Blood Work
Hyponatremia
NA 125
This electrolyte imbalance can affect cardiac function specially.
Hypokalemia
Fluids running at this rate can be an example of an IV Bolus
500ml/hr to 999ml/hr
This can be given for nausea (three meds)
Zofran, Compazine, and Phenergan
What are some interventions for a patient with low potassium?
PO, Powder K, IV Bag repletion
Hypernatremia
NA 150
This electrolyte imbalance can be an example of fluid volume overload
Hypervolemia (too much water, excess sodium intake)
Your patient needs dextrose but isn't dehydrated. Why might you choose D5W over D5NS (dextrose in normal saline)?
D5W provides needed glucose without adding sodium, which is appropriate when the patient only needs sugar supplementation and doesn't require additional electrolytes.
Lasix
This treats fluid overload and / or edema
What are interventions for patients with a low magnesium?
PO or IV repletion
Hypokalemia
K 2.9
A nurse caring for a hospitalized patient with dehydration is told in the shift report that the
patient’s laboratory results have just come in. Will Sodium be high or low?
High! Above 145
A patient after surgery is receiving fluid resuscitation. Why could Lactated Ringer's be a fluid of choice?
Lactated Ringer's helps replace electrolytes lost while providing needed fluid volume.
Rapid-Acting (Insulin Aspart, Lispro, Glulisine)
Give this diabetes medication approx 5 minutes before meals
The pt is receiving an IVF of 60 mEq of potassium chloride in a 1000 mL solution of dextrose 5% in 0.45% saline. The pt states that the area around the IV site burns. What intervention does the nurse perform first?
Stop it.
Hyperkalemia
K 5.7
If a patient is in the hospital when should bloodwork/ electrolytes be checked?
Daily unless there is a vital critical that needs to be re drawn
Your patient is severely dehydrated with hypernatremia (high sodium). Why would 0.45% normal saline be a better choice than normal saline for this patient?
0.45% NS has less sodium than normal saline, helping to gradually correct hypernatremia while rehydrating the patient without worsening their high sodium levels.
These two medications can treat hyperkalemia
Kayexalate and Veltassa
What do you do if your pt has a critical lab/ electrolyte?
Notify provider, document, complete any interventions
Hypomagnesemia
Mg 1.3
Your pt has a low sodium level of 127, what are 3 interventions for this patient you can implement during your shift?
Your surgical patient has been NPO for 8 hours and is going into the OR in 1 hour. The surgeon orders normal saline. Why is NS an appropriate choice?
Normal saline maintains hydration and also provides a consistent IV access for medication administration and allows for quick volume expansion if needed during the procedure.
You should do this before giving insulin to a patient...
Check this blood sugar within an hour !
What are some factors affecting fluid and electrolyte imbalances for a patient?
Age: elderly more susceptible to fluid imbalances
Stress: increased fluid retention and decreased renal excretion
Weight: total body fluid disproportionate weight in people who are obese
Surgery: preoperative NPO, blood loss, stress, fluid drainage, and postoperative vomiting
Medical conditions: cardiac, hepatic, renal, and respiratory disorders