QUESTIONS AND CORRECT ANSWERS
◉severe hyponatremia. Answer: - EMERGENCY
- below 115
- give hypertonic saline if patient is symptomatic
- in ICU setting
*infused slowly in small amounts....be prepared to handle seizures*
◉hypokalemia ECG changes. Answer: - prolonged QT
- ST depression
*U WAVE is hallmark sign*
if you see a U wave then YOU need K+
◉hypokalemia. Answer: - 3.5 to 5
- muscle weakness
,◉hyperkalemia ECG changes. Answer: - tall tented T waves is the
earliest sign
- AV blocks
◉treating hyperkalemia. Answer: - Calcium chloric or gluconate to
antagonize cardiac abnormalities
- Bicarbonate for pt with acidosis
- IV insulin and 50% dextrose to shift K into cells
- kayexelate (fecal excretion of K)
- dialysis for ARF
◉hypocalcemia. Answer: 8.5 - 10.2
- tetany
- muscle cramps
- trousseau's and chvosteks sign
- colicky abdominal pain
◉treating hypocalcemia. Answer: - IV calcium gluconate or calcium
chloride (CENTRAL LINE)
, - consider seizure precautions
- replace Mg in addition to Ca because pt might not respond to Ca
treatment
◉hypercalcemia. Answer: caused by
- cancers and hyperparathyroidism
- excessive Ca and Vit. D supplements
- muscle weakness
- depressed CNS (confusion)
- dysrhythmias (prolong QT, AV block)
- abdominal pain
◉treating hypercalcemia. Answer: - administer IV NS to promote
diuresis
- administer loop diuretics
- corticosteroids to decrease absorption from GI
- phosphates to decrease breakdown of bones by inhibiting release
- dialysis
◉hypomagnesemia. Answer: - tetany
- weakness