Downloaded 86 times
More Related Content
![Fluid and electrolyte imbalance [autosaved]](https://cdn.slidesharecdn.com/ss_thumbnails/btwa8l8ysletobnf0row-signature-f3069b4a7063ad7d39b14083d6e8689bac823dbcf19c3f5cb443fa8d754857b7-poli-171013171124-thumbnail.jpg?width=640&height=640&fit=bounds)
Similar to Chapter 13 And 15 Electrolyte Imbalance Part 5
Chapter 13 And 15 Electrolyte Imbalance Part 5
- 1. Electrolyte Imbalances PartV Peggy D. Johndrow 2009
- 2. Hypophosphatemia Causes includeMalnourishment/malabsorption Alcohol withdrawal Use of phosphate-binding antacids During parenteral nutrition with inadequate replacement
- 3. Hypophosphatemia Clinical ManifestationsCNS depression Confusion Muscle weakness and pain Dysrhythmias Cardiomyopathy
- 4. Hypophosphatemia Management Oralsupplementation Ingestion of foods high in phosphorus May require IV administration of sodium or potassium phosphate
- 5. Nursing Diagnoses Impairedphysical mobility r/t Risk for bone injury r/t Impaired gas exchange r/t Risk for falls r/t Risk for decreased cardiac output
- 6. Nursing Actions MonitorV/S, respiratory rate & depth (assess S/S hypoxia) Monitor lab values Nutrition Therapy: increase foods high in HPO4 Oral/IV if necessary Monitor ECG Monitor Serum K+ Salt substitutes Teach use of diuretics, laxatives, diet
- 7.
- 8. Magnesium 50-60% containedin bone Coenzyme metabolism protein & carbohydrates Factors that regulate calcium balance appear to influence magnesium balance Acts directly on myoneural junction Important for normal cardiac function
- 9. Hypermagnesemia Causes includeIncreased intake or ingestion of products containing magnesium when renal insufficiency or failure is present
- 10.
- 11. Hypermagnesemia Clinical ManifestationsLethargy Drowsiness Somnolence N/V Reflexes impaired Respiratory and cardiac arrest can occur
- 12. Hypermagnesemia Management PreventionIV CaCl or calcium gluconate Fluids
- 13. Nursing Diagnoses Riskfor injury r/t Risk for altered cardiac function r/t Risk for impaired gas exchange Knowledge deficit r/t
- 14. Nursing Actions Assessneuromuscular, V/S, S/S Monitor serum Mg+ levels; ECG Safety measures Teach: foods/medications high in Mg
Editor's Notes
- #8 Magnesium (1.5-2.5 mEq/L) General facts 50-60% in bone Catalyst for many enzyme functions; especially CHO, protein, Na-K pump Neuromuscular activity affected r/t transmission of neural impulses Factors regulate Ca++ -play role in regulating Mg and vitamin D Kidneys – excrete; diuretics on Henle’s loop increase Mg excretion Bound to protein & ionized – ionized only has neuromuscular effect Deficit – increase muscular irritability Excess – sedative effect ETOH – deficit secondary to decreased diet intakeHypomagnesium < 1.5 mEq/L Etiology - Decreased absorption GI; increased excretion urine; mannitol/urea/glucose; renal disease; pancreatitis; diabetes (osmotic diuresis due to hyperglycemia) Lab tests- Serum Mg, Serum albumin, Serum K+, Serum Ca++, ECG Therapeutic Management Increased diet intake of Mg Mg++ antacids Severe – give Mg sulfate IV; give slowly, monitor carefully Nursing Care Assess S/S - vertigo, hallucinate, laryngeal stridor, hypotension, tachycardia, hypotension, sensitive to digoxin, Trousseau’s/Chvostek’s signs, paresthesias, N/V, anorexia Nursing Diagnosis - Risk for injury r/t, Risk for altered cardiac function r/t, Altered nutrition less than requirements r/t; Knowledge deficit Nursing actions Monitor serum levels Oral Mg Diet – foods high in Mg (green vegetables, nuts, peanut butter, chocolate, grapefruit, orange juice IV – MgSO4 if severe Ca gluconate – for tetany Monitor respiratory status, V/S, HR, ECG Teach use of diuretics, laxatives, diet Client education Explanation of condition; include risk factors Strategies to prevent further episodes Foods high in Mg Medication therapy including possible side effects S/S and what and when to reportHypermagnesemia > 2.5 mEq/L– decreased excitability of muscles; vasodilation Etiology – Mg antacids, renal failure, DM ketoacidosis Lab tests - Serum Mg+, ECG Therapeutic management Prevent! D/C foods, meds high in Mg Adequate renal function – give 1/2 NS & diuretics to excrete excess IV Ca gluconate Respiratory support Hemodialysis Nursing Care Assess S/S - hypotension, irregular HR, lethargy, drowsy, confusion, muscle weakness, coma, decreased DTR's Nursing diagnosis - Risk for injury r/t; Risk for altered cardiac function r/t; risk for altered respiratory status; Knowledge deficit r/t Nursing actions Assess neuromuscular, V/S, S/S Monitor serum Mg+ levels; ECG Safety measures Teach: foods/medications high in Mg Client education Explanation of condition; include risk factors Strategies to prevent further episodes Foods high in Mg Medication therapy including possible side effects S/S and what and when to report