Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

38824365 electrolyte-imbalances


Published on

Published in: Health & Medicine, Business
  • Be the first to comment

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