NURS 1060 Electrolyte Knowledge PDF

NURS 1060 Outcomes: - Describe principles of safe, patient-centered, evidence-based nursing care to adults at the basic level, guided by the Caritas philosophy. - Discuss critical thinking and clinical reasoning to provide quality patient care. Competency: - Describe factors t...

NURS 1060 Outcomes: - Describe principles of safe, patient-centered, evidence-based nursing care to adults at the basic level, guided by the Caritas philosophy. - Discuss critical thinking and clinical reasoning to provide quality patient care. Competency: - Describe factors that create a culture of safety related to medication administration. - Discuss critical thinking and clinical judgment used to provide accurate and safe medication administration. Concept: Fluid and Electrolyte **[Electrolyte Knowledge ]** K Potassium Na Sodium Ca Calcium P Phosphorus Mg Magnesium **Use the following page to create your own reference page for each electrolyte:** +-----------------------+-----------------------+-----------------------+ | Electrolyte: Sodium | Symbol: Na^+^ | Normal Range: 135-145 | +=======================+=======================+=======================+ | How does Sodium work | | | | in the body? | | | | | | | | - Generation and | | | | transmission of | | | | nerve impulses | | | | | | | | - Muscle | | | | contractility | | | | | | | | - The kidneys are | | | | the primary | | | | regulator of | | | | sodium balance. | | | +-----------------------+-----------------------+-----------------------+ | How does sodium | | How does sodium | | **enter** the body? | | **exit** the body? | | | | | | Sodium primarily | | Sodium exits via the | | enters the body via | | Kidneys | | food and drink | | | | consumption | | | +-----------------------+-----------------------+-----------------------+ | What **causes** the | | What **causes** the | | Sodium levels to be | | Sodium levels to be | | **too high**? | | **too low**? | | | | | | - Dehydration | | - Fluid overload or | | | | loss of | | - Impaired | | sodium-rich | | LOC/inability | | fluids. | | to obtain | | | | fluid | | - Diuretics, Renal | | | | Disease, Profuse | | - Diabetes | | Diaphoresis, | | Insipidus | | Draining Wounds, | | (body | | Excessive | | produces too | | Diarrhea or | | much urine) | | Vomiting, trauma | | | | with significant | | - Excessive Sodium | | blood loss. | | intake, with | | | | adequate water | | - Inappropriate use | | intake | | of sodium-free or | | | | hypotonic | | - Excessive IV | | solutions. This | | Admin of | | may occur in | | hypertonic | | patients post-op. | | saline | | | | (3%NaCl) also | | | | causes | | | | cellular | | | | dehydration | | | +-----------------------+-----------------------+-----------------------+ | How do high Sodium | | How do low Sodium | | levels effect the | | levels effect the | | patient? | | patient? | | | | | | (Signs and Symptoms, | | (Signs and Symptoms, | | Potential | | Potential | | Complications) | | Complications) | | | | | | Symptoms: | | - Confusion, | | | | Headache | | - Thirst | | | | | | - Nausea | | - Dry Mucous | | | | Membranes | | - Seizure (**severe | | | | cases**) | | - Decreased Urine | | | | Output | | | | | | | | - Restless, | | | | Agitation, | | | | Lethargy | | | | | | | | - Muscle Twitching | | | +-----------------------+-----------------------+-----------------------+ | **Priority Nursing | | | | Assessments:** | | | | | | | | Hypernatremia: | | | | | | | | - Monitor Serum | | | | Sodium Levels | | | | | | | | - Monitor Neuro | | | | | | | | - Quickly | | | | reducing | | | | serum sodium | | | | levels can | | | | cause a rapid | | | | shift of | | | | water back | | | | into the | | | | cells | | | | | | | | - May result in | | | | **cerebral | | | | edema** and | | | | neurologic | | | | complications | | | | - | | | | seizures | | | | | | | | Hyponatremia: | | | | | | | | - Neuro Status, | | | | including LOC, | | | | Mental Status, | | | | any signs of | | | | cerebral edema. | | | | | | | | - Monitor VS | | | | | | | | - Fluid Intake and | | | | Output | | | | | | | | - Monitor | | | | Electrolyte | | | | Levels, | | | | specifically | | | | serum Sodium | | | | Levels. | | | +-----------------------+-----------------------+-----------------------+ | **Priority Nursing | | | | Interventions:** | | | | | | | | Hypernatremia: | | | | | | | | - Treat underlying | | | | cause | | | | | | | | - In the case of | | | | **Primary Water | | | | Deficit**: | | | | replace fluid | | | | orally or IV with | | | | isotonic or | | | | hypotonic fluids | | | | **(D5 in water or | | | |.45% NaCl)** | | | | | | | | - In the case of | | | | **Excess | | | | Sodium:** dilute | | | | with sodium-free | | | | IV fluids and | | | | promote excretion | | | | with diuretics | | | | **(D5 in Water)** | | | | | | | | Hyponatremia: | | | +-----------------------+-----------------------+-----------------------+ - Fluid Restriction if caused by water excess - Sodium Replacement - May have orders for small amount of IV hypertonic saline solution (3% NaCl) - Monitor Neuro Status for severe symptoms (Seizures) - Room assignment where they will be central to the unit to monitor and prevent falls (Acute confusion, Risk for Falls/Injury) +-----------------------+-----------------------+-----------------------+ | Electrolyte: | Symbol: K^+^ | Normal Range: 3.5 -- | | Potassium | | 5.3 | +=======================+=======================+=======================+ | How does potassium | | | | work in the body? | | | | | | | | - Transmission and | | | | conduction of | | | | nerve and muscle | | | | impulses | | | | | | | | - Cellular growth | | | | | | | | - Maintenance of | | | | cardiac rhythms | | | +-----------------------+-----------------------+-----------------------+ | How does potassium | | How does potassium | | **enter** the body? | | **exit** the body? | | | | | | Potassium enters the | | Potassium is excreted | | body via PO intake, | | via the Kidneys and | | Eg: Fruits and | | the Stool | | Veggies (Bananas, | | | | Oranges), Salt | | | | Substitutes, | | | | Potassium Meds and | | | | Supplements (PO and | | | | IV), Stored Blood. | | | +-----------------------+-----------------------+-----------------------+ | What **causes** | | What **causes** | | potassium levels to | | potassium levels to | | be **too high**? | | be **too low**? | | | | | | - Renal failure | | - Increased K+ loss | | | | via the kidneys | | - Meds (ACE | | (Renal losses | | Inhibitors, | | occur when the | | K-Sparing | | patient has a low | | diuretics) | | magnesium level | | | | or is taking | | - Acidosis | | diuretics) | | | | | | - Cell Destruction | | - Increased loss of | | (hemolysis, | | K+ via the GI | | burns, trauma) | | Tract | | | | | | | | - GI tract losses | | | | of potassium are | | | | associated with | | | | diarrhea, | | | | laxative abuse, | | | | vomiting | | | | | | | | - | +-----------------------+-----------------------+-----------------------+ | How do high potassium | | How do low potassium | | levels effect the | | levels effect the | | patient? | | patient? | | | | | | (Signs and Symptoms, | | (Signs and Symptoms, | | Potential | | Potential | | Complications) | | Complications) | | | | | | - Muscle cramps and | | - Cardiac | | numbness | | Dysrhythmias | | (weakness, resp | | (MOST SERIOUS) | | distress, | | | | abdominal | | - Skeletal Muscle | | cramping) | | Weakness (legs), | | | | lethargy | | - Cardiac Rhythm | | | | (ECG changes: | | - Weakness of Resp | | Peaked T-Wave) | | Muscles (Low RR, | | | | Shallow) | | Risk for injury | | | | | | - Polyuria | | Risk for Electrolyte | | (Excessive Urine | | Imbalance | | Production) | | | | | | Potential | | - Hyperglycemia (a | | Complications: | | condition in | | | | which the level | | Dysrhythmias | | of glucose in the | | | | blood is higher | | | | than normal) | +-----------------------+-----------------------+-----------------------+ | Priority Nursing | | | | Assessments: | | | | | | | | Hyperkalemia: | | | | | | | | - Monitor Cardiac | | | | Rhythm on ECG | | | | (look for peaked | | | | T waves) | | | | | | | | - Assess muscle | | | | weakness | | | | | | | | - Monitor Serum | | | | Potassium Levels | | | | | | | | - Monitor Urine | | | | Output | | | | | | | | Hypokalemia: | | | | | | | | - Monitor Serum | | | | Potassium Levels | | | | | | | | - | | | +-----------------------+-----------------------+-----------------------+ | Priority Nursing | | | | Interventions: | | | | | | | | Hyperkalemia: | | | | | | | | - **Decrease** oral | | | | and parenteral K | | | | **intake** | | | | | | | | - Increase K | | | | elimination | | | | | | | | - Loop | | | | Diuretics | | | | | | | | - Dialysis | | | | | | | | - Kayexalate | | | | (binds | | | | potassium in | | | | exchange for | | | | sodium and | | | | the resin is | | | | excreted in | | | | feces.) | | | | | | | | Moderate to Severe | | | | Hyperkalemia | | | | Interventions: | | | | | | | | - **IV Insulin and | | | | Dextrose** | | | | (Potassium will | | | | be forced to | | | | enter cell via | | | | Na-K pump) | | | | | | | | - IV Calcium and | | | | Gluconate | | | | | | | | - IV Sodium Bicarb | | | | | | | | *All patients with | | | | clinically | | | | significant | | | | hyperkalemia should | | | | be **monitored | | | | electrocardiographica | | | | lly** | | | | to detect | | | | dysrhythmias.* | | | | | | | | Hypokalemia: | | | | | | | | - Increase | | | | Potassium Intake | | | | | | | | - KCl Supplements | | | | PO or IV | | | | | | | | - NEVER GIVE KCL | | | | via IV PUSH or | | | | BOLUS | | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | Electrolyte: Calcium | Symbol: Ca+ | Normal Range: 8.5 -- | | | | 10.5 mg/dL | +=======================+=======================+=======================+ | How does Calcium work | | | | in the body? | | | | | | | | - Calcium is | | | | necessary for | | | | many metabolic | | | | processes. | | | | | | | | - It is the major | | | | cation in the | | | | structure of | | | | bones and teeth. | | | | | | | | - Other functions | | | | of calcium | | | | include | | | | blood-clotting, | | | | transmission of | | | | nerve impulses, | | | | myocardial | | | | contractions, and | | | | muscle | | | | contractions. | | | | | | | | - Formation of | | | | Teeth and Bone | | | +-----------------------+-----------------------+-----------------------+ | How does Calcium | | How does Calcium | | **enter** the body? | | **exit** the body? | | | | | | Calcium is obtained | | Calcium is excreted | | from ingested foods | | via Kidney, Bile, and | | (dairy, green leafy | | Stool. | | veggies, beans) | | | | | | | | You need vitamin D to | | | | absorb calcium | | | | (either obtained by | | | | diet or through | | | | sunlight) | | | +-----------------------+-----------------------+-----------------------+ | What **causes** | | What **causes** | | Calcium levels to be | | Calcium levels to be | | **too high**? | | **too low**? | | | | | | - Hyperthyroidism | | - Parathyroid | | (2/3 of cases) | | hormone | | | | deficiency | | - Malignancy | | | | | | - Vitamin D | | - Prolonged | | deficiency | | Immobilization | | | | | | - Chronic Kidney | | | | Disease | | | | | | | | - Malabsorption | | | | | | | | - Overuse of | | | | laxatives | | | | | | | | Disease such as | | | | Crohn's or Celiacs | +-----------------------+-----------------------+-----------------------+ | How do high calcium | | How do low calcium | | levels effect the | | levels effect the | | patient? | | patient? | | | | | | (Signs and Symptoms, | | (Signs and Symptoms, | | Potential | | Potential | | Complications) | | Complications) | | | | | | - Lethargy, muscle | | - Tetany | | weakness, | | | | confusion, | | - Positive | | decreased | | Trousseau's or | | reflexes | | Chvostek's sign | | | | | | - From | | - Laryngeal | | decreased | | stridor, | | excitability | | Dysphagia, | | of muscle and | | Tingling around | | nerve cells | | the mouth or in | | | | the extremities | | - Constipation | | | | | | - Cardiac | | - Bone pain, | | dysrhythmias- | | fractures | | prolonged QT | | | | interval | | - Kidney stones | | | +-----------------------+-----------------------+-----------------------+ | Priority Nursing | | | | Assessments: | | | | | | | | Hypercalcemia: | | | | | | | | - Calcium Levels | | | | | | | | - Bone Health | | | | | | | | - Renal Function | | | | | | | | - Neuro Status | | | | | | | | Hypocalcemia: | | | | | | | | - Calcium Levels | | | | | | | | - Chvostek Signs | | | | | | | | - Trousseau Signs | | | | | | | | - | | | +-----------------------+-----------------------+-----------------------+ | Priority Nursing | | | | Interventions: | | | | | | | | Hypercalcemia: | | | | | | | | - Loop diuretics- | | | | promote excretion | | | | | | | | - Hydrating with | | | | isotonic saline | | | | IV | | | | | | | | - PO Fluid 3000 to | | | | 4000 mL daily to | | | | promote the renal | | | | excretion of | | | | calcium and | | | | decrease kidney | | | | stone formation | | | | | | | | - Diet low in | | | | calcium | | | | (Vitamins) | | | | | | | | - Increase in | | | | weight-bearing | | | | activity to | | | | enhance bone | | | | mineralization. | | | | | | | | - Synthetic | | | | Calcitonin given | | | | IM or | | | | subcutaneously | | | | lowers serum | | | | calcium levels. | | | | | | | | - Bisphosphonates | | | | (example: | | | | Fosamax) | | | | | | | | - Most | | | | effective | | | | agents in | | | | treating | | | | hypercalcemia | | | | and | | | | osteoporosis | | | | | | | | - Medication | | | | inhibits the | | | | activity of | | | | osteoclasts | | | | (cells that | | | | break down | | | | bone and | | | | result in | | | | calcium | | | | release) | | | | | | | | Hypocalcemia: | | | +-----------------------+-----------------------+-----------------------+ - **Diet high in calcium-rich** foods and **vitamin D** supplementation. - **Oral calcium supplements**, such as calcium carbonate or citrate, can be used when patients are unable to consume enough dietary calcium, such as those who do not tolerate dairy products. +-----------------------+-----------------------+-----------------------+ | Electrolyte: | Symbol: | Normal Range: 2.5 -- | | Phosphate | | 4.5 mg/dL\` | | | PO4(3-) | | +=======================+=======================+=======================+ | How does phosphate | | | | work in the body? | | | | | | | | - Phosphate is the | | | | primary anion in | | | | the ICF and the | | | | second most | | | | abundant element | | | | in the body, | | | | second to | | | | calcium. Most | | | | phosphorus is in | | | | the bones and | | | | teeth as calcium | | | | phosphate. | | | | | | | | - The remaining | | | | phosphorus is | | | | metabolically | | | | active and | | | | essential to the | | | | function of | | | | muscle, RBCs, and | | | | the nervous | | | | system. | | | | | | | | - It is also | | | | involved in the | | | | acid-base | | | | buffering system, | | | | the mitochondrial | | | | formation of ATP, | | | | cellular uptake | | | | and use of | | | | glucose, and the | | | | metabolism of | | | | carbohydrates, | | | | proteins, and | | | | fats. | | | | | | | | - A reciprocal | | | | relationship | | | | exists between | | | | phosphorus and | | | | calcium | | | | | | | | - High serum | | | | phosphate level | | | | tends to cause a | | | | low calcium | | | | concentration in | | | | the serum | | | | | | | | - Low serum calcium | | | | levels stimulate | | | | the release of | | | | PTH, which | | | | decreases | | | | reabsorption of | | | | phosphorus | | | +-----------------------+-----------------------+-----------------------+ | How does phosphate | | How does phosphate | | **enter** the body? | | **exit** the body? | | | | | | Phosphate primarily | | Phosphate is | | enters the body via | | primarily excreted | | PO Intake. | | through the kidneys. | +-----------------------+-----------------------+-----------------------+ | What **causes** | | What **causes** | | phosphate levels to | | phosphate levels to | | be **too high**? | | be **too low**? | | | | | | Causes | | - Malnourishment/ | | include advanced | | malabsorption | | chronic kidney | | (low vitamin D) | | disease, | | | | hypoparathyroidism | | - Alcoholism | | and metabolic and | | | | respiratory acidosis. | | - Use of | | | | phosphate-binding | | | | antacids | +-----------------------+-----------------------+-----------------------+ | How do high phosphate | | How do low phosphate | | levels effect the | | levels effect the | | patient? | | patient? | | | | | | (Signs and Symptoms, | | (Signs and Symptoms, | | Potential | | Potential | | Complications) | | Complications) | | | | | | - Rare and often | | - Most clinical | | asymptomatic | | manifestations of | | | | hypophosphatemia | | - hypocalcemia | | result from | | symptoms | | impaired cellular | | possible- | | energy and oxygen | | neuromuscular | | delivery related | | irritability | | to deficient | | and tetany | | cellular ATP and | | | | 2,3-diphosphoglyc | | - Ca ↓      P↑ | | erate | | | | (2,3-DPG), an | | - Can be caused by | | enzyme in RBCs | | excessive intake | | that facilitates | | | | oxygen delivery | | | | to the tissues. | | | | | | | | - Mild to moderate | | | | hypophosphatemia | | | | is often | | | | asymptomatic. | | | | | | | | - Severe | | | | hypophosphatemia | | | | may be fatal | | | | because of | | | | decreased | | | | cellular | | | | function. | | | | | | | | - Acute | | | | manifestations | | | | include CNS | | | | depression, | | | | confusion, and | | | | other mental | | | | changes. Other | | | | manifestations | | | | include muscle | | | | weakness and | | | | pain, | | | | dysrhythmias, and | | | | cardiomyopathy. | | | | | | | | - Results from | | | | impaired cellular | | | | energy and oxygen | | | | delivery related | | | | to deficient | | | | cellular ATP and | | | | an enzyme | | | | (requires P) in | | | | RBCs that | | | | facilitates | | | | oxygen delivery | | | | to the tissues. | +-----------------------+-----------------------+-----------------------+ | Priority Nursing | | | | Assessments: | | | | | | | | Hyperphosphatemia: | | | | | | | | - Monitor Renal | | | | Function | | | | | | | | - Monitor for | | | | Hypocalcemia | | | | | | | | - Monitor Serum | | | | Phosphate Levels | | | | and Serum Calcium | | | | Levels | | | | | | | | Hypophosphatemia: | | | | | | | | - Monitor for signs | | | | of heart failure | | | | | | | | - Signs of | | | | respiratory | | | | failure | | | | | | | | - Monitor for signs | | | | of Hypercalcemia | | | | | | | | - Monitor serum | | | | phosphate and | | | | calcium levels | | | | | | | | - Monitor | | | | Underlying Cause | | | | | | | | - Monitor Symptoms | | | +-----------------------+-----------------------+-----------------------+ | Priority Nursing | | | | Interventions: | | | | | | | | Hyperphosphatemia: | | | | | | | | - The primary | | | | management of | | | | hyperphosphatemia | | | | is identifying | | | | and treating the | | | | underlying cause. | | | | | | | | - **Ingestion of | | | | foods and fluids | | | | high in | | | | phosphorus** | | | | (e.g., dairy | | | | products) | | | | **should be | | | | restricted.** | | | | | | | | - Phosphate-binding | | | | agents or gels | | | | (e.g., calcium | | | | carbonate) limit | | | | intestinal | | | | phosphate | | | | absorption and | | | | increase | | | | phosphate | | | | secretion into | | | | the intestine. | | | | | | | | - If hypocalcemia | | | | is present, | | | | adequate | | | | hydration and | | | | instituting | | | | measures to | | | | correct calcium | | | | levels assist | | | | with returning | | | | phosphorus levels | | | | to normal. | | | | | | | | - With severe | | | | hyperphosphatemia | | | | , | | | | hemodialysis or | | | | an insulin and | | | | glucose infusion | | | | can rapidly | | | | decrease levels. | | | | | | | | Hypophosphatemia: | | | | | | | | - Management of a | | | | mild phosphorus | | | | deficiency may | | | | involve oral | | | | supplementation | | | | (e.g., | | | | Neutra-Phos) and | | | | ingestion of | | | | foods high in | | | | phosphorus (e.g., | | | | dairy products). | | | | | | | | - Symptomatic | | | | hypophosphatemia | | | | can be fatal and | | | | often requires IV | | | | administration of | | | | sodium phosphate | | | | or potassium | | | | phosphate. | | | | | | | | - Frequent | | | | monitoring of | | | | serum phosphate | | | | and calcium | | | | levels is | | | | necessary to | | | | guide IV therapy. | | | | Sudden | | | | symptomatic | | | | hypocalcemia, | | | | secondary to | | | | increased calcium | | | | phosphorus | | | | binding, is a | | | | potential | | | | complication of | | | | IV phosphorus | | | | administration. | | | +-----------------------+-----------------------+-----------------------+ +-----------------------+-----------------------+-----------------------+ | Electrolyte: | Symbol:Mg | Normal Range: 1.5 -- | | Magnesium | | 2.5 mEq/L | +=======================+=======================+=======================+ | How does Mg work in | | | | the body? | | | | | | | | - Magnesium is the | | | | second most | | | | abundant | | | | intracellular | | | | cation. | | | | | | | | - Magnesium plays | | | | an important role | | | | in many essential | | | | cellular | | | | processes. The | | | | most notable is | | | | the activation of | | | | a wide variety of | | | | enzyme systems. | | | | Magnesium is a | | | | coenzyme in the | | | | metabolism of | | | | carbohydrates and | | | | protein and is | | | | required for the | | | | synthesis of | | | | nucleic acids and | | | | proteins. | | | | | | | | - Magnesium plays a | | | | role in | | | | maintaining | | | | normal calcium | | | | and potassium | | | | balance. | | | | Manifestations of | | | | magnesium | | | | imbalance are | | | | often mistaken | | | | for calcium | | | | imbalances. | | | | Because | | | | magnesium, | | | | calcium, and | | | | potassium balance | | | | are closely | | | | related, assess | | | | all three cations | | | | together. | | | | | | | | - Adequate | | | | intracellular | | | | magnesium is | | | | necessary for | | | | normal function | | | | of the | | | | sodium-potassium | | | | pump. | | | | | | | | - Acts directly on | | | | affect | | | | neuromuscular | | | | excitability | | | | | | | | - Important for | | | | normal **cardiac | | | | function** | | | | | | | | - Contained in bone | | | | | | | | - Magnesium is | | | | regulated by GI | | | | absorption and | | | | renal excretion. | | | +-----------------------+-----------------------+-----------------------+ | How does Mg **enter** | | How does Mg **exit** | | the body? | | the body? | | | | | | **Magnesium enters | | Magnesium is excreted | | the body through the | | via the Kidneys. | | small and large | | | | intestines, where | | | | it\'s absorbed from | | | | food** | | | +-----------------------+-----------------------+-----------------------+ | What **causes** the | | What **causes** the | | Mg levels to be **too | | Mg levels to be **too | | high**? | | low**? | | | | | | - Hypermagnesemia | | - Poor dietary | | usually occurs | | intake | | only with an | | | | increase in | | - Chronic | | magnesium intake | | alcoholism | | accompanied by | | | | renal | | - Starvation | | insufficiency or | | | | failure. | | - Diuretics | | | | increase the risk | | - A patient with | | of magnesium loss | | chronic kidney | | through renal | | disease who | | excretion. | | ingests products | | | | containing | | | | magnesium (e.g., | | | | Maalox, milk of | | | | magnesia) will | | | | have a problem | | | | with excess | | | | magnesium. | | | | | | | | - Magnesium excess | | | | could develop in | | | | the pregnant | | | | woman who | | | | receives | | | | magnesium sulfate | | | | for the | | | | management of | | | | eclampsia. | | | +-----------------------+-----------------------+-----------------------+ | How do high Mg levels | | How do low Mg levels | | effect the patient? | | effect the patient? | | | | | | (Signs and Symptoms, | | (Signs and Symptoms, | | Potential | | Potential | | Complications) | | Complications) | | | | | | *Depressed | | *Neuromuscular and | | Neuromuscular and CNS | | CNS | | functions* | | hyperexcitability* | | | | | | - Lethargy | | - Confusion | | | | | | - Flaccid muscle | | - Hyperactive | | tone | | reflexes | | | | | | - Decreased | | - Muscle cramps, | | reflexes | | tremors | | | | | | | | - Cardiac | | | | dysrhythmias | | | | | | | | Positive Chvostek's | | | | sign | +-----------------------+-----------------------+-----------------------+ | Priority Nursing | | | | Assessments: | | | | | | | | Hypermagnesemia: | | | | | | | | - Monitor Magnesium | | | | Levels | | | | | | | | - Monitor Vital | | | | signs | | | | | | | | - Monitor Fluid | | | | intake and output | | | | | | | | - ECG | | | | | | | | Hypomagnesemia: | | | | | | | | - Monitor Magnesium | | | | Levels | | | | | | | | - Monitor Vital | | | | signs | | | | | | | | - Monitor Fluid | | | | intake and output | | | | | | | | - BMP | | | | | | | | - ECG | | | +-----------------------+-----------------------+-----------------------+ | Priority Nursing | | | | Interventions: | | | | | | | | Hypermagnesemia: | | | | | | | | - Emergency | | | | treatment | | | | | | | | - IV Calcium | | | | Gluconate | | | | | | | | - Diuretics or | | | | dialysis | | | | | | | | - Patients with | | | | kidney disease | | | | should not take | | | | magnesium-contain | | | | ing | | | | drugs, and | | | | ingestion of | | | | magnesium | | | | containing foods | | | | (e.g., green | | | | vegetables, nuts, | | | | bananas, oranges, | | | | peanut butter, | | | | chocolate). | | | +-----------------------+-----------------------+-----------------------+ Hypomagnesemia: - Oral supplements - Increase dietary intake - green vegetables, nuts, bananas, oranges, peanut butter, and chocolate - Parenteral IV or IM magnesium when severe - When Magnesium sulfate is given: - Monitor vital signs - Use an infusion pump- too rapid administration of magnesium can lead to cardiac or respiratory arrest.