Fluid and Electrolytes
Plan of care for Hypernatremia
Expect Provider to order chem profile- serum sodium + osmolality, BUN, Creatinine
Urine SG
Replace lost water or remove excess sodium gradually
nursing intervention for hypokalemia
administer ordered potassium replacement, order frequent labs, potassium rich foods
NEVER IV PUSH POTASSIUM
infused 10 mEq/hr
causes of hypocalcemia
surgeries in thyroid area, massive blood transfusions, decreases GI absorption
nursing intervention for hypercalcemia
correct underlying cause, dialysis, isotonic NS, increase fluid intake to prevent calculi
nursing interventions for resp acidosis
provide supplemental O2, maintain hydration, bronchodilators
Causes of hypokalemia
diuretics, kidneys are effected, GI tract
nursing intervention for hyperkalemia
I&O, kayexelate, D5W with insulin, renal function test, check ABG+chem , potassium restriction
causes of hypercalcemia
hyperthyroidism, bone disease, immobility, excessive calcium supplements, thiazide diuretics
clinical manifestation of respiratory acidosis
increase pulse and respiratory rate, headache, dizziness, confusion, muscle twitching
nursing intervention for resp alkalosis
if caused by anxiety, encourage to calm down adn relax
if another cause, treat underlying problem
causes of hyperkalemia
renal failure, high K+ intakes, rapid IV infusion, excessive salt, trauma, hypoaldosterone
potassium rich foods
potatoes, tomatoes, avocados, bananas, oranges, peas, raisins, cantaloupe, cauliflower, strawberries
clinical manifestations of hypocalcemia
trousseau's signs, dysrrythmias, increase bowel sounds, tetany, twitching, seizures, chvosteks sign, hypotension, numbness in extremities
clinical manifestation of respiratory alkalosis
confusion, headache, tingling, palpitation, tremors, headache
nursing intervention for metabolic acidosis
treat underlying problem
bicarb may be ordered
clinical manifestation hypokalemia
(weak) weak and irregular pulse, elevate for hyporeflexia, arrythmias, K<3.5, fatigue
What does Calcitonin do?
takes calcium out of the blood and puts it back into the bone
clinical manifestations of hypercalcemia
neurological, GI symptoms, cardiac effects, kidney stones, muscle weakness, constipation, nausea/vomiting, polyuria+polydypsia
clinical manifestations of metabolic acidosis
confusion, peripheral vasodilation, nausea and vomiting, kussmauls breathing, frequently associated with hyperkalemia
nursing intervention for metabolic alkalosis
treat underlying cause
clinical manifestation of hyperkalemia
(DEATH) dysrrythmias, ECG changes, abdminal cramping, twitching muscles, hypotension
hypotension, irritability, restlessness,
what does parathyroid hormone (PTH) do?
takes calcium out of the bone and puts it into the blood stream.
nursing intervention for hypocalcemia
calcium supplements, seizure and safety precautions, IV calcium
clinical manifestation for metabolic alkalosis
dizziness, tingling in extremities, hypertonic muscles, decreased respiratory rate and depth
phosphate =
magnesium =
muscle contraction
muscle relaxation