NURS 121 Electrolytes

jasmine's version from 2016-03-23 04:40

Section 1

Question Answer
Hypernatremia Mnemonic for signs and symptomsF.R.I.E.D
F in FriedFever (low grade, flushed skin)
R in FriedRestless (irritable)
I in FriedIncreased fluid retention and increased BP
E in FriedEdema (peripheral and pitting)
D in FriedDecreased urine output, dry mouth
Hyponatremia symptomsConfusion, headaches, seizures (can progress to coma), abdominal cramps, nausea, vomiting
Nursing interventions for hypernatremiaReduce sodium slowly; Treat underlying cause; diuretics; sodium restriction; and seizure precautions
Nursing interventions for hyponatremiaReplace sodium slowly; 3% normal saline; if caused by fluid excess, will need fluid restriction; usually cannot be fixed by adding sodium to the diet

Section 2

Question Answer
Hyperkalemia mnemonic for signs and symptomsM.U.R.D.E.R.
M in MurderMuscle weakness
U in MurderUrine, oliguria, anuria
R in MurderRespiratory distress
D in MurderDecreased cardiac contractility
E in MurderECG changes
R in MurderReflexes, hyperreflexia or areflexxia
Hypokalemia signs and symptomsDysrhythmias, weakness, nausea, vomiting, paralytic ileus, constipation, low BP, weak pulse, increased digoxin, toxicity, muscle weakness and paralysis, diuresis
Nursing interventions for hyperkalemiaCardiac monitor; kayexalate, calcium gluconate, or glucose and insulin IV; Furosemide (Lasix) if kidneys are functioning; stop potassium in IV fluids; have patient avoid foods high in potassium; dialysis if severe
Nursing interventions for hypokalemiaWatch for digoxin toxicity; Cardiac monitor; foods high in potassium; potassium IV (only if good urine output); Spirinolactone; treat constipation
Some potassium administration guidelinesMust have urine output; never give IV push; must be on cardiac monitor; assess IV site often (prefer CVC); always dilute and give no more than 20 mEq in a bolus (IVPB), no faster than 1 hr.; max concentration in IV fluids is 40 mEq/L

Section 3

Question Answer
Hypercalcemia signs and symptomsLarthary, confusion, muscle weakness, faster clotting times puting at risk for DVT, depressed reflexes, kidney stones, fractures
Hypocalcemia mnemonic for signs and symptomsC.A.T.S.
C in CatsConvulsions
A in CatsArrhythmias
T in CatsTetany
S in CatsSpasms and stridor
Nursing interventions for hypercalcemiaDiuretic (Furosemide); hydration with normal saline; fluid intake; synthetic calcitonin; weight bearing activity; mytherson: rehibits bone resorption; no antacids due to Ca+; If severe may need dialysis and cardiac monitoring
Nursing interventions for hypocalcemiaCalcium supplement; diet high in calcium; vitamin D

Section 4

Question Answer
Hyperphosphatemia signs and symptomsCalcium deposits in joints, skin, kidneys, eyes; hypocalcemia; tetany; neuromuscular irritability
Hypophosphatemia signs and symptomsCNS depression; confusion; muscle weakness; dysrhythmias; fractures
Nursing interventions for hyperphosphatemiaFix hypocalcemia
Nursing interventions for hypophosphatemiaNeutra-phosphate supplements; decrease calcium intake; IV phosphate (careful as can cause sudden hypocalcemia); stop antacids and calcium supplements

Section 5

Question Answer
Hypermagnesemia signs and symptomsLethargy, nausea, vomiting, loss of deep tendon reflexes, can have respiratory and cardiac arrest
Hypomagnesemia signs and symptomsConfusion, hyperactive deep tendon reflexes, tremors, seizures, cardiac dysrhythmias
Nursing interventions for hypermagnesemiaAvoid magnesium-containing drugs; increase fluid intake; may need dialysis
Nursing interventions for hypomagnesemiaSupplements; increase green veggies, nuts, bananas, oranges, peanut butter, chocolate; IV or IM magnesium (if given too rapidly can cause cardiac or respiratory arrest)
Caution for hypermagnesemiaMaalox; Chronic kidney disease do not give Maalox or Milk of Magnesia

Section 6

Question Answer
General Rules for MedicationsDo not give at night; Commonly given with an anti-hypertensive; Most meds except for potassium-sparing diuretic will decrease potassium levels
Potassium is most commonElectrolyte given
LasixCause loss of potassium
KayexalateBinds to potassium to remove from body

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