Normal Range
135-145 mEq/L
What is sodium?
What two methods are commonly used to monitor fluid status?
Daily weights and intake and output (I&O).
How do you treat hyponatremia?
Administer IV fluids with Na
Eat foods with Na
Monitor V/S’s, I&O, labs
Administer hypertonic IV saline solutions as ordered
greater than 145, water deprivation, excess aldosterone secretion
What is Hypernatremia
What are the normal values for pH, PCO2, and HCO3-?
Normal pH = 7.35-7.45
Normal PCO2 = 35-45 mmHg
Normal HCO3- = 22-28
3.5-5.0 mEq/L
What is potassium?
What should be done for a patient with hypervolemia?
Administer diuretics or restrict fluids.
How do you treat hypokalemia?
Monitor V/A’s, especially heart rate and rhythm, labs (K+)
Cardiac monitor
Administer K+ supplements, IV fluids with K+ as ordered
Never IV bolus or IV push K+
Eat foods rich in K
If taking diuretics, make sure they are K sparing diuretics
Less than 3.5, use of potassium-wasting diuretics, alkalosis
What is hypokalemia
What health problems put a patient at risk for respiratory acidosis? Respiratory alkalosis?
Chronic lung disease, such as COPD
Hyperventilation, anxiety, and high altitude
9-10.5 mg/dL
What is calcium?
What is one clinical sign of dehydration?
Dry mucous membranes, low blood pressure, or increased heart rate.
How do you treat hypocalcemia?
Monitor heart rate & rhythm
Cardiac monitor
Fall and seizure precautions
Give Calcium and Vit D as ordered
Eat foods rich in Ca
greater than 5.0, acidosis, use of potassium-sparing diuretics, fluid volume deficit
What is Hyperkalemia
What would be a nursing action for a patient experiencing a severe anxiety episode and respiratory alkalosis and why?
Have the patient breathe into a paper bag. The patient is hyperventilating, causing the patient to lose CO2, resulting in respiratory alkalosis. Rebreathing the air in the paper bag provides more CO2 to correct the respiratory alkalosis.
98-106 mEq/L
What is chloride?
Name three types of IV fluid solutions?
Isotonic, hypertonic, and hypotonic solutions.
How do you treat hypomagnesemia?
Assess V/S’s, especially heart rate & rhythm
Cardiac monitor
Assess mental status, change LOC
Give Magnesium, assess swallowing before foods, fluids, and meds
Eat foods rich in MG
Avoid alcohol
Seizure precautions
below 1.3, positive chvostek's sign, hyperactive deep tendon reflexes
What is hypomagnesium
What health issues put a patient at risk for metabolic acidosis? What about metabolic alkalosis?
Acidosis: prolonged diarrhea, kidney issues, excessive ingestion of acid (such as salicylates)
Alkalosis: vomiting or suctioning, excessive ingestion of antacids
1.3-2.1 mg/dL
What is magnesium?
How do we lose fluid? 4 ways
Urine, Stool, Breathing, Skin
How do you treat hypermagnesemia?
Assess V/S’s, especially heart rate & rhythm
Cardiac monitor
Assess mental status, change loc
Assess neuromuscular status
Encourage increased oral intake, and increase IV fluids
Dialysis
Administer loop diuretic as ordered
Respiratory support as needed
Low magnesium diet
Serum level above 10.5, can create kidney stones, hypoactive reflexes
What is hypercalcemia
Interpret these ABGs:
1. pH: 7.33 CO2: 48 HCO3: 25
2. pH: 7.48 CO2: 30 HCO3: 26
3. pH: 7.30 CO2: 41 HCO3: 18
4. pH 7.52 CO2: 36 HCO3: 30
1. Resp Acidosis
2. Resp Alkalosis
3. Metabolic Acidosis
4. Metabolic Alkalosis