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Questions and Answers
Which condition is NOT a cause of hypomagnesemia?
Which condition is NOT a cause of hypomagnesemia?
What is a potential nursing intervention for a patient with hypomagnesemia?
What is a potential nursing intervention for a patient with hypomagnesemia?
Which medication can be administered to manage hypomagnesemia?
Which medication can be administered to manage hypomagnesemia?
Which symptom is associated with hypomagnesemia?
Which symptom is associated with hypomagnesemia?
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What could indicate magnesium toxicity during replacement therapy?
What could indicate magnesium toxicity during replacement therapy?
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What is the maximum rate of phosphorus administration that should not be exceeded?
What is the maximum rate of phosphorus administration that should not be exceeded?
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Which of the following conditions is NOT a cause of hyperphosphatemia?
Which of the following conditions is NOT a cause of hyperphosphatemia?
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What is a key nursing intervention for managing patients at risk for hypophosphatemia?
What is a key nursing intervention for managing patients at risk for hypophosphatemia?
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Which clinical manifestation is associated with hyperphosphatemia?
Which clinical manifestation is associated with hyperphosphatemia?
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Which of the following is a preventive measure for hypophosphatemia?
Which of the following is a preventive measure for hypophosphatemia?
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What pH level indicates acidosis?
What pH level indicates acidosis?
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In which scenario might mixed acid-base disorders occur?
In which scenario might mixed acid-base disorders occur?
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How do the lungs compensate for metabolic disturbances?
How do the lungs compensate for metabolic disturbances?
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Which clinical manifestation would indicate hypernatremia in a patient?
Which clinical manifestation would indicate hypernatremia in a patient?
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Which electrolyte is primarily responsible for determining the concentration of extracellular fluid?
Which electrolyte is primarily responsible for determining the concentration of extracellular fluid?
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What is a significant effect of alkalosis on potassium movement in the body?
What is a significant effect of alkalosis on potassium movement in the body?
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Which food is recommended for increasing potassium intake in patients with hypokalemia?
Which food is recommended for increasing potassium intake in patients with hypokalemia?
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What is the proper administration method for potassium in cases of severe hypokalemia?
What is the proper administration method for potassium in cases of severe hypokalemia?
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Which condition must be established before administering potassium intravenously?
Which condition must be established before administering potassium intravenously?
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What potential complication can occur from oral potassium supplements?
What potential complication can occur from oral potassium supplements?
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What is a key clinical manifestation of hypokalemia?
What is a key clinical manifestation of hypokalemia?
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What should be monitored closely in patients receiving potassium supplementation?
What should be monitored closely in patients receiving potassium supplementation?
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In which condition might hypokalemia likely occur due to acid-base imbalance?
In which condition might hypokalemia likely occur due to acid-base imbalance?
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What is a significant cause of dilutional hyponatremia?
What is a significant cause of dilutional hyponatremia?
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Which of the following is a clinical manifestation of hyponatremia?
Which of the following is a clinical manifestation of hyponatremia?
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What is the primary treatment for mild hyponatremia caused by water excess?
What is the primary treatment for mild hyponatremia caused by water excess?
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Which nursing intervention should be prioritized in a patient with hyponatremia?
Which nursing intervention should be prioritized in a patient with hyponatremia?
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What is a common cause of hypernatremia?
What is a common cause of hypernatremia?
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Which medication is most likely to contribute to hypernatremia?
Which medication is most likely to contribute to hypernatremia?
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In which circumstance is IV hypertonic saline typically administered?
In which circumstance is IV hypertonic saline typically administered?
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How does hyponatremia affect patients taking lithium?
How does hyponatremia affect patients taking lithium?
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Study Notes
Hyponatremia
- Low sodium level (< 135 mEq/L)
- Causes:
- Inadequate sodium intake
- Dilution of serum sodium
- Predisposing Conditions:
- Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
- Hyperglycemia
- Use of tap-water enemas
- Irrigation of gastric tubes with water instead of normal saline
- Clinical Manifestations:
- Low serum sodium levels
- Low urine sodium levels
- Low urine specific gravity
- Low urine osmolality
- Management:
- Fluid restriction
- Loop diuretics
- IV hypertonic saline
- Nursing Interventions:
- Monitor fluid intake and output
- Monitor weight
- Assess level of consciousness
- Provide safety and seizure precautions
- Encourage foods and fluids high in sodium
Hypernatremia
- Sodium level (exceeding 145 mEq/L)
- Causes:
- Decreased sodium excretion
- Corticosteroids
- Cushing’s syndrome
- Increased water loss
- Diabetes Insipidus
- Watery diarrhea
- Increased sodium intake
- Movement of potassium from the ECF to ICF
- Magnesium deficiency
- Decreased sodium excretion
Hypokalemia
- Low potassium level (< 3.5 mEq/L)
- Causes:
- Inadequate potassium intake
- Increased potassium loss
- Clinical Manifestations:
- Muscle weakness
- Fatigue
- Cardiac dysrhythmias
- Constipation
- Management:
- Oral Potassium supplements
- IV potassium replacement
- Nursing Interventions:
- Place the patient on a cardiac monitor
- Monitor cardiovascular, respiratory & neuromuscular function
- Encourage intake of foods and fluids high in potassium
- Observe for signs of metabolic alkalosis
- Administer potassium only after adequate urine flow has been established
- Assess for abdominal distention, pain, or GI bleeding
Hyperkalemia
- Potassium Level (> 5.0 mEq/L)
- Causes:
- Increased potassium intake
- Decreased potassium excretion
- Clinical Manifestations:
- Muscle weakness
- Fatigue
- Cardiac dysrhythmias
- Nausea and vomiting
- Diarrhea
- Management:
- Restrict dietary potassium
- Diuretics
- IV calcium gluconate
- Sodium polystyrene sulfonate (Kayexalate)
- Nursing Interventions:
- Monitor ECG closely
- Avoid potassium-sparing diuretics
- Monitor I&O
Hypomagnesemia
- Low magnesium level (< 1.5 mEq/L)
- Causes:
- Inadequate magnesium intake
- Increased magnesium loss
- Clinical Manifestations:
- Muscle weakness
- Fatigue
- Tremors
- Seizures
- Cardiac dysrhythmias
- Management:
- Magnesium sulfate (IM)
- Magnesium hydroxide (PO)
- Magnesium-based antacids
- Nursing Interventions:
- Monitor for signs of digoxin intoxication
- Monitor status of airway and swallowing
- Assess level of consciousness
- Provide quiet environment
- Auscultate bowel sounds
- Encourage intake of dairy products and green leafy vegetables
Hypermagnesemia
- High magnesium level (> 2.5 mEq/L)
- Causes:
- Reduced renal function
- Excessive intake or absorption
- Clinical Manifestations:
- Nausea and vomiting
- Muscle weakness
- Drowsiness
- Bradycardia
- Hypotension
- Management:
- Stop magnesium administration
- Diuretics
- IV calcium gluconate
- Dialysis
- Nursing Interventions:
- Monitor vital signs
- Assess for signs of heart block
- Monitor intake and output
Hypophosphatemia
- Low phosphate level (< 2.5 mg/dL)
- Causes:
- Inadequate phosphate intake
- Increased phosphate loss
- Clinical Manifestations:
- Muscle weakness
- Fatigue
- Bone pain
- Respiratory failure
- Rhabdomyolysis
- Management:
- Oral phosphate supplements
- IV phosphate replacement
- Nursing Interventions:
- Monitor serum phosphorus levels
- Encourage intake of foods high in phosphate
- Prevent infection
Hyperphosphatemia
- High phosphate level (> 4.5 mg/dL)
- Causes:
- Renal failure
- Chemotherapy
- Hypoparathyroidism
- Respiratory acidosis or DKA
- High phosphate intake
- Profound muscle necrosis
- Increased phosphorus absorption
- Clinical Manifestations:
- Tetany
- Anorexia
- Nausea
- Vomiting
- Muscle weakness
- Hyperreflexia
- Tachycardia
- Decrease urine output
- Impaired vision
- Palpitations
- Management:
- Treatment of underlying disorder
- Phosphate binders
- Dialysis
- Nursing Interventions:
- Monitor serum phosphorus levels
- Restrict dietary phosphate
- Encourage fluid intake
Acid-Base Imbalances
- Normal Values
- pH: 7.35 to 7.45
- PaCO2: 38-42 mm hg
- Mixed Acid-Based Disorders
- Patients can simultaneously experience two or more independent acid–base disorders
- Normal pH in the presence of changes in the PaCO2 and plasma HCO3 concentration immediately suggest mixed disorder
- Compensation
- Pulmonary and renal systems compensate for each other to return the pH to normal.
- In a single acid–base disorder, the system not causing the problem will try to compensate by returning the ratio of HCO3 to carbonic acid to the normal 20:1.
- The lungs compensate for metabolic disturbances by changing CO2 excretion.
- The kidneys compensate for respiratory disturbances by altering bicarbonate retention and H+ secretion.
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Description
This quiz covers the essential concepts of Hyponatremia and Hypernatremia, including their causes, clinical manifestations, and management strategies. It also highlights nursing interventions crucial for patient care in these conditions. Test your knowledge on sodium imbalances and improve your understanding of how to manage them effectively.
