Electrolytes 1
The normal range for potassium is ________
3.5-5 mEq/L
Identify 3 functions of water
1. Transports nutrients & wastes, 2. transports hormones, enzymes, RBCs, WBCs, PLTs, 3. solvent for electrolytes, 4. helps maintain body temperature, 5. facilitates cell metabolism, digestion, & elimination, 6. acts as a tissue lubricant
135-145
Your patient is receiving 0.9% NS infusing at 250 mL/hr. While assessing your patient you note bilateral crackles in the lungs, JVD, swelling in both legs, & the patient has gained 4 lb since yesterday. What complication is likely occurring?
Fluid Overload/Edema
HYPERcalcemia is commonly associated with what?
Malignancy
The normal range for calcium is _____
8.5-10.5
0.9% NS, Lactated Ringers, Plasmalyte, & D5W are examples of what?
Isotonic Fluids
The nursing preceptor is reviewing HYPOmagnesemia with a nursing student. Which statements made by the nursing student about this condition are CORRECT? Select All That Apply
A. K+ & magnesium are directly related-when one is low the other is low
B. We should teach the patient to increase foods high in magnesium
C. Alcoholism & malnutrition are common causes of this condition
D. I would expect the patient to be flushed, have diminished DTRs, & decreased respirations with this condition
A. K+ & magnesium are directly related-when one is low the other is low
B. We should teach the patient to increase foods high in magnesium
C. Alcoholism & malnutrition are common causes of this condition
Your patient identifies themselves as a Jehovah's Witness & does not wish to receive blood products no matter what during their upcoming procedure. What alternative will you anticipate that the HCP write orders for?
Erythropoietin- Epogen or Procrit (administered IV or Subcut.)
What is the MAXIMUM rate we can administer potassium?
NO faster than 10 mEq/hr & NEVER EVER EVER EVER give it IV Push! This can cause cardiac & respiratory arrest....YIKES!
List 3 s/s that indicate HYPOcalcemia
Tetany, paresthesias, laryngeal spasms, seizures, heart block, hypotension, confusion, POSITVE TROUSSEAU and/or CHVOSTEKS SIGN
This type of fluid causes fluid to shift OUT of cells, causing cell shrinkage, increasing ECF.
Name at least one example.
HYPERtonic fluids; 3% NS, 5% NS, D5+ 0.9% NS, D5+LR, D10W
Your patient's most recent lab studies show a serum sodium level of 115 mEq/L, which would you most likely expect to observe?
A. Fissured, beefy red tongue
B. Tall peaked T waves on ECG
C. Positive Chvostek's sign
D. Cerebral edema
D. Cerebral edema
____________ are isotonic volume expanders that contain electrolytes & increases circulatory volume without altering the chemical balance in vascular system
____________ are gelatinous solutions used to improve circulatory volume & stay in circulation longer, but carry a risk of anaphylaxis & volume overload
Crystalloids (0.9% NS, LR, D5W)
Colloids (albumin, dectran, hetastarch, gleofusine, haemaccel)
Your patient is prescribed furosemide (Lasix) IVP for hypertension. Which electrolyte imbalance will you closely monitor for?
A. Hypercalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hypernatremia
B. Hypokalemia
You are taking care of multiple patients with electrolyte imbalances. Which patient lab result is MOST concerning to you?
A. Patient A with serum sodium of 148
B. Patient B with serum calcium of 8.3
C. Patient C with serum potassium of 5.3
D. Patient D with serum magnesium of 1.2
C. Patient C with serum potassium of 5.3
Your patient was admitted with a diagnosis of hypovolemia. What do you expect to note on assessment? Select All That Apply
A. Edema
B. Weak, thready pulse
C. Hypotension with bradycardia
D. Hypotension with tachycardia
E. Dry mucosa
B. Weak, thready pulse
D. Hypotension with tachycardia
E. Dry mucosa
May also see oliguria, sunken eyes, increased cap refill (>3 sec), depressed fontanels, poor skin turgor, increased complaint of thirst
Your patient has had severe nausea with vomiting for several days. The patient had an NG tube placed on intermittent suction. What major electrolyte imbalance is the patient at risk for?
HYPOnatremia
Name the type of diuretic that will elicit the greatest degree of diuresis
Loop diuretics (i.e. furosemide (Lasix))
Your patient has end stage renal failure & in the last 3 hours has produced 30 mL of urine, has an increasing complaint of thirst, & their tongue is fissured. What do you expect their lab studies to show?
HYPERnatremia; >145
Your patient has just been admitted with HYPOcalcemia, which additional electrolyte imbalance might you worry is HIGH in this patient?
While administering a blood transfusion your patient develops a fever & is complaining of headache & low back pain. Identify the order in which you complete the following steps?
1. Notify the MD
2. Stop infusion
3. Obtain blood samples from the site
4. Keep IV patent & initiate NS infusion
5. send all components to blood bank
CORRECT ORDER
(2) STOP THE INFUSION
(4) Keep IV patent & initiate NS infusion
(1) Notify MD
(3) Obtain blood samples from site
(5) Send all components to blood bank
Your patient is recovering from a parathyroidectomy & is complaining of numbness & tingling around their lips & their face twitches when you tap their cheek. What electrolyte imbalance is the patient likely experiencing?
HYPOcalcemia
Urination, defecation, & wound drainage are examples of _________ losses
Sweat & water vapor from respirations are examples of _________ losses
Sensible Losses
Insensible Losses
You are assigned to an elderly client admitted with confusion & seizures. What electrolyte imbalance would you most likely suspect?
HYPernatremia