Electrolytes

Question 1

Mg - Magnesium (normal blood value)

Answer 1

1.6-2.6 mg/dL

Question 2

Na - Sodium (normal blood value)

Answer 2

135-145 mEq/L

Question 3

K - Potassium (normal blood value)

Answer 3

3.5-5.0 mEq/L

Question 4

Ca - Calcium (normal blood value)

Answer 4

8.6-10 mEq/L

Question 5

Phosphorus (normal blood value)

Answer 5

2.7-4.5 mEq/L

Question 6

Hypokalemia causes what changes to ECG

Answer 6

1. ST Depression
2. Shallow, flat, or inverted T Wave
3. Prominent U Wave

Question 7

Foods High in Potassium Include

Answer 7

• Avocado
• Banana
• Cantaloupe
• Carrots
• Fish
• Mushrooms
• Oranges
• Potatoes
• Pork
• Beef
• Veal
• Raisins
• Spinach
• Strawberries
• Tomatoes

Question 8

Signs of Hypocalcemia

Answer 8

• decreased heart rate
• hypotension
• diminished peripheral pulses
• hyperactive deep tendon reflexes
• increased gastric motility
• hyperactive bowel sounds
• Twitching
• Muscle spasm
• Numbness
• Hyperactive Reflexes
• Positive Trousseaus & Chvostek signs
• Anxiety & irritability

Question 9

What type of patients are at high risk for fluid loss?

Answer 9

• elderly

- patients with an ileostomy or colostomy

Question 10

Hyperkalemia and burns

Answer 10

Patients with wounds or substantial burns are at greater risk of hyperkalemia due to cellular fluid shifting during trauma. Also can be caused by sepsis or respiratory acidosis.

Question 11

Administration of potassium

Answer 11

Potassium is administered by infusion solution. It is never given IM, subcut or bolus.

Should be diluted to 1 mEq/10ml.

Administration rate is 5-10 mEq per hour, NEVER to exceed 20 mEq per hour.

Renal function should assessed prior to administration & fluid balance should be monitored during administration.

Potassium infusion can cause phlebitis.

Question 12

Hypocalcemia & Changes to the ECG

Answer 12

1. Prolonged ST segment

2. Prolonged QT interval

Question 13

Hypercalcemia & Changes to the ECG

Answer 13

1. Shortened ST segment

2. Widened T wave

Question 14

Hypokalemia & Changes to the ECG

Answer 14

1. ST depression
2. Shallow, flat or inverted T Wave
3. Prominent U wave

Question 15

Hypomagnesemia & Changes to the ECG

Answer 15

1. Tall T Waves

2. Depressed ST segment

Question 16

Hypermagnesemia & Changes to the ECG

Answer 16

1. Prolonged PR interval

2. Widened QRS Complexes

Question 17

Chvostek’s Sign

Answer 17

Contraction of the facial muscles in response to a light tap over the facial nerve in front of the ear.

Question 18

Trousseau’s Sign

Answer 18

Carpal spasm induced by inflating a blood pressure cuff . The thumb and forefinger come together and contract inward toward the wrist.

Question 19

Signs of Hypercalcemia

Answer 19

• increased heart rate
• increased BP
• bounding peripheral pulses
• ineffective respiratory movement
• profound muscle weakness
• diminished or absent deep tendon reflexes
• disorientation, lethargy, coma
• formation of renal calculi, flank pain
• decreased gastric motility & hypoactive bowel sounds
• anorexia, nausea, abdominal distention, constipation

Question 20

Common sources of Magnesium

Answer 20

• almonds
• avocado
• canned white tuna
• cauliflower
• green leafy vegetables
• milk
• oatmeal
• peanut butter
• peas
• pork
• beef
• chicken
• soy beans
• potatoes
• raisins
• yogurt

Question 21

Signs of Hypomagnesemia

Answer 21

• tachycardia
• hypertension
• shallow respirations
• twitching
• • trousseaus & chvosteks signs
• hyperreflexia
• seizures
• irritability
• confusion

Question 22

Signs of Hypermagnesemia

Answer 22

• bradycardia
• hypotension
• respiratory inssufficiency
• diminished deep tendon reflexes
• drowsiness, lethargy, coma

Question 23

Common Sources of Phosphorus

Answer 23

Fish
Pumpkin, squash
Nuts
Pork, beef, chicken & organ meats
Whole Grain breads & Cereals
Dairy Products

Question 24

Cardiac changes in hypokalemia

Answer 24

Includes:
- impaired depolarization resulting in flattening of the T wave and eventually emergence of a U wave.
- potentially lethal dysrhythmias is increased
-

Question 25

Signs of Hyponatremia

Answer 25

- pulse can be rapid, thready, weak, bounding or normal depending on whether the patient is normovolemic, hypovolemic or hypervolemic. - shallow ineffective respiration - generalized muscle weakness - diminished deep tendon reflexes - headache - personality changes - confusion - seizures - coma - increased gastric motility and hyperactive bowel sounds - nausea - abdominal cramping - dry mucous membranes

Question 26

Signs of Hypernatremia

Answer 26

- heart rate and BP respond to vascular volume status - pulmonary edema if hypervolemia is present - early: muscle twitching & irregular contractions - late: muscle weakness, diminished deep tendon reflexes - altered mental function - normo or hypovolemia - agitation, confusion, seizures - hypervolemia - lethargy, stupor, coma - extreme thirst - decreased urinary output - dry flushed skin - dry sticky tongue & mucous membranes - edema depending on fluid volume changes