Electrolyte Imbalances Practice #2

Electrolyte Imbalances Practice Quiz: Key Concepts

• Hyperkalemia Management: Administering IV insulin with glucose is the most appropriate intervention for a patient with hyperkalemia and ECG changes. This drives potassium into cells, lowering serum potassium levels. Glucose prevents hypoglycemia.

• Hypermagnesemia Symptoms: Symptoms expected in hypermagnesemia include lethargy, decreased deep tendon reflexes, and muscle flaccidity. Hyperactive reflexes and a positive Chvostek's sign are associated with hypocalcemia, not hypermagnesemia.

• Phosphate-Calcium Relationship: Hyperphosphatemia can lead to hypocalcemia due to the reciprocal relationship between calcium and phosphate.

• Severe Hyponatremia Intervention: The priority intervention for a patient with severe hyponatremia and seizures is to administer 3% sodium chloride IV slowly. Careful administration is critical to restore sodium levels safely.

• Hypercalcemia Assessment: Nursing assessment in hypercalcemia should monitor for bone pain and kidney stones, as these are common complications.

• Hypocalcemia ECG Changes: A prolonged QT interval is commonly associated with hypocalcemia.

• Hypernatremia Intervention: The priority nursing action for a patient with hypernatremia due to a water deficit is to administer sodium-free fluids, such as 5% dextrose in water.

• Hypokalemia Dietary Teaching: A correct dietary teaching response for hypokalemia is to choose bananas and oranges, as these are high in potassium, helping to correct the imbalance.

• Hypophosphatemia Interventions: IV potassium phosphate is the appropriate intervention for severe hypophosphatemia.

Hyperkalemia Specifics

• Rationale: IV insulin with glucose is used to move potassium into cells, thus lowering blood potassium levels.

Hypermagnesemia Specifics

• Rationale: Hypermagnesemia can cause neuromuscular depression, leading to lethargy, reduced reflexes, and muscle flaccidity.

Hypocalcemia Specifics

• Rationale: Hypocalcemia leads to neuromuscular irritability, as indicated by the presence of Trousseau's sign.

Hyponatremia Specifics

• Rationale: Severe hyponatremia and seizures necessitates cautious administration of hypertonic saline (3% sodium chloride) to avoid rapid shifts in sodium levels.

Hypernatremia Specifics

• Rationale: Restoring fluid balance is critical for a patient in a water deficit, requiring sodium-free fluids to address the water deficit without further increasing sodium levels.

Hypokalemia Specifics

• Rationale: Bananas and oranges are high in potassium, helping to correct hypokalemia.

Hypophosphatemia Specifics

• Rationale: IV potassium phosphate is the appropriate intervention as it is the best delivery method for immediate phosphate replacement in severe hypophosphatemia.

Hyperkalemia Dietary Teaching

• Rationale: Salt substitutes often contain potassium, which should be avoided in hyperkalemia patients to prevent detrimental impacts.

Magnesium Imbalance Assessment

• Rationale (Hypomagnesemia): Hypomagnesemia causes neuromuscular hyperirritability, evidenced by hyperactive reflexes and tremors.

IV Magnesium Administration

• Rationale (Magnesium IV): The priority nursing action involves monitoring for respiratory depression, as rapid administration of IV magnesium sulfate can lead to respiratory and cardiac depression.

Hypercalcemia Complications

• Rationale (Hypercalcemia): Prolonged hypercalcemia can weaken bones, increasing the risk of bone fractures.

Nursing Diagnosis for Hyperkalemia

• Rationale: Risk for decreased cardiac output is the priority because hyperkalemia directly affects cardiac conduction, potentially leading to decreased cardiac output and potentially life-threatening arrhythmias.