Sodium
Nursing considerations for hypernatremia
What is monitor: I&O, daily weight, neuro and VS changes, skin and oral hygeine, dydration, and Na restriction. Educate: encourage fluids, NO added salt, avoid high sodium foods (milk, processed, ham, shimp, canned soup), awareness of "hidden" salt?
Nursing considerations of Hyperkalemia
What is eliminate oral and parenteral K intake, stop K infusion, withhold oral K, K restricted diet. Increase K elimination with diuretics & calcium gluconate, kayexalate (enema or PO), dialysis. monitor EKG?
Nursing considerations of hypercalcemia
What is treat cause, phosphate by mouth blocks absorption, IV saline followed by loop diuretics, hemodialysis?
Nursing considerations for hypermagnesemia
What is identify cause, D/C Mg products, IV diuretics, antidote is Calcium Gluconate?
What is the proper range for Na, K, Ca, and Mg?
Causes of hyponatremia
What is N/V/D, burns, diuretic use, water excess/intoxication, Increased fluid volume, cirrosis, CHF?
What is increased loss from V/D, NG suction, loop diuretics (furosemide), inadequate intake (NPO). Wound losses, burns, trauma. Excessive alcohol use, excessive sweating, and diabetic ketoacidosis?
Causes of hypocalcemia
What is surgery for thyroid/parathyroid, multiple blood transfusions, hypoparathyroidism. Decreased calcium/vitamin D intake, renal failure, chronic diarrhea. Meds: laxatives, glucocorticoids, diuretics. menopausal women?
Causes of hypomagnesemia
What is increased magnesium sulfate output, malnutrition, proton pump inhibitors, diuretics, alcoholism, rapid admin of citrated blood?
Nursing considerations of hyponatremia
What is treat underlying cause, increase Na lvl slowly. Monitor: I&O, daily weights, VS, LOC, resp status (if muscle weakness. Encourage foods high in sodium, restrict fluids (if related to excess water), sports drinks in demanding physical activity, change positions slowly.
Causes of hypernatremia
What is vomiting, water deprivation, hypertonic saline and meds, age-related changes, increased sweating, overall decreased fluid volume?
Causes of Hyperkalemia
What is increased retention from renal failure, oliguria, burns, meds (potassium sparing diuretics, NSAIDS, ACE inhibs), diabetic ketoacidosis. Increased intake (salt substitutes). Older adults increased risk due to decreased kidney Fx.
Causes of hypercalcemia
What is hyperparathyroidism, cancer, prolonged immobilization, increased calcium intake, long-term glucocorticoid use, thiazide diuretics? Tums also contribute to calcium buildup.
Causes of hypermagnesemia
Renal insufficiency or failure, increased intake of magnesium products
Nursing considerations of hypokalemia
What is treat underlying cause, monitor: H rhythm &pulse, LOC. Ensure safety. Replacement PO (KCl w 6-8oz H2O). Education knw S?S, diet, prevention & follow-up. Never push IV K. IV replacement mixed by pharmacist (1 meq/10mL) and 2 RN's check. Do NOT administer >10-20meq/hr. If painful in periheral veins, discontinue IV and call HCP. Urine output should be >0.5ml/kg/hr.
Symptoms of hyponatremia
What is N/V, irritability, confusion, apprehension, hyperactive bowel sounds, decrease in DTRs, tremors, seizures, coma, tachycardia, decreased BP?
Symptoms of hypokalemia
What is muscle weakness (legs), muscle cramping. Increased digoxin toxicity. Arrhythmias, bradycardia, weak irregular pulse. Decreased gastric motility, paralytic illeus. Rhabdomylysis (muscle wasting K moves into cell)?
Symptoms of hypocalcemia
What is numbness, tingling, tetany, seizures, arrhythmias, hyperactive deep tendon reflexes, hyperactive bowl sounds, diarrhea. Positive Chvostek and Trousseau's signs. muscle cramping?
Symptoms of hypomagnesemia
What is tachycardia, HTN, dysrhythmias, Torsades de Pointes, N/V/D, some constipation, hypoactive bowel sounds, increased DTRs, muscle weakness, twitching, cramping, tetany, positive Chvostek's?
Nursing considerations of hypocalcemia
What is replacement with calcium glucaonate and Vitamin D. Diet: increase dairy products (cheese yogurt, almond and soymilk) canned fish w bones, broccoli, dark leafy greens, oranges and OJ fortified w Ca. Monitor neck/thyroid surgery clients. Initiate seizure precautions, emergency equipment on standby?
Symptoms of hypernatremia
What is thirst, dry mouth, dry flushed skin, tented skin, sticky mucous membranes, swollen dry tongue, seizures, lethargy, irritability, confusion?
Symptoms of hyperkalemia
What is muscle weakness (legs), irritability, confusion. Abdominal cramps, diarrhea, hyperactive bowel sounds. Arrhythmias, slow, irregular pulse?
Symptoms of hypercalcemia
What is confusion, heart irregularities, muscle weakness, kidney stones, constipation, N/V, bone pain, lethargy, malaise?
Symptoms of hypermagnesemia
Decreased LOC, lethargy, bradycardia, hypotension, dysrhythmias. Severe: decreased resp, DTRs. Cardiac arrest?
Nursing considerations for hypomagnesemia
What is replae Mg thru IV. Monitor: DTRs and seizure precautions. Diet: increase Mg (meat, nuts,whole grains, legumes, dark leafy greens, bananas, salmon, soybeans)?