Fluids
This type of IV solution has the same osmolality as plasma and is used to expand intravascular volume.
What is isotonic solution (0.9% NS, LR, D5W initially)
Normal sodium range.
→ What is 135–145 mEq/L?
This sign of hypocalcemia occurs when the cheek is tapped, causing facial twitching.
→ What is Chvostek’s sign?
Normal blood pH range.
→ What is 7.35–7.45?
Formula for calculating IV drip rate in gtt/min.
→ What is (Volume × Drop factor) ÷ Time (min)?
Dry mucous membranes, tachycardia, hypotension, and increased urine specific gravity are signs of this condition.
→ What is dehydration (hypovolemia)?
Confusion, seizures, headache, nausea, cramps and weakness are symptoms of this sodium imbalance.
→ What is hyponatremia?
→ What is hypermagnesemia?
Too much magnesium = muscles too relaxed, everything slows down)
Decreased reflexes, hypotension, bradycardia, and respiratory depression are symptoms of this imbalance.
Normal ranges: PaCO₂ and HCO₃⁻.
→ What are 35–45 mmHg (PaCO₂) and 22–26 mEq/L (HCO₃⁻)?
Formula for IV pump mL/hr.
→ What is Volume (mL) ÷ Time (hr)?
The most important intervention for fluid overload is this.
→ What is fluid and sodium restriction (with diuretics if ordered)?
Thirst, dry mucosa (sticky), agitation, and seizures, coma tachycardia, dry skin poor skin tugor. Oliguria (low urine) are symptoms of this imbalance.
→ What is hypernatremia?
Tetany, seizures, numbness, Trousseau’s sign, and laryngospasm are symptoms of this imbalance.
→ What is hypocalcemia?
DKA, renal failure, and diarrhea are common causes of this acid-base imbalance.
→ What is metabolic acidosis?
Ordered: 1000 mL over 8 hours. What rate should the IV pump be set at?
→ What is 125 mL/hr?
Name three causes of dehydration.
→ What are vomiting, diarrhea, fever, diuretics, hemorrhage, burns, diabetes insipidus, or inadequate intake?
Muscle weakness, flattened T waves, ileus, and cramps are symptoms of this imbalance.
→ What is hypokalemia?
hypocalcium- low calcium calcium calms the nerves and muscles — so if it’s low, nerves/muscles go wild”)
What causes this?
Hypoparathyroidism
- Vitamin D deficiency/malabsorption
- Chronic kidney disease
- Pancreatitis (fat binds Ca²⁺)
- Hypoalbuminemia
- Citrate from massive transfusions
Vomiting, NG suction, and excess antacids are common causes of this imbalance.
→ What is metabolic alkalosis?
Electrolyte with an inverse relationship to phosphate.
→ What is calcium?
Daily weights, diuretics, fluid and sodium restriction, and lung sound monitoring are interventions for this condition.
→ What is fluid overload?
Peaked T waves, arrhythmias, and muscle weakness occur in this imbalance. Treatment includes calcium gluconate, insulin/glucose, or dialysis.
→ What is hyperkalemia?
Numbness/tingling (perioral, fingers, toes)
Muscle cramps, twitching
Tetany (sustained muscle contraction)
Chvostek’s sign: facial twitch when tapping the cheek
Trousseau’s sign: carpal spasm with BP cuff inflation
Hyperreflexia
Seizures
Hypoventilation due to COPD, drug overdose, or pneumonia may cause this imbalance.
→ What is respiratory acidosis?
This electrolyte is important for clotting, nerve transmission, and bone strength.
→ What is calcium?
This electrolyte should never be given IV push; it must be diluted and infused slowly while monitoring cardiac rhythm.
→ What is potassium (K+)?
Nursing interventions for Hyponatrenia
Restrict fluids if dilutional
- Administer hypertonic saline (3% NaCl) for severe cases (ICU)
- Monitor neuro status closely
- Seizure precautions
- Encourage sodium in diet if mild
hypocalcium symptoms effecting the heart
Prolonged QT interval
Hypotension
Dysrhythmias (can progress to ventricular arrhythmias)
Anxiety, fever, or pain may cause hyperventilation leading to this imbalance.
→ What is respiratory alkalosis?
This electrolyte is closely linked to potassium; both decrease with alcohol abuse and diuretics.
→ What is magnesium?
Low sodium = low and slow”
→ confusion, weakness, lethargy.
nursing interventions for hypocalcemia
Administer oral or IV calcium (IV calcium gluconate for acute/severe)
Vitamin D supplements to enhance absorption
Monitor airway and breathing (laryngeal spasm risk!)
Seizure precautions
Correct underlying cause (CKD, low albumin, low magnesium, etc.)
Educate on calcium-rich diet (dairy, green leafy vegetables, fortified foods)
Kussmaul respirations and fruity breath odor occur in this condition.
→ What is metabolic acidosis (DKA)?
High sodium = big and dry”
→ thirst, fever, restlessness, seizures
Low Calcium = Low Calm”
Muscles twitch, reflexes ↑, nerves irritable, heart rhythm unstable.
This electrolyte often rises in acidosis due to H+/K+ exchange.
→ What is potassium (hyperkalemia)?
nursing interventions for Hypernatremia
Treat underlying cause
- Give hypotonic fluids (0.45% NS, D5W) slowly to avoid cerebral edema
- Monitor I&O, daily weight
- Oral care for dry mouth
- Neuro checks, seizure precautions
nursing interventions
Administer calcium (oral or IV calcium gluconate)
- Vitamin D supplements
- Seizure precautions
- Monitor airway & breathing (laryngeal spasm)
- Correct underlying cause
nursing interventions for hypermagnesium
Stop magnesium intake (hold laxatives, antacids, IV Mg)
Administer IV calcium gluconate → magnesium antagonist that protects heart/muscles
Loop diuretics with IV fluids (if kidneys work) to flush out Mg²⁺
Dialysis if severe or renal failure
Continuous cardiac + respiratory monitoring
Educate patients with renal issues to avoid Mg-containing OTC meds