FandE

Question 2

–Sodium (Na+)–Found in?Normal Levels?Function?

Answer 2

• found in ECF- 135-145mEq/L- Nerve/muscle conduction, and acid-base balance

Question 3

Hyponatermia S/S?

Answer 3

• hypothermia (↓ temp)- tachycardia (rapid thready pulse)- Hypotension/Orthostatic Hypotension- Headache, confusion- Lethargy - ↓ Deep Tendon Reflexes (DTR)-Seizures-Hyperactive bowel sounds- Muscle Weakness

Question 4

Treatment for Hyponatermia?

Answer 4

• Follow Facility protocols- Monitor I&O and weigh Pt. daily at same time/clothing/sheets, ect…- Restrict H2O- Hypertonic (IV/Oral)- ↑ Na+ (ECF)

Question 5

Causes of Hypernatermia?

Answer 5

• ↑ Na+ intake- ↑ Na+ retention- Fluid losses- Age-related changes- ↑ thirst and ↑ ADH production- Renal Failure- Dehydration - Watery diarrhea- Corticosteroids

Question 6

Hypernatermia S/S?

Answer 6

• Hyperthermia- Tachycardia- Orthostatic Hypotension- Restlessness/irritability- ↓ DTR’s →Seizures- Thirst, Dry mucous membranes- ↑ BS- Nausea - Edema- Oliguria (↓ Urine output)- Muscle Twitching

Question 7

Treatment for Hypernatermia?

Answer 7

-Isotonic/Hypotonic (IV/Oral) -Diuretics (Loop)- H2O intake- Oral Hygiene - Monitor I&O/LOC

Question 8

–Potassium (K+)–Where is it Found?Normal Levels?Function?

Answer 8

• ICF- 3.5-5mEq/L- Nerve conduction (Cardiac, lungs, muscle tissue), and acid-base balance

Question 9

Causes for Hypokalemia?

Answer 9

• ↓ Ka+ intake- Loss GI/Vomit/Diarrhea - Med (Lasix/corticosteroids)-Skin-loss- Nasogastric Suction- Prolonged Hypotonic IV

Question 10

Hypokalemia S/S?

Answer 10

[A SIC WALT]- Alkalosis- Shallow RR- Irritability- Confusion- Weakness/ fatigue- Arrhythmias- Lethargy- Thready Pulse (Bradycardia)- ↓ GI Motility→Nausea, Vomit, Constipation- Hyperthermia- Paresthesia (tingling sensation)

Question 11

Treatment of Hypokalemia?

Answer 11

• ↑ K+- Supplement (Food/Oral/IV)

Question 12

Causes for Hyperkalemia?

Answer 12

• Excess K+ (IV/Salt Substitute)- Diabetic Ketoacidosis (DKA)- Sepsis/trauma/injuries- Renal failure→ ↓K+ excretion- Severe dehydration- Meds (K+sparing diuretics, ACE inhibitors, NSAIDS)- Adrenal insufficiency

Question 13

Hyperkalemia S/S?

Answer 13

• ↓BP- Abd Cramping→ Diarrhea- Muscle twitch/ weakness→ Flaccid paralysis - Irritability/ anxiety- Tall Peaked T-waves (ECG)- Arrhythmia Bradycardia

Question 14

Treament for Hyperkalemia?

Answer 14

[Inverse w/sodium]- Insulin/Kayexalate/Lasix- Dialysis- Sodium bicarbonate

Question 15

–Calcium (Ca+)–Where found?Normal Levels? Function?

Answer 15

• Skeletal system/ Small amounts in ECF- 9-10.5- Cardiovascular/ muscle/ endocrine system, Blood clotting, bone and teeth

Question 16

Causes of Hypocalcemia?

Answer 16

• Crohn’s disease- Hypoparathyroidism/ Post-thyroidectomy- Renal failure/end-stage disease- Diarrhea- Wound drainage

Question 17

Hypocalcemia S/S?

Answer 17

• Chovestek’s Sign (tap facial nerve→ twitching)- Trousseau’s Sign (Prolonged cuff inflation→ Hand/finger spasms)- Muscle twitch (Tetany)- Seizure- Hyperactive DTR- Diarrhea/ ↑BS- Abd Cramping- ↓HR & BP- ↑ phosphorus

Question 18

Treatment of Hypocalcemia?

Answer 18

• Oral/IV supplement- Seizure precautions- ER equipment on standby

Question 19

Causes of hypercalcemia?

Answer 19

• ↑ intake- excess Vit D- Cancer- Thiazid diuretics- Immobility- Hyperparathyroidism- Dehydration

Question 20

Hypercalcemia S/S?

Answer 20

• Renal stone- Muscle weakness- Cardiovascular changes (Life-threatening)- ↓ Phosphorus

Question 21

Treatment of hypercalcemia?

Answer 21

• Supplemental oral/IV/food- Furosemide- Phosphorus - Calcitonin- Dialysis- Monitor for arrhythmias

Question 22

–Magnesium (Mg)–Where Found?Normal Levels?Function?

Answer 22

• Skeletal/ intracellular fluid- 1.3-2.1- Helps transfer Na+ & K+ across cell membrane (ICF)

Question 23

Causes of hypomagnesemia?

Answer 23

• Malnutrition (Crohn’s)- Alcohol- Diarrhea- Celiac disease- Meds (Loop diuretics, Aminoglycoside, amphotericin B, Cyclosporine)- Citrate (Blood products)- Ethanol ingestion

Question 24

Hypomagnesemia S/S?

Answer 24

[STARVED]- Seizure- Tetany- Anorexia- Rapid HR- Vomit- Emotional- DTRs ↑- Constipation→ ↓BS/ Abd Distention- Paresthesia

Question 25

Treatment of Hypomagnesemia?

Answer 25

• D/C Loop diuretics- Supplement food/oral/IV (MgSO4)

Question 26

Causes of Hypermagnesemia?

Answer 26

- Excess Mg (Antacid/laxative)- ↑Mg Intake- ↓Renal excretion

Question 27

Hypermagnesemia S/S?

Answer 27

- Drowsiness- ↓HR/ Bradycardia- Danger of cardiac arrest- Depressed CNS→ Coma

Question 28

Treatment of Hypermagnesemia?

Answer 28

- IV (No Mg)- Ca+ (Reverses effect of hyper-Mg)- Lasix

Question 29

--Phosphorus--Where Found?Normal Levels?Function?

Answer 29

-ICF & ECF- 2.4-4.4- Acid-base balance, Bone, & all body tissues

Question 30

Causes of Hyperphosphatemia?

Answer 30

- Cancer treatment- Renal insufficiency- Hypoparathyroidism- ↑intake (Diet)

Question 31

Hyperphosphatemia S/S?Treatment?

Answer 31

S/S: ↓ Ca+Treatment: Manage Hypocalcemia

Question 32

Causes of hypophosphatemia?

Answer 32

- Malnutrition/starvation- Hyperalimentation- Hyperparathyroidism- RR Alkalosis- Hypercalcemia- Alcohol- Renal failure- Uncontrolled diabetes

Question 33

Hypophosphatemia S/S?Treatment?

Answer 33

[Inverse to calcium]S/S: Renal failure, ↑Ca+, & RhabdomyolysisTreatment: Supplement oral/IV, ↑P, ↓Ca+

Question 34

[Bicarbonate]Normal Ranges tor Arterial/Venous?What Regulates it?

Answer 34

- Arterial: 22-26mEq/L- Venous: 24-30mEq/L- Kidneys regulate

Question 35

Causes of Hypovolemia?

Answer 35

- GI Losses- Skin loss (Diaphoresis)- Renal Losses- 3rd spacing- Hemorrhage- Altered intake (NPO)

Question 36

Hypovolemia S/S?

Answer 36

- Hyperthermia- Tachycardia/Thready pulse- Hypotension & Ortho Hypotension- ↑Hct- Oliguria (↓urin output)- Dehydration- ↑Protein, BUN, electrolytes, & glucose

Question 37

Treatment of hypovolemia?

Answer 37

- Check Vitals/ I&O's (Hypotension/Ortho Hypotension)- Weigh daily (same time/scale)- Replace fluids (isotonics)

Question 38

Causes of hypervolemia?

Answer 38

- Chronic Kidney Stimulus (HF, Cirrhosis, Glucocorticosteroids)- Abnormal Renal function (failure)- Excessive Na+ intake- H2O replacement w/o electrolye replacement

Question 39

Hypervolemia S/S?

Answer 39

- ↑HR, P, BP, & Central venous pressure- Confusion- Muscle weakness- ↑weight/ ascites- Dyspnea/crackles- Edema/ Distended Neck Veins

Question 40

Treatment of Hypervolemia?

Answer 40

[Venous pooling]- Elevate extremity- Measure Circumference Daily[Pulmonary congestion]- Elevate HOB- Auscultate lungs[Edematous skin]- Assess frequently- Reduce pressure points- Reposition Q2

Question 41

Normal Saline (0.9%), D5W, & Lactated ringers are examples of what "type" of solution?

Answer 41

Isotonic

Question 42

0.25 & 0.45% Saline, & 2.5% Dextrose are considered what "types" of solution?

Answer 42

Hypotonic

Question 43

5% dextrose in 0.45% saline, D5NS, & 5% dextrose in lactated ringers are examples of what "type" of solution?

Answer 43

Hypertonic

Question 44

[Normal Levels; Blood] Hemoglobin?Hematocrit?RBC?WBC?Neutrophils?Lymphocytes?

Answer 44

Hemoglobin: 12-18g/dLHematocrit: 37-52%RBC: 4.2-6.1WBC: 5,000-10,000Neutrophils: 55-70Lymphocytes: 20-40

Question 45

[Normal Levels; Electrolytes]Sodium?Potassium?BUN?Creatinine?Glucose?Chloride?

Answer 45

Sodium: 136-145Potassium: 3.5-5BUN: 10-20Creatinine: 0.5-1.2Glucose: 70-110Chloride: 98-106

Question 46

[Normal Levels; ABG's]pH?Pco2?Po2?HCO3?O2 Sat?

Answer 46

pH: 7.35-7.45Pco2: 35-45Po2: 80-100HCO3: 21-28O2 Sat: >95%