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38824365 electrolyte-imbalances
1.
2. Most abundant electrolyte in the ECF
135 to 145 mEq/L
Has a major role in controlling water
distribution throughout the body
Regulated by ADH, thirst and the renin-
angiotensin-aldosterone system
3. Primary regulator of ECF volume
Also functions in establishing the
electrochemical state necessary for muscle
contraction and the transmission of nerve
impulses
7. Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
If hyponatremia is accompanied by a fluid
deficit, IV sodium chloride infusions are
administered
If hyponatremia is accompanied by a fluid
excess, osmotic diuretics are administered
8. Instruct client to increase oral sodium intake
and inform the client about the foods to
include in the diet
If the client is taking lithium, monitor the
lithium level, because hyponatremia can
cause diminished lithium excretion, resulting
in toxicity
9. Is a serum sodium level that exceeds 145
mEq/L
Causes include: decreased sodium excretion,
increased sodium intake, decreased water
intake, increased water loss
10. Heart rate and BP that respond to vascular
volume status
Pulmonary edema if hypervolemia is present
Spontaneous muscle twitches, irregular
muscle contractions (early)
Skeletal muscle weakness (late)
Altered cerebral function is the most
common manifestation
Increased urinary specific gravity; decreased
urine output
11. Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
If the cause is fluid loss, prepare to administer
IV infusions
If the cause is inadequate renal excretion of
sodium, prepare to administer diuretics
Restrict sodium as prescribed
12. Is the major intracellular electrolyte
Ranges from 3.5 to 5.1mEq/L
98% of the body’s potassium is inside the
cells, the remaining 2% is in the ECF that is
important in neuromuscular function
Influences both skeletal and cardiac muscle
activity
14. Is a serum potassium level lower than 3.5meq/L
Potassium deficit is potentially life-threatening
because every body system is affected
Causes include: excessive use of medications
such as diuretics, vomiting, diarrhea, inadequate
potassium intake, hyperinsulinism
15. Weak peripheral pulses
FUS – flattened T wave, U wave, ST segment
depression in ECG
Shallow
respirations, anxiety, lethargy, confusion
Skeletal muscle weakness
Deep tendon hyporeflexia
Hypoactive to absent bowel sounds
Nausea and vomiting
16. Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
Monitor electrolyte values
Administer potassium supplements orally or
intravenously
17. Oral potassium supplements may cause
nausea and vomiting and they should not be
taken on an empty stomach
Liquid potassium chloride has an unpleasant
taste and should be taken with juice or
another liquid
Potassium is never given by IV push or by the
IM or SQ route
18. After adding potassium to an IV solution, rotate
and invert the bag to ensure that the potassium
is distributed evenly
Label IV bag containing potassium properly
Potassium infusion can cause phlebitis; thus the
nurse should assess the IV site frequently
Monitor renal function and I&O before
administering potassium
19. Institute safety measures for the client
experiencing muscle weakness
Potassium sparing diuretic may be prescribed
instead
Instruct the client about foods that are high in
potassium content
20. Is a serum potassium level that exceeds
5.1mEq/L
Is caused by: excessive potassium
intake, decreased potassium excretion, tissue
damage, hypercatabolism
22. Monitor
cardiovascular, respiratory, neuromuscular, c
erebral, renal, and GI status
Discontinue IV potassium and hold oral
potassium supplements
Initiate a potassium-restricted diet
Prepare to administer potassium-excreting
diuretics if renal function is not impaired
23. Prepare to administer sodium polysterene
sulfonate (Kayexalate), cation exchange resin
that promotes GI sodium absorption and
potassium excretion
Prepare the client for dialysis if potassium levels
are critically high
Prepare for the IV administration of hypertonic
glucose with regular insulin to move excess
potassium into the cells
24. Monitor renal function
When blood transfusions are prescribed for a
client with a potassium imbalance the client
should receive fresh blood
Teach the client to avoid foods high in potassium
Instruct the client to avoid the use of salt
substitutes
25. Major component of bones and teeth
Plays a major role in transmitting nerve
impulses and helps regulate muscle
contraction and relaxation, including cardiac
muscle, also plays a role in blood coagulation
8.6 to 10mg/dL
26. The serum calcium level is controlled by
parathyroid hormone and calcitonin
Cheese, milk, soy
milk, sardines, spinach, tofu, yogurt
27. Is a serum calcium level lower than 8.6 mg/dL
Causes include: inadequate oral intake of
calcium, lactose intolerance, inadequate
intake of vitamin D, diarrhea, steatorrhea,
hyperphosphatemia, , acute pancreatitis,
removal or destruction of the parathyroid
glands
28. Decreased heart rate
Hypotension
Diminsihed peripheral pulses
Prolonged ST interval, prolonged QT interval
Twitches, cramps
Painful muscle spasms during periods of
inactivity
Positive Trousseau’s and Chvostek’s sign
29. Inflate a blood pressure cuff around the
client’s upper arm for 1 to 4 minutes above
the systolic pressure
In a client with hypocalcemia, the hand and
fingers become spastic and go into palmar
flexion
30. Tap the face just below and in front of the ear
Facial twitching on that side of the face
indicates a positive test
31. Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
Administer calcium supplements orally or
calcium intravenously
When administering calcium IV, warm the
injection solution to body temperature
before administration and administer slowly
32. Monitor for ECG changes, observe for
infiltration, and monitor for hypercalcemia
during therapy
Administer medications that increase calcium
absorption (aluminum hydroxide, vitamin D)
Provide a quiet environment to reduce stimuli
33. Initiate seizure precautions
Move the client carefully, and monitor for
signs of a fracture
Keep 10% calcium gluconate available for
treatment of acute calcium deficit
Instruct client to consume foods high in
calcium
34. Is a serum calcium level that exceeds
10mg/dL
Causes include: increased calcium
absorption, decreased calcium excretion (use
of thiazide
diuretics), hyperparathyroidism, malignancy,
immobility
35. Increased heart rate in early
phase, bradycardia that can lead to cardiac
arrest in late phases
Increased BP
Shortened ST segment, widened T wave
Profound muscle weakness
Increased urinary output
Formation of renal calculi
36. Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
Discontinue IV infusions of solutions
containing calcium and oral medications
containing calcium or vitamin D
Discontinue thiazide diuretics and replace
with diuretics that enhance the excretion of
calcium
37. Prepare client with severe hypercalcemia for
dialysis
Move client carefully and monitor for signs of
fracture
Monitor for flank or abdominal pain, and strain
the urine to check for the presence of urinary
stones
Instruct client to avoid calcium rich foods
38. Acts as an activator for many intracellular
enzyme systems and plays a role in both
carbohydrate and protein metabolism
Acts peripherally to produce vasodilation
Affect neuromuscular irritability and
contractility
39. 1.6 to 2.6 mg/dL
Avocado, canned white tuna, cauliflower,
milk, green leafy vegetables, oatmeal, peanut
butter, peas, pork, beef, chicken, potatoes,
raisins, yogurt
40. Is a serum magnesium level lower than 1.6
mg/dL
Causes include: insufficient magnesium
intake, chronic alcoholism, malnutrition and
starvation, insulin administration
41. Tall T waves, depressed ST segments
Tachycardia
Twitches
Hyperreflexia
Seizures
Irritability
Confusion
42. Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
Monitor serum magnesium levels frequently
Initiate seizure precautions
Instruct client to increase intake of foods that
contain magnesium
43. Is a serum magnesium level that exceeds 2.6
mg/dL
Causes include: increased magnesium intake,
decreased renal excretion of magnesium
45. Monitor
cardiovascular, respiratory, neuromuscular, c
erebral, renal, and GI status
Diuretics are prescribed to increase renal
excretion
Instruct client to restrict dietary intake of
magnesium-containing foods
46. Intravenously administered calcium chloride
or calcium gluconate may be prescribed to
reverse the effects of magnesium on cardiac
muscle
Instruct the client to avoid the use of laxatives
and antacids containing magnesium
47. Essential to the function of muscle and red
blood cells, formation of ATP, maintenance of
acid base balance
Provides structural support to bones and
teeth
2.7 to 4.5 mg/dL
48. Fish, organ meats, nuts, pork, beef, chicken,
whole grain breads and cereals
49. Is a serum phosphorus level lower than
2.7mg/dL
A decrease in the serum phosphorus level is
accompanied by an increase in the serum
calcium level
Causes include: insufficient
intake, malnutrition, starvation, hyperparath
yroidism
50. Decreased contractility and cardiac output
Weakness
Decreased bone density
Irritability
Confusion
seizures
51. Monitor
cardiovascular, respiratory, neuromuscular, c
erebral, renal, and GI status
Administer phosphorus orally along with
vitamin D supplement
Prepare to administer phosphorus IV
Assess renal system before administering
phosphorus
52. Move client carefully, and monitor for signs of
fracture
Instruct client to increase intake of
phosphorus containing foods while
decreasing the intake of calcium-containing
foods
53. Serum phosphorus level that exceeds
4.5mg/dL
Increase in serum phosphorus is accompanied
by a decrease in serum calcium
Causes include: decreased renal
excretion, increased intake of
phosphorus, hypoparathyroidsm
55. Entails management of hypocalcemia
Instruct client to avoid phosphate containing
medications
Instruct client to decrease the intake of food
that