Fluid/Electrolyte Balance

Description

College - Junior Adult Health Flashcards on Fluid/Electrolyte Balance, created by ddj2866 on 27/10/2013.
ddj2866
Flashcards by ddj2866, updated more than 1 year ago
ddj2866
Created by ddj2866 over 10 years ago
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Resource summary

Question Answer
Serum level Sodium 135-145 mEq/L
Critically Low Limit: Sodium <115mEq/L
Critically High Limit: Sodium >155 mEq/L
Serum level Potassium 3.5-5.0 mEq/L
Serum level: Calcium 8.5 - 10.5 mg/dL
Serum level: Magnesium 1.2 - 2.1 mEq/L
Serum level: Phosphorus 1.8 - 2.6 mEq/L
Critical Low: Potassium <3.0 mEq/L
Critical Low: Calcium < 7mg/dL
Critical Low: Magnesium <1.0 mEq/L
Critical Low: Phosphorus <1.0mg/dl
Critical High: Potassium > 6.4 mEq/L
Critical High: Calcium >12mg/dL
Critical High: Magnesium >3 mEq/L
Critical High: Phosphorus >5mg/dL
S/S: cerebral edema and increased ICP, mental status changes, decreased LOC, lethargy, confusion, muscle twitching, weakness, hyperreflexia, headache, personality change, hemiparesis, seizures, muscle cramps, exhaustion, anorexia Hyponatremia
S/S: thirst, altered neuro-function, restlessness, weakness, disorientation, lethargy, delusions, stupor, convulsions, coma, dry swollen tongue, increased temp, increased excitability/conductivity of nerve cells, muscle irritability and twitching, peripheral/pulmonary edema or postural hypotension Hypernatremia
S/S: fatigue, muscle weakness, leg cramps, paresthesia, confusion, slowed GI motility, N/V, anorexia, flat T waves, depressed ST, elevated U wave, dig. toxicity, cardiac/respiratory arrest hypokalemia
peaked narrow T waves, prolonged PR, widened QRS may progress to atrial systole, dysrhythmias, heightened neuromuscular activity, speeds up GI: diarrhea, abdominal cramping, anxiety irritability, paresthesia, muscle tremor, twitching muscle weakness, flaccid paralysis, respiratory paralysis hyperkalemia
tetany, convulsions, tingling numbness, hyperactive reflexes, positive Chvostek's and Trousseau's signs, bronchospasms, abd. pain, laryngospasm, respiratory arrest, impaired memory, confusion, delirium, depression, prolonged QT and ST, V-tach hypocalcemia
muscle weakness, incoordination, anorexia, constipation, abd. pain, bone pain, abd. distention and paralytic ileus, confusion, impaired memory, slurred speech, lethargy, acute psychotic behavior, coma, short QT and ST, renal calculi hypercalcemia
hyperexcitable muscles with weakness, tremor, tetany, seizures, laryngeal spasms, positive Chvostek's and Trousseau's, dysrhythmias, mood alterations, apathy, depression, apprehension, agitation, dizziness, insomnia, confusion, paresthesia, dysphagia hypomagnesemia
CNS depression, peripheral vasodilation, low BP, N/V, soft tissue calcification, facial flushing, feeling warm --> increases to lethargy, difficulty speaking, drowsiness, decreased/absent DTR, muscle weakness --> >10mEq coma, A/V block, cardiac arrest hypermagnesemia
irritability, fatigue, paresthesia, confusion, seizures, apprehension, weakness, numbness, coma, muscle damage weakness and pain, impaired ventilation due to respiratory muscle weakness, platelet dysfunction (bruising/bleeding), altered granulocyte function, anorexia, dysphagia, N/V decreased motility of GI hypophosphatemia
tetany, hypocalcemia, anorexia, N/V, muscle weakness, hyperreflexia, tachycardia hyperphosphatemia
Caused by: vomiting, diarrhea, fistulas, excess sweating, diuretics, aldosterone deficiency, excessive water: water intoxication, GI irrigation, electrolyte poor fluids,tap water enemas hyponatremia
causes: hypertonic enteral formulas and IV solution, salty foods, medications, drowning in salt water, water loss: altered thirst mechanism, NPO/elderly water deprivation, watery diarrhea, burns, diaphoresis, fevers, hyperfunction of aldosterone, diabetes insipidus, osmotic diuresis (Hyperglycemia) hypernatremia
Causes: diuretics, sodium-antibiotics, penicillin, glucocorticoids, osmotic diuresis, DM, hyperaldosteronism (CHF, renal disease, cirrhosis, adrenal adenomas), vomiting, diarrhea, laxative overuse, excessive ileostomy drainage, suction, extended therapy without X - replacement, alkalosis, burns, trauma, starvation, high insulin hypokalemia
high x intake, decreased excretion by kidneys (renal disease x-sparing meds, hypovolemia, adrenal insufficiency, rapid infusion of blood, metabolic acidosis, hyperglycemia, crush injuries, burns, trauma, severe infection, chemo hyperkalemia
Causes: large transfusion of citrated blood, decreased PTH, alkalosis, rapid infusion of IV phosphate, cimetidine, phenytoin, heparin, loop diuretics, MgSO4, gentamicin, decreased absorption due to bowel disease, deficient vit D/sunlight, acute pancreatitis, hypoparathyroidism, bed rest/decreased mobility hypocalcemia
Causes: hyperparathyroidism, malignancies of the bone, lack of stress on bone, paget's disease, multiple fractures, addison's disease, overuse of antacids, excess milk intake, IV od, thiazide diuretics hypercalcemia
Causes: alcoholism, esp with withdrawal, GI tract, NG suction, diarrhea, fistulas, IBD, disruption of bowel function, starvation, aminoglycosides, cyclosporin, diuretics, digitalis, rapid infusion of citrated blood, DKA, sepsis, burns, hypothermia Hypomagnesemia
renal failure, excessive antacid use or laxative use, excessive Mg, adrenocortical insufficiency, addison's disease, hypothermia hypermagnesemia
TPN with insufficient x, severe protein-cal malnutrition, aloholism, anorexia nervosa, prolonged intense hyperventilation, DKA, major burns, metabolic or respiratory acidosis, antacids, excess calcium, vomiting/diarrhea, decreased absorption, increased renal excretion, glycosuria, polyuria, diuretics hypophosphatemia
Causes: Renal failure, chemo, hypoparathyroidism and decreased calcium, respiratory acidosis, DKA, increased intake, muscle necrosis, hyperthyroidism Hyperphosphatemia
Tx: increase intake, if hypovolemia - isotonic LR or NS, GRADUAL increase! If VERY low - hypertonic NS, ICU care, and if hypervolemic - loop diuretics hyponatremia
Tx: gradually decrease, hypotonic IV solution, diuretics, restrict intake hypernatremia
replace with oral supplement, salt substitutes, IV supplement, KCL (NEVER BOLUS) hypokalemia
Restrict x, calcium gluconate, monitor EKG, IV sodium bicarbonate, hypertonic dextrose and insulin for temporary shift, beta2agonist, kayexalate, dialysis hyperkalemia
oral supplement, or IV calcium gluconnate, but gradually as rapid infusion could cause bradycardia and cardiac arrest, may cause dig. toxicity hypocalcemia
Tx: treat cause, IV fluids to promote excretion, restrict in diet, give IV phosphorus, lop diuretics, calcitonin IM, mithramycin hypercalcemia
Tx: diet (peanut butter, chocolate, green leafy veggies, nuts) x salts - be careful they may cause diarrhea in excess, IV hypomagnesemia
restrict intake, DC antacids/laxatives, give calcium to antagonize, resp. support, loop diuretics and hypotonic saline hypermagnesemia
Tx: replace orally of if <1mg/dl give IV hypophosphatemia
Tx: treat underlying cause, restrict x-rich foods (cheese, cream, nuts, whole grains, dried fruits), restrict meds, increase GI/urinary elimination hyperphosphatemia
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