Electrolytes and Body Fluids Quiz

Charged ions dissolved in body fluids, maintaining electrical neutrality.

Different electrolyte concentrations in intracellular (inside cells) and extracellular (outside cells) fluids are crucial for cell function.

Sodium (Na+) is the major electrolyte in extracellular fluid (ECF), influencing fluid balance and nerve/muscle function.

Illness and aging increase the risk of electrolyte imbalances due to changing intake and output.

Plasma electrolyte levels can be measured, but intracellular concentrations are not directly measurable.

Hyponatremia is a condition where sodium levels in the blood are lower than 136 mEq/L. This can happen due to either gaining too much water or losing too much sodium-rich fluids.

Hyponatremia slows down the electrical signals in the body. Water moves from outside the cells to inside, causing the cells to swell, which is called cellular edema.

Urine sodium levels help doctors figure out if the hyponatremia is caused by losing fluid outside the kidneys (like through vomiting or sweating) or by the kidneys not holding onto enough salt.

Hyponatremia usually happens because of a fluid imbalance in the body, leading to a loss of sodium.

To correct for hyponatremia, your kidneys try to get rid of extra water by making urine without salt in it.

Conditions or factors that increase the likelihood of low sodium levels in the body. These include excessive sweating, diuretic use, wound drainage, nasogastric suction, decreased aldosterone secretion, inadequate sodium intake, low-sodium diet, and hyperglycemia.

Excessive sweating leads to a loss of sodium and other electrolytes, potentially causing hyponatremia if not replenished.

Diuretics increase urine production, leading to the excretion of sodium and water, which can lead to a sodium deficiency.

Fluid loss through wounds, particularly gastrointestinal drainage, can deplete sodium levels in the body.

Aldosterone helps the kidneys retain sodium. A decrease in aldosterone levels can lead to increased sodium loss.

Hyponatremia caused by excess water intake or insufficient sodium intake, diluting the sodium concentration in the blood.

A state where the body has too much water relative to sodium, leading to hyponatremia. This can be caused by excessive water intake, psychogenic polydipsia, or irrigation with hypotonic solutions.

Drowning in freshwater can cause hyponatremia due to the rapid influx of water into the bloodstream, diluting sodium levels.

Kidney failure, particularly nephrotic syndrome, can lead to hyponatremia due to excessive sodium loss in urine.

Heart failure can contribute to hyponatremia by reducing blood flow to the kidneys, causing them to retain water and dilute sodium levels.

A strong, forceful pulse often associated with hypervolemia and hyponatremia, indicating an excess of fluid in the body.

Hypovolemia (low blood volume) is characterized by vital signs like low body temperature, rapid heart rate, weak and fast pulse, low blood pressure, and dizziness.

Hypovolemia can cause neurological and musculoskeletal symptoms like confusion, weakness, fatigue, and reduced reflexes due to decreased blood flow to the brain and muscles.

Hypovolemia can lead to increased gut motility, hyperactive bowel sounds, and abdominal cramping due to the body trying to conserve fluids.

A drop in blood pressure when standing up quickly, often associated with hypovolemia.

Hyponatremia is a condition where the blood sodium level is lower than 136 mEq/L. This means there's less sodium in your blood than normal.

Hyponatremia occurs when you either gain too much water or lose too much sodium-rich fluid. This can be due to conditions like vomiting, diarrhea, sweating, or taking certain medications.

Urine sodium levels help doctors determine whether hyponatremia is caused by loss of fluid outside the kidneys (like through vomiting or sweating) or by the kidneys not holding onto enough salt.

Treatment aims to correct the sodium imbalance. This can involve replacing lost sodium through fluids, dietary changes, or medications, depending on the cause.

Rapidly increasing sodium levels can be dangerous, potentially leading to neurologic damage due to demyelination. Therefore, sodium replacement should be gradual.

Nephrology is consulted to manage electrolyte and fluid imbalance in the body. This is vital for maintaining proper fluid balance and preventing complications related to electrolyte levels.

Respiratory services are consulted for oxygen management, which is essential for patients with breathing difficulties or compromised lung function.

Nutritional services assist in creating a diet plan that restricts fluids and increases sodium intake. This is crucial in managing fluid balance and maintaining electrolyte levels.

Clients need to monitor their daily weight for any significant changes. A 1-2 lb gain in 24 hours or 3-lb gain in a week must be reported to the provider.

Clients should consume a high-sodium diet as advised by the healthcare provider. They need to read food labels carefully and track their daily sodium intake.

Severe hyponatremia is when sodium levels in the blood are extremely low, leading to potentially life-threatening neurological complications.

Severe hyponatremia can cause coma, seizures, and respiratory arrest. These are serious medical emergencies that require immediate treatment.

The goal is to raise blood sodium levels to decrease the neurological symptoms of hyponatremia, such as lethargy, confusion, and seizures. This is done by administering hypertonic fluids and monitoring sodium levels closely.

When using hypertonic solutions to raise sodium levels, the blood sodium level should not exceed 125 mEq/L to prevent complications.

Medications like conivaptan or tolvaptan can help promote excess fluid excretion, assisting in correcting sodium levels.

A condition where blood sodium levels are higher than 145 mEq/L, leading to dehydration of cells due to water shifting out.

Symptoms include neurological issues (confusion, seizures), endocrine problems (increased thirst, decreased urination), and heart disturbances (irregular rhythm).

Hypernatremia is a serious electrolyte imbalance that can cause significant problems if left untreated.

Hypernatremia causes water to move out of cells, leading to cell dehydration and shrinking. This can impact cell function.

A condition where sodium levels appear high due to a decrease in fluid volume. This is not a true increase in sodium, but a relative increase due to less fluid.

Being NPO (nothing by mouth) can lead to relative sodium excess because you are not taking in fluids, but your body continues to lose water through normal processes like breathing and sweating.

Common causes include: water deprivation (NPO), hypertonic enteral feedings without adequate water, diabetes insipidus, heatstroke, hyperventilation, watery stools, burns, and excessive sweating.

Concentrated enteral feedings can lead to relative sodium excess if not enough water is provided alongside them. This is because the feedings are drawing water from the body to dilute the concentrated nutrients.

Diabetes insipidus is characterized by excessive urination, leading to water loss and potential relative sodium increase. This happens because the body cannot properly concentrate urine, resulting in dilute urine and increased water loss.

Hypernatremia is a condition where your blood sodium levels are too high, usually above 145 mEq/L. This can happen when you lose too much water or don't drink enough, making your blood more concentrated with sodium.

People with hypernatremia might feel confused, have seizures, or have trouble with their heart rhythm. They may also be very thirsty, pee less, and have dry mouth.

Hypernatremia means there's truly too much sodium in your blood. Relative sodium excess means your sodium level seems high because you've lost a lot of water, making your blood more concentrated.

Being NPO (no food or drinks), diabetes insipidus, hypertonic enteral feedings, sweating a lot, or burns can all cause relative sodium excess.

High blood sodium causes water to move out of your cells, making them shrink. This can disrupt normal cell function.

Monitor the patient's level of consciousness to ensure their safety. Changes in consciousness may indicate complications.

Monitor vital signs (temperature, pulse, respirations, blood pressure) and heart rhythm for any abnormal patterns.

Listen to the patient's lung sounds using a stethoscope to assess for any abnormalities.

Provide regular oral hygiene and other comfort measures to decrease thirst and increase patient well-being.

Monitor the patient's intake and output (I&O) and alert the provider if there is inadequate urinary output. If diuretics are being administered, monitor potassium levels.

Solutions that, once infused, become less concentrated than the patient's blood, helping to lower sodium levels and reduce risk of cerebral edema.

Solutions that are initially more concentrated than the patient's blood, but quickly become hypotonic due to glucose metabolism.

Solutions that have the same concentration as the patient's blood, maintaining fluid balance without causing shifts.

Encourage water intake, limit sodium intake, and consider diuretics for poor kidney function.

Assess blood osmolarity and hemodynamic stability to determine the appropriate IV solution.

Limiting fluid intake to prevent fluid overload and lower sodium levels in individuals with hyponatremia. This is often part of the treatment plan for hyponatremia, aiming to restore normal sodium balance.

A diet plan that restricts the intake of sodium. It involves reading food labels carefully and selecting low-sodium options to reduce overall sodium consumption and help manage health conditions like hyponatremia.

Monitoring your daily weight for any significant changes. A gain of 1-2 pounds in 24 hours or 3 pounds in a week should be reported to your healthcare provider.

Be cautious of over-the-counter medications, as some may contain sodium bicarbonate, which can increase sodium levels and counteract efforts to manage hyponatremia.

A life-threatening condition with dangerously high blood sodium levels (>145 mEq/L), leading to cell dehydration and potentially causing seizures, convulsions, and even death.

Potassium (K+) is crucial for numerous bodily functions including nerve impulse transmission, muscle contraction, heart rhythm, and acid-base balance.

Sodium (Na+) and potassium (K+) have a reciprocal relationship meaning changes in one directly affect the other. This is crucial for maintaining electrolyte balance.

A condition where blood potassium levels are below 3.5 mEq/L, caused by excessive loss or movement of potassium into cells.

Factors that increase the likelihood of low potassium levels, including excessive diuretic use, certain medications, GI losses, and kidney disease.

Excessive vomiting, diarrhea, prolonged nasogastric suctioning, and overuse of laxatives or tap water enemas can all lead to potassium loss through the gastrointestinal tract.

Being NPO (nothing by mouth) can contribute to hypokalemia due to the body's continued loss of electrolytes without intake.

Kidney disease impairs the reabsorption of potassium, making it more likely to be lost in urine, leading to hypokalemia.

A condition where potassium levels appear low due to a shift of potassium into cells, rather than an actual loss of potassium from the body.

A condition characterized by a high blood pH, caused by a loss of acids or an excessive gain of bases.

An excess of insulin in the bloodstream, leading to abnormally low blood sugar levels (hypoglycemia).

A method of providing nutrition intravenously (IV) that is more concentrated and complete than standard IV fluids. Can be used for people who cannot eat or absorb nutrients.

A specialized type of hyperalimentation providing all necessary nutrients intravenously for patients who cannot meet their nutritional needs orally or through enteral feeding.

Potassium replacement should be administered orally or intravenously (IV). Never give potassium via intramuscular (IM) or subcutaneous (SC) routes, as this can cause tissue necrosis.

Hypokalemia (low potassium) increases the risk of digoxin toxicity.

Hypokalemia can lead to muscle weakness, including respiratory muscles, leading to shallow, ineffective respirations and diminished breath sounds.

Assess for muscle weakness by evaluating hand grasps and reflexes.

Implement fall precautions due to muscle weakness associated with hypokalemia.

Replenishing potassium levels through the mouth using food sources, salt substitutes, or oral medications.

Administering potassium directly into the bloodstream using a vein.

Never give potassium via an IV bolus. Administer slowly (max 10 mEq/hr) with a concentration no greater than 1 mEq/10mL.

Foods high in potassium include: avocados, broccoli, dairy products, dried fruit, cantaloupe, bananas, juices, melon, lean meats, milk, whole grains, and citrus fruits.

Avoid excessive use of diuretics and laxatives as they can lead to potassium loss.

A condition where the lungs cannot adequately exchange oxygen and carbon dioxide, leading to hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide).

A sudden cessation of heart function, resulting in no heartbeat and no blood circulation.

Ensure that the patient's airway is clear and unobstructed to allow for breathing.

Observe for signs of low blood oxygen (hypoxemia) and high blood carbon dioxide (hypercapnia) to assess respiratory function.

Provide support by assisting medical professionals with inserting a breathing tube (intubation) or using a mechanical ventilator to aid breathing.

Factors that increase the likelihood of high potassium levels, including chronic illness, older age, excessive potassium replacement, and kidney failure.

High potassium levels can disrupt heart function, leading to an increased risk of cardiac arrest.

Check for risk factors, monitor potassium levels, and assess for muscle weakness, fatigue, and irregular heartbeat.

Treatment includes limiting potassium intake, using medications to promote excretion, and in severe cases, dialysis.

A situation where potassium levels seem high due to a shift of potassium into cells, rather than an actual increase in total potassium in the body.

Conditions that can shift potassium into cells include: decreased insulin production (diabetic ketoacidosis), acidosis, tissue damage (sepsis, trauma, surgery, fever, myocardial infarction), and hyperuricemia.

Symptoms can include: slow irregular pulse, hypotension, restlessness, irritability, weakness, paresthesia, premature ventricular contractions, ventricular fibrillation, peaked T waves, widened QRS, increased motility, diarrhea, hyperactive bowel sounds, and oliguria.

ECG changes associated with potassium excess can include peaked T waves and widened QRS complex, indicating potential cardiac issues.

Management focuses on addressing the underlying cause and restoring electrolyte balance. This may include: controlling blood sugar levels, treating acidosis, addressing tissue damage, and managing fluid and electrolyte imbalances.

A blood potassium level greater than 5.0 mEq/L, indicating a potential imbalance in potassium levels.

Dehydration increases hemoglobin and hematocrit values due to a decrease in plasma volume, concentrating the red blood cells.

Kidney failure leads to elevated blood potassium, BUN, creatinine, and metabolic acidosis.

Electrocardiograms (ECGs) in kidney failure show characteristic changes like peaked T waves, widened PR and QRS, absent/flat P waves, and ST depression, reflecting electrolyte imbalances.

Kidney failure can cause dangerous heart rhythm disturbances such as heart block, ventricular fibrillation, and asystole due to electrolyte imbalances.

Hyperkalemia is a condition where the blood potassium level is too high, usually above 5.5 mEq/L. It means there's more potassium in your blood than is normal.

Some common causes include chronic kidney disease, excessive potassium intake (like supplements), certain medications, and some medical conditions that damage muscle tissue (like severe injuries).

Signs and symptoms include muscle weakness, tingling or numbness, fatigue, irregular heartbeat, shortness of breath, and potentially even cardiac arrest.

Treatment depends on the severity. For mild cases, diet changes or medications to help the body eliminate potassium may be enough. Severe cases may require dialysis to remove excess potassium from the blood.

It's important to monitor potassium levels closely, limit potassium intake, and avoid medications or supplements that increase potassium levels. In severe cases, dialysis may be needed.

Clients with impaired kidney function should avoid foods high in potassium, like citrus fruits, legumes, whole-grain foods, lean meat, milk, and eggs.

Reducing potassium in vegetables by slicing, peeling, soaking overnight, and boiling can make them safer for people with kidney problems.

Clients with impaired kidney function taking potassium-conserving diuretics should not receive potassium replacement or salt substitutes.

Brewed tea, coffee, ginger ale, and root beer are low in potassium and can be good choices for those limiting potassium intake.

Refined grains have less potassium than whole grains and cereals, offering a lower potassium option.

Loop diuretics, like furosemide, increase potassium excretion from the kidneys, possibly leading to hypokalemia (low potassium).

This medication, a cation exchange resin, works in the intestines to bind and remove excess potassium from the body through feces.

A diet limited in potassium-rich foods to help manage high potassium levels.

If potassium levels are dangerously high, dialysis might be necessary to remove excess potassium from the blood.

These supplements should be withheld until a healthcare provider advises otherwise.

A type of medication, like albuterol, that helps open up the airways in the lungs, but also shifts potassium into cells, potentially lowering blood potassium levels.

A medication that binds to potassium in the gastrointestinal tract, decreasing the amount of potassium absorbed into the bloodstream.

A combination therapy that lowers blood potassium levels by shifting potassium into cells.

Low calcium levels can weaken heart muscle, causing arrhythmias and increasing the risk of cardiac arrest.

Low magnesium levels can lead to an increased risk of ventricular tachycardia and fibrillation, making the heart beat too fast or erratically.

High potassium levels can disrupt the heart's electrical impulses, leading to potentially fatal arrhythmias and increasing the risk of cardiac arrest.

Nurses must act quickly to perform CPR, administer medication, and maintain a clear airway to restore blood circulation and heart function.

Continuous heart monitoring is crucial because electrolyte abnormalities can significantly affect heart rhythm, potentially leading to serious complications.

Hypocalcemia can occur due to an actual lack of calcium in the body (e.g., poor intake, malabsorption), OR a shift of calcium from the blood to other tissues (e.g., alkalosis, hyperphosphatemia).

Conditions or factors that increase the chances of low calcium include poor dietary intake, malabsorption, kidney disease, certain medications, and immobility.

Immobility leads to a loss of calcium from bones, reducing the levels in the blood. This is because the body doesn't need as much calcium to support weight-bearing activities.

Treatment includes addressing the underlying cause (e.g., dietary changes, vitamin D supplementation), treating symptoms (e.g., calcium replacement therapy), and preventing complications.

Tetany is a common symptom seen in patients with low calcium (hypocalcemia) caused by increased nerve excitability. It leads to tingling sensations, muscle twitches, and sometimes even seizures due to overactive nerves.

Hypocalcemia displays a variety of symptoms including tingling in the fingers and lips, muscle twitches, seizures, painful muscle spasms at rest, overreactive reflexes, and positive Chvostek's and Trousseau's signs.

It is a test for hypocalcemia where tapping on the facial nerve (near the cheek) causes a twitch in the facial muscles.

It's a way to test for hypocalcemia where inflating a blood pressure cuff around the upper arm causes hand and finger spasms after a few minutes.

Hypocalcemia can affect the heart by prolonging the QT interval (electrical activity), increasing the risk of dangerous heart rhythm disturbances (like torsades de pointes), and decreasing the heart's pumping strength (leading to lower heart rate and blood pressure).

A condition where blood calcium levels are below 9.0 mg/dL. It can be caused by factors like vitamin D deficiency, parathyroid gland dysfunction, or certain medications.

Hypocalcemia can manifest as muscle cramps, twitches, spasms, and even seizures. It can also affect the heart, leading to irregular heartbeats.

Treatment for hypocalcemia typically involves oral or IV calcium supplementation, along with vitamin D supplements to aid calcium absorption. Seizure and fall precautions are essential.

Hypocalcemia can be detected through ECG changes, specifically a prolonged QT and ST interval. This is because calcium affects the electrical activity of the heart.

In life-threatening cases, rapid treatment with IV calcium gluconate is necessary. Calcium chloride is rarely used due to tissue damage risk. IV administration should be diluted and given slowly to avoid cardiac arrest.

Endocrinologists can be consulted for managing electrolyte and fluid balance, which is crucial for patients with conditions affecting their electrolyte levels, especially sodium and potassium.

Clients should consume foods rich in calcium, like yogurt and milk, and read food labels to increase their calcium intake, which can help with overall health and bone health.

Cardiology specialists can be consulted for managing dysrhythmias (abnormal heart rhythms), as electrolyte imbalances can significantly impact heart function.

Clients need to be aware of their sodium intake by reading food labels and tracking their daily sodium consumption. A high-sodium diet is often recommended for those with hyponatremia, but it's crucial to follow the healthcare provider's guidance.

A condition where blood magnesium levels are below 1.3 mg/dL, impacting various bodily functions such as nerve impulses, muscle function, and heart rhythm.

Conditions or factors that increase the likelihood of low magnesium levels, including malabsorption disorders (celiac disease, Crohn's disease), insufficient magnesium intake, excessive alcohol consumption, diarrhea, and certain medications.

Signs and symptoms that may indicate low magnesium levels, including cardiovascular issues (heart rhythm problems, ECG changes), neuromuscular problems (muscle spasms, twitching, seizures), and gastrointestinal disturbances (constipation, abdominal distention).

Low magnesium levels can increase the risk of digoxin toxicity by enhancing its negative effects on the heart.

Treatment aims to correct the magnesium deficiency by replacing lost magnesium using oral supplements or intravenous injections depending on the severity and cause.

The typical range for blood sodium levels is 136 to 145 mEq/L. This is important for maintaining fluid balance and nerve function.