Fluid and Electrolyte

Question 1

Hyponatermia Symptoms

Answer 1

poor skin turgor,
dry mucosa,
headache,
decreased salivation,
decreased blood pressure,
nausea,
abdominal
cramping,
neurologic changes

Question 2

Hyponatermia Treatment

Answer 2

sodium replacement with isotonic/hypertonic iv solutions
Water restriction
Med: Tovactin, Samsca
Assess Labs: sodium, potassium, BUN, creatine
Give dietary sodium
Loop diuretics and lithium can drop sodium

Question 3

Hypernatremia Symptoms

Answer 3

thirst
elevated temperature

Question 4

Hypernatremia treatment

Answer 4

Hypotonic iv solution
Diuretics
Assess for OTC sources of sodium

Question 5

Hypokalemia Symptoms

Answer 5

• ECG changes,
  dysrhythmias,
• dilute urine,
  excessive thirst,
  fatigue,
  anorexia,
• muscle weakness,
  decreased
  bowel motility,
• paresthesia

Question 6

Hypokalemia treatment

Answer 6

Replace K oral or diluted iv 20 or 40 in 100ml. no faster than 10 meq/hr
Must be on a pump
Monitor ECG, ABGs
Watch for Digitalis

Question 7

Hyperkalemia Symptoms

Answer 7

Cardiac changes
dysrhythmias,
muscle weakness,
paresthesias,
anxiety,
GI manifestations
crash cart nearby

Question 8

Hyperkalemia treatment

Answer 8

Give kayexilate enema for stable PT
Give iv insulin push and amp of D50
Limit dietary K
Check iv site for potency before giving meds

Question 9

Hypocalcemia Symptoms

Answer 9

tetany,
circumoral numbness (around lips)
paresthesias,
hyperactive DTRs,
*Trousseau sign,
*Chvostek sign,
seizures,
respiratory symptoms of dyspnea and
laryngospasm, (Emergancy) IV calcium gluconate
abnormal clotting, anxiety

Question 10

Hypocalcemia Treatment

Answer 10

IV of calcium gluconate for emergent situations
Seizure precautions
Oral calcium and vitamin D supplements
Exercises to decrease bone calcium loss

Question 11

Hypercalcemia Symptoms

Answer 11

polyuria,
thirst,
muscle weakness,
intractable nausea,
abdominal cramps,
severe constipation,
diarrhea,
peptic ulcer,
* bone pain, Flank pain, kidney stones
ECG changes,
dysrhythmias

Question 12

hypercalcemia Treatment

Answer 12

Treat cause (Cancer)
Give fluids (lasix)
Give oral bisphosphonate (suffix -nate) meds: have to take with a full glass of water and sit up for 30 minutes after
Give fiber

Question 13

Hypomagnesemia symptoms

Answer 13

Associated with alcoholism- get banana bag
Chvostek and Trousseau signs
tremors,
ECG changes and dysrhythmias

Question 14

Hypomagnesemia Treatment

Answer 14

Must be on a pump “Steal a pump”
Have to have adequate urine output
seizure precautions
Dietary teaching (green, leafy vegetables; beans, lentils, almonds, peanut butter)

Question 15

Hypermagnesemia Symptoms

Answer 15

**hypoactive reflexes,
drowsiness,
muscle weakness,
**depressed respirations, <8
ECG changes,
dysrhythmias,
cardiac arrest
Assessed in OB