to store glycogen in muscles and liver.

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Potassium's Acid-Base Role

Potassium helps balance the body's acidity.

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Vitamin D

Essential for calcium absorption from the diet; Increases serum calcium levels.

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Parathyroid Hormone (PTH)

Mobilizes calcium from bones; increases serum calcium levels.

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Calcitonin

Promotes bone deposition; lowers serum calcium levels.

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Fluid Volume Deficit

Decreased blood volume and pressure due to fluid loss

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Ionized Calcium

Free calcium in serum; crucial for bodily functions.

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Total Serum Calcium

Includes all forms of calcium in the blood.

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Acidosis Effect on Calcium

Decreases calcium binding to albumin, increasing ionized calcium.

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Hyperparathyroidism

Most common cause of hypercalcemia (high calcium).

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Phosphate's Role

Phosphate is essential for bone and teeth health, muscle function, red blood cell production, and nervous system activity. It also plays a role in acid-base balance, energy production (ATP), glucose uptake, and various metabolic processes.

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Phosphate Levels

Normal phosphate levels are maintained between 2.5 - 4.5 mg/dl in serum.

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Kidney's Role in Phosphate

Kidneys control phosphate excretion and reabsorption.

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Hyperphosphatemia

Hyperphosphatemia is high phosphate levels in the blood. It can result from kidney dysfunction, excessive phosphate intake, or certain medications. It can lower calcium levels and potentially cause symptoms like hypocalcemia.

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Hyperphosphatemia Symptoms

Hyperphosphatemia is often asymptomatic, but it can lead to hypocalcemia symptoms like muscle cramps, weakness, tingling, seizures, and even cardiac problems in severe cases.

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Hyperphosphatemia Management

Managing hyperphosphatemia involves restricting dietary phosphorus, using phosphate-binding agents that prevent absorption, and sometimes dialysis in severe cases.

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Phosphate and Calcium Relationship

Phosphate and calcium have a reciprocal relationship. High phosphate levels can lower calcium levels, and vice versa. This is important to consider when managing hyperphosphatemia and hypocalcemia.

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Hyperphosphatemia's Clinical Application

Hyperphosphatemia is a significant clinical issue because it can contribute to hypocalcemia, leading to various symptoms and complications.

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Study Notes

Electrolyte Imbalances

  • Electrolytes are minerals that conduct electrical impulses in the body
  • Hypovolemic shock is a condition of low blood volume due to massive internal or external bleeding, leading to major organ failure.
  • Basic Metabolic Panel (BMP) is a series of blood tests measuring glucose, calcium, sodium, potassium, bicarbonate (Total CO2), chloride, blood urea nitrogen (BUN), and creatinine.
  • BUN (Blood Urea Nitrogen) normal levels are 10-20 mg/dL, and creatinine levels are 0.5-1.2 mg/dL
  • CBC (Complete Blood Count) measures white blood cells (WBC), red blood cells (RBC), and platelets.
  • Hypernatremia is high sodium levels above 145 mEq/L. Causes include dehydration, impaired LOC, and excessive sodium intake.
  • Hyponatremia is low sodium levels below 135 mEq/L, a primary determinant of extracellular fluid osmolality.
  • Sodium Regulation: Primarily regulated by the kidneys, concentrating solutes in body fluids.
  • Dehydration Causes for Hypernatremia: Impaired LOC or excessive sodium intake. Symptoms include thirst, dry mucous membranes, and decreased urine output.
  • Hyperkalemia: Elevated potassium levels above 5.3 mEq/L, causes include renal failure, medications (ACE inhibitors, potassium-sparing diuretics), acidosis, and cell destruction.
  • Hypokalemia: Low potassium levels below 3.5 mEq/L
  • Critical potassium values: 7.0 mEq/L or higher for hyperkalemia and 2.5 mEq/L or less for hypokalemia. Potassium is essential for nerve conduction and cardiac rhythms.
  • Potassium sources include fruits, vegetables, salt substitutes, potassium medications, and stored blood.
  • Hyperkalemia symptoms: Muscle cramps, numbness, weakness, respiratory distress, abdominal cramping, and ECG changes (peaked T waves)
  • Hyperkalemia Interventions: Decreasing oral and parenteral potassium intake, loop diuretics, dialysis, and Kayexalate. Includes IV insulin and dextrose, IV calcium gluconate or calcium chloride, and IV sodium bicarbonate.
  • Hypokalemia Causes and interventions: Increased loss of potassium via kidney (due to diuretics or low magnesium); Gastrointestinal tract (diarrhea, laxative abuse, vomiting) and Insulin therapy, adrenergic stimulation, and alkalosis trigger shift of potassium to intracellular fluid. Interventions include fluid replacement with isotonic or hypotonic fluids
  • Clinical Manifestations to assess in T.M.: muscle weakness, cardiac irregularities, dehydration; potassium concentration in muscle cells (approx 140 mEq/L) and extracellular fluid (3.5-5.0 mEq/L)
  • Risk for activity intolerance is noted in patients with hyperkalemia.
  • Hyperkalemia nursing diagnoses include; risk for electrolyte imbalance, risk for activity intolerance, and risk for injury
  • Hypercalcemia causes: Malignancy, prolonged immobilization, Hyperparathyroidism
  • Hypercalcemia symptoms: lethargy, muscle weakness, confusion, constipation, bone pain, fractures, kidney stones; high plasma calcium concentration; low phosphorus levels.
  • Hypercalcemia interventions: loop diuretics, hydration with isotonic saline IV, diet low in calcium, increase weight bearing activity to enhance bone mineralization. Bisphosphonates (example: Fosamax).
  • Hypocalcemia causes: parathyroid deficiency, vitamin D deficiency, malabsorption, overuse of laxatives and disease such as Crohn's or Celiacs.
  • Hypocalcemia symptoms: Tetany (sustained muscle contraction), Trousseau's Sign (carpal spasm), Chvostek's Sign (facial muscle contraction).
  • Hypocalcemia interventions: Calcium supplements (IV calcium preparations), diet high in calcium and vitamin D supplementation, and increasing intake of calcium-rich foods.
  • Normal phosphate levels range between 2.5 and 4.5 mg/dL in serum, and it's controlled by kidneys with high levels potentially lowering calcium concentration.
  • Hyperphosphatemia: high plasma phosphate level. Interventions include restricting phosphorus intake, use phosphate-binding agents, and Increasing calcium levels to normalize phosphate levels
  • Hypophosphatemia: Low phosphorus levels, often asymptomatic. Causes include malnutrition, alcoholism, and phosphate-binding antacids. Symptoms: include CNS depression, confusion, muscle weakness. -Hypophosphatemia interventions: Oral supplements, increase dietary phosphorus intake, and IV administration of potassium phosphate.
  • Hypermagnesemia: excess magnesium in blood due to renal insufficiency. Symptoms: include lethargy, decreased reflexes, muscle tone issues, and depressed neuromuscular and CNS functions.
  • Hypomagnesemia: Low magnesium, causes include poor intake, alcoholism, and chronic use of diuretics. Symptoms include confusion, hyperactive reflexes, muscle cramps, and cardiac dysrhythmias. Hypomagnesemia interventions include oral supplements, increasing intake of green vegetables, nuts, bananas, and chocolate; Parenteral IV or IM magnesium when severe.

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Description

Explore the complexities of electrolyte imbalances, including key concepts like hypovolemic shock and the Basic Metabolic Panel. This quiz will cover essential electrolytes, their normal levels, and regulatory mechanisms, as well as conditions such as hypernatremia and hyponatremia. Test your knowledge on how these factors impact health.

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