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   Most abundant electrolyte in the ECF   135 to 145 mEq/L   Has a major role in controlling water    distribution thro...
   Primary regulator of ECF volume   Also    functions   in   establishing the    electrochemical state necessary for mu...
   Butter, bacon, canned food, cheese, ketchup,    frankfurters, processed food, soy sauce, table    salt
   Serum sodium level lower than 135 mEq/L   Causes include: increased sodium excretion    (excessive diaphoresis, diure...
   Rapid pulse rate   Generalized skeletal muscle weakness   Headache   Diminished deep tendon reflexes   Confusion ...
   Monitor     cardiovascular,       respiratory,    neuromuscular, cerebral, renal, and GI status   If hyponatremia is ...
   Instruct client to increase oral sodium intake    and inform the client about the foods to    include in the diet   I...
   Is a serum sodium level that exceeds 145    mEq/L   Causes include: decreased sodium excretion,    increased sodium i...
   Heart rate and BP that respond to vascular    volume status   Pulmonary edema if hypervolemia is present   Spontaneo...
   Monitor     cardiovascular,       respiratory,    neuromuscular, cerebral, renal, and GI status   If the cause is flu...
   Is the major intracellular electrolyte   Ranges from 3.5 to 5.1mEq/L   98% of the body’s potassium is inside the    ...
   Avocado, banana, cantaloupe, carrots, fish,    mushroom, oranges, potatoes, raisins,    spinach, strawberries, tomatoe...
   Is a serum potassium level lower than 3.5meq/L   Potassium deficit is potentially life-threatening    because every b...
   Weak peripheral pulses   FUS – flattened T wave, U wave, ST segment    depression in ECG   Shallow    respirations, ...
   Monitor     cardiovascular,       respiratory,    neuromuscular, cerebral, renal, and GI status   Monitor electrolyte...
   Oral potassium supplements may cause    nausea and vomiting and they should not be    taken on an empty stomach   Liq...
   After adding potassium to an IV solution, rotate    and invert the bag to ensure that the potassium    is distributed ...
   Institute safety measures for the client    experiencing muscle weakness   Potassium sparing diuretic may be prescrib...
   Is a serum potassium level that exceeds    5.1mEq/L   Is caused by: excessive potassium    intake, decreased potassiu...
   Slow, weak, irregular heart rate   Decreased BP   TWiFP – Tall peaked T waves, widened QRS    complexes, flat P wave...
   Monitor    cardiovascular, respiratory, neuromuscular, c    erebral, renal, and GI status   Discontinue IV potassium ...
   Prepare to administer sodium polysterene    sulfonate (Kayexalate), cation exchange resin    that promotes GI sodium a...
   Monitor renal function   When blood transfusions are prescribed for a    client with a potassium imbalance the client...
   Major component of bones and teeth   Plays a major role in transmitting nerve    impulses and helps regulate muscle  ...
   The serum calcium level is controlled by    parathyroid hormone and calcitonin   Cheese,                milk,        ...
   Is a serum calcium level lower than 8.6 mg/dL   Causes include: inadequate oral intake of    calcium, lactose intoler...
   Decreased heart rate   Hypotension   Diminsihed peripheral pulses   Prolonged ST interval, prolonged QT interval  ...
   Inflate a blood pressure cuff around the    client’s upper arm for 1 to 4 minutes above    the systolic pressure   In...
   Tap the face just below and in front of the ear   Facial twitching on that side of the face    indicates a positive t...
   Monitor     cardiovascular,       respiratory,    neuromuscular, cerebral, renal, and GI status   Administer calcium ...
   Monitor for ECG changes, observe for    infiltration, and monitor for hypercalcemia    during therapy   Administer me...
   Initiate seizure precautions   Move the client carefully, and monitor for    signs of a fracture   Keep 10% calcium ...
   Is a serum calcium level that exceeds    10mg/dL   Causes       include:   increased    calcium    absorption, decrea...
   Increased       heart    rate   in    early    phase, bradycardia that can lead to cardiac    arrest in late phases  ...
   Monitor     cardiovascular,       respiratory,    neuromuscular, cerebral, renal, and GI status   Discontinue IV infu...
   Prepare client with severe hypercalcemia for    dialysis   Move client carefully and monitor for signs of    fracture...
   Acts as an activator for many intracellular    enzyme systems and plays a role in both    carbohydrate and protein met...
   1.6 to 2.6 mg/dL   Avocado, canned white tuna, cauliflower,    milk, green leafy vegetables, oatmeal, peanut    butte...
   Is a serum magnesium level lower than 1.6    mg/dL   Causes include: insufficient magnesium    intake, chronic alcoho...
   Tall T waves, depressed ST segments   Tachycardia   Twitches   Hyperreflexia   Seizures   Irritability   Confusion
   Monitor     cardiovascular,       respiratory,    neuromuscular, cerebral, renal, and GI status   Monitor serum magne...
   Is a serum magnesium level that exceeds 2.6    mg/dL   Causes include: increased magnesium intake,    decreased renal...
   Bradycardia   Hypotension   Prolonged PR interval,     widened   QRS    complexes   Skeletal muscle weakness   Dro...
   Monitor    cardiovascular, respiratory, neuromuscular, c    erebral, renal, and GI status   Diuretics are prescribed ...
   Intravenously administered calcium chloride    or calcium gluconate may be prescribed to    reverse the effects of mag...
   Essential to the function of muscle and red    blood cells, formation of ATP, maintenance of    acid base balance   P...
   Fish, organ meats, nuts, pork, beef, chicken,    whole grain breads and cereals
   Is a serum phosphorus level lower than    2.7mg/dL   A decrease in the serum phosphorus level is    accompanied by an...
   Decreased contractility and cardiac output   Weakness   Decreased bone density   Irritability   Confusion   seizu...
   Monitor    cardiovascular, respiratory, neuromuscular, c    erebral, renal, and GI status   Administer phosphorus ora...
   Move client carefully, and monitor for signs of    fracture   Instruct client to increase intake of    phosphorus    ...
   Serum phosphorus      level   that   exceeds    4.5mg/dL   Increase in serum phosphorus is accompanied    by a decrea...
   Same as assessment of hypocalcemia
   Entails management of hypocalcemia   Instruct client to avoid phosphate containing    medications   Instruct client ...
38824365 electrolyte-imbalances
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38824365 electrolyte-imbalances

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Transcript of "38824365 electrolyte-imbalances"

  1. 1.  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
  2. 2.  Primary regulator of ECF volume Also functions in establishing the electrochemical state necessary for muscle contraction and the transmission of nerve impulses
  3. 3.  Butter, bacon, canned food, cheese, ketchup, frankfurters, processed food, soy sauce, table salt
  4. 4.  Serum sodium level lower than 135 mEq/L Causes include: increased sodium excretion (excessive diaphoresis, diuretics, vomiting, diarrhea, wound drainage, decreased secretion of aldosterone); inadequate sodium intake; dilution of serum sodium (freshwater drowning, SIADH)
  5. 5.  Rapid pulse rate Generalized skeletal muscle weakness Headache Diminished deep tendon reflexes Confusion Seizures Nausea Decreased urinary specific gravity Increased urine output
  6. 6.  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
  7. 7.  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
  8. 8.  Is a serum sodium level that exceeds 145 mEq/L Causes include: decreased sodium excretion, increased sodium intake, decreased water intake, increased water loss
  9. 9.  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
  10. 10.  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
  11. 11.  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
  12. 12.  Avocado, banana, cantaloupe, carrots, fish, mushroom, oranges, potatoes, raisins, spinach, strawberries, tomatoes, pork, beef
  13. 13.  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
  14. 14.  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
  15. 15.  Monitor cardiovascular, respiratory, neuromuscular, cerebral, renal, and GI status Monitor electrolyte values Administer potassium supplements orally or intravenously
  16. 16.  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
  17. 17.  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
  18. 18.  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
  19. 19.  Is a serum potassium level that exceeds 5.1mEq/L Is caused by: excessive potassium intake, decreased potassium excretion, tissue damage, hypercatabolism
  20. 20.  Slow, weak, irregular heart rate Decreased BP TWiFP – Tall peaked T waves, widened QRS complexes, flat P waves, widened QRS complexes Muscle twitches, cramps (early) Profound weakness (late) Diarrhea
  21. 21.  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
  22. 22.  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
  23. 23.  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
  24. 24.  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
  25. 25.  The serum calcium level is controlled by parathyroid hormone and calcitonin Cheese, milk, soy milk, sardines, spinach, tofu, yogurt
  26. 26.  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
  27. 27.  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
  28. 28.  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
  29. 29.  Tap the face just below and in front of the ear Facial twitching on that side of the face indicates a positive test
  30. 30.  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
  31. 31.  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
  32. 32.  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
  33. 33.  Is a serum calcium level that exceeds 10mg/dL Causes include: increased calcium absorption, decreased calcium excretion (use of thiazide diuretics), hyperparathyroidism, malignancy, immobility
  34. 34.  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
  35. 35.  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
  36. 36.  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
  37. 37.  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
  38. 38.  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
  39. 39.  Is a serum magnesium level lower than 1.6 mg/dL Causes include: insufficient magnesium intake, chronic alcoholism, malnutrition and starvation, insulin administration
  40. 40.  Tall T waves, depressed ST segments Tachycardia Twitches Hyperreflexia Seizures Irritability Confusion
  41. 41.  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
  42. 42.  Is a serum magnesium level that exceeds 2.6 mg/dL Causes include: increased magnesium intake, decreased renal excretion of magnesium
  43. 43.  Bradycardia Hypotension Prolonged PR interval, widened QRS complexes Skeletal muscle weakness Drowsiness and lethargy
  44. 44.  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
  45. 45.  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
  46. 46.  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
  47. 47.  Fish, organ meats, nuts, pork, beef, chicken, whole grain breads and cereals
  48. 48.  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
  49. 49.  Decreased contractility and cardiac output Weakness Decreased bone density Irritability Confusion seizures
  50. 50.  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
  51. 51.  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
  52. 52.  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
  53. 53.  Same as assessment of hypocalcemia
  54. 54.  Entails management of hypocalcemia Instruct client to avoid phosphate containing medications Instruct client to decrease the intake of food that
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