Team A
What cations are most abundant in blood and intracellular fluid?
Sodium and Potassium
What signs or symptoms may the nurse see in a patient who has fluid excess?
Peripheral edema, changes to urine output, & crackles in the lungs.
What electrolytes can be impacted by GI problems?
Sodium, Potassium, Magnesium, Calcium, and phosphate.
What electrolytes could be low for a patient with vomiting and diarrhea?
Magnesium, phosphate, potassium, calcium, and sodium.
What are 5 causes of hypovolemia? And how can you treat them?
Decreased H2O intake, excess fluid out, blood loss, vomiting, diarrhea, burns, GI suction, and drains. Treat by correcting the problem.
Name one food the nurse could educate a patient with hypomagnesemia to include in their diet?
Bananas, chia seeds, chick breast, peanuts, almonds, spinach, and salmon.
What hormone causes an increase in calcium levels? Explain
Parathyroid hormone (PTH). PTH is released when Ca level is low and signals the body to retain Ca. patients who have had a thyroidectomy may have difficulty maintaining adequate Ca levels.
What types of food should be limited for a patient who has a sodium level of 163 mEq/L?
Processed meats, cheeses, bakery items, most canned items, chips, crackers, and table salt.
What are at least three commonly seen signs and symptoms of hyponatremia?
Headache, confusion, seizure, increased bowel motility, nausea, cramping, dry mucosa membranes, increased urinary output, and late-stage coma.
Name one type of food that should be avoided with a patient who has hyperphosphatemia?
Dairy, soda, meats, nuts & seeds, and canned fish, lentils & beans, and bran cereals.
What are three common signs or symptoms a patient with hypokalemia may experience?
Generalized weakness, paresthesia, muscle cramping, ECG changes, hypoactive bowels, N/V, confusion, anorexia, anxiety, & alkalosis.
Name one type of food that should be limited in a patient who has a potassium level of 5.3 mEq/L?
Potatoes, avocado, spinach, banana, salmon, melons, dried fruit, broccoli, and organ/preserved meats.
Define osmosis and name a hypertonic IV fluid?
Osmosis is the process of a higher particulate solution moving to an area of lower particulates. Hypertonic fluids like Dextrose 10%, D5 0.45NaCl, and 3% NaCl can be used to move fluid from intracellular to extracellular space.
What assessment findings does the nurse anticipate in a client with a magnesium level of 1.3 mEq/L?
EKG changes, tachycardia, rapid shallow respirations, irritability, insomnia, cramping, clonus, seizures, positive Chvostek’s/Trousseau’s, and hyperactive deep-tendon reflexes.
What is one possible cause for hypermagnesemia?
Causes: increased intake such as IV replacement, foods, or medications with Mg (some antacids and laxatives), and decreased renal excretion.
What are three major causes of hypernatremia?
Fluid loss, sweating, excess processed foods, tube feedings w/o water supplement, renal impairment, hyperaldosteronism (too much aldosterone), and poor water intake.
Name one intervention that may be used to treat a potassium level of 3.2 mEq/L?
Give K supplement PO or IV piggyback (not push), give potassium-rich foods stop k-wasting diuretics, medicate to stop vomiting/diarrhea, and stop sweating.
What is one possible intervention for a patient with a sodium level of 122 mEQ/L?
Safety, Isotonic IV solutions (LR, D5W, NS)
What might the nurse see on the assessment of a patient with a calcium level of 8.2 mg/dL?
Increased cell excitability, increased bleeding risk, dyspnea, increased DTRs, cramping, confusion, seizures, laryngeal spasms, dysrhythmias, and fractures d/t decreased bone density.
Explain two interventions that may be used to treat a potassium level of 6.0 mEq/L?
Dialysis, K wasting diuretic (furosemide or HCTZ), stop po or IV K, give kayexalate (sodium polystyrene sulfonate) or, give insulin and dextrose.
What are three causes of Hyperkalemia?
Renal impairment, overuse of potassium replacements, excess intake of K+ foods, trauma to cells, acidosis, adrenal insufficiency, K-sparing diuretic (ex. spironolactone)
A hypertonic intravenous (IV) fluid is used to move fluid to shift in what direction?
Intracellular to extracellular (intravascular). Hypertonic solutions are of a greater concentration than normal bodily fluids.
Name one sign & symptom and one cause for hypophosphatemia?
S/S: Decreased cardiac contractility/cardiac output, slow pulse, shallow respirations, weakness, decreased DTR, and rhabdomyolysis. Causes: starvation, malnutrition, hyperparathyroidism, hyperglycemia, respiratory alkalosis, and malignancy.
What type of patient might the nurse see a positive Chvostek’s or Trousseau’s sign? And name one type of patient most at risk for this finding?
Hypocalcemia: Chvostek’s sign – facial twitching after taping on the cheek. Trousseau’s- finger and hand spasms or palmar flexion when a BP cuff is inflated. Patients with Alcoholism, Crohn’s, and kidney diseases are at risk for hypocalcemia
List three interventions for hypervolemia? And why are they helpful?
Reduce fluid intake, administer diuretics, limit salt, daily weight, dialysis, strict I & O, and assessments for progress or worsening of the problem.
The nurse observes that a patient has an elevated calcium level. What does that nurse expect of the phosphate level?
A decrease in phosphate level. There is an inverse relationship to these electrolytes in most patients, the exception is some patients with end-stage renal disease.
If a patient has severe malnutrition they typically have a low serum albumin level. What electrolyte is most affected and elevated by a low serum albumin level?
Total serum calcium (Hypercalcemia)
What assessment findings does the nurse expect in a client with a magnesium level of 3.2 mEq/L?
Patients are seen as "Low & Slow" bradycardia, EKG changes, slow shallow respirations, fatigue, drowsy, lethargy, and decreased DTR
What kinds of electrolyte problems occur in a patient who has renal problems? Think under or over diuresis issues
Under leads to hyper-electrolyte problems and over diuresis leads to hypo- electrolyte problems.
What is the most accurate way for the nurse to evaluate the fluid balance of a patient with multiple draining wounds who is admitted for hypovolemia?
Obtain a daily weight.