NGN NCLEX Review 2024 Verified Guide

NGN NCLEX Review 2024 Verified Guide Normal Sodium level Hyponatremia 135-145 low sodium in the blood Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability Severe: gait changes, stupor, seizures, coma causes of hyponatremia Diuretics-Thiazide Drugs Causes of hyponatremia: Dietary Changes,Low Na diet, Excessive water intake with sweating Fad diets, Anorexia nervosa. GI vomiting, diarrhea, GI suctioning, Tap water enemas,diuretics, kidney disease Treatments for hyponatremia 0.9% NaCl, accurate I&O, vitals (pulse), watch for signs of water intoxication, monitor blood gases, watch for respiratory difficulties Hypernatremia high sodium in the blood Mild: thirst, rough dry tongue, dry sticky mucous membranes, tachycardia, fever, flushed dry skin Severe: disorientation, hallucinations, lethargy, irritability, seizure, coma causes of hypernatremia Causes: Dietary Changes-Excessive Salt intake Excessive IV Saline Deprivation of water GI Disorders (Watery Diarrhea) Decreased Renal Function Insensible Water Loss Heat Stroke Salt water drowning Head Injury Trauma treatments for hypernatremia restrict sodium intake, identify drugs that are sodium retaining, monitor Na levels daily, check for rales, edema in lower extremities, I&O, Urine specific gravity urine specific gravity level normal potassium levels hypokalemia 1.015 3.5-5.0 mEq/L low potassium nausea, vomiting, diarrhea, vertigo, ventricular arrhythmias, hypotension, polyuria, muscle cramps, alkalosis, lethargy causes of hyponatremia Potassium wasting diuretics Malnutrition; Alcoholism Renal Failure, Hyperaldosteronism Steroids GI Losses;laxative abuse,diarrhea,vomiting, gastric suctioning Trauma & injury, excessive sweating Alkalosis, Insulin treatments for hypokalemia oral supplements or food replacement, K Cl(20-40) meq, Kay Ciel, Kaochlor, oral potassium is extremely irritating to the stomach and should be diluted in water hyperkalemia Abd cramps Tachycardia Widened QRS high potassium Ventricular arrhythmia Cardiac Arrest Oliguria Numbness face, tongue, feet , hands causes of hyperkalemia Decreased renal function Excessive K intake, IV K Infusions K sparing diuretics -Aldactone,Dyrenium Metabolic Acidosis,Hypergylcemia Addisons disease Hemolysis, Chemotherapy Tissue damage, crush injuries, burns Drugs: Capotril,Cyclosporin, Heparin, Dig toxicity,Penicillin Salts, Beta Blockers treatments for hyperkalemia IV sodium bicarb Potassium restriction Kayexalate (sodium polystyrene sulfonate) Orally given every 4-6 hours and results occur in 1-2 hours Rectally given has a retention enema every 2-4 hours Enema removes K in 30-60 minutes Monitor labs and EKG normal calcium levels hypocalcemia 9.0-10.5 mEq/l low calcium in blood Tetany Prolonged Q-T wave Anxiety Irritability Confusion Convulsions Dietary: Lack of Ca intake, Inadequate Vit D or lack of protein, causes of hypocalcemia malabsorption Hypomagnesemia, Hyperphosphatemia GI: Chronic Diarrhea Pancreatitis Calcium Binders treatments of hypocalcemia Oral Calcium with Vit D bid 10% IV Calcium Gluconate in D5W Monitor serum Ca levels Monitor ECG, and Vital Signs Teach foods rich in Calcium tetany nervous disorders marked by intermittent spasms or tingling around mouth and hands and feet as well as muscle spasms of extremities and face Chvostek's sign the parotid gland HYPOcalcemia Trousseau's sign HYPOcalcemia hypercalcemia Muscle weakness Tiredness Lethargy a spasm of the facial muscles elicited by tapping the facial nerve in the region of a muscle spasm elicited by putting pressure on the upper arm high calcium Constipation, anorexia, N&V Depression Apathy Deep bone pain Calcium stones causes of hypercalcemia Increased PTH, Immobility Metastasis Neoplastic Disease -breast , prostate, melanomas, bone, others Cellular destruction, bone tumor Dietary increased calcium salts, or Vit D Diuretics, Thiazides Over use of Ca containing antacids Fluid volume deficit Signs and Symptoms Weight loss Decreased skin Turgor, too little fluid in the body Dry mucous membranes Thirst UOP less than 30mL/hr Weak rapid pulse Oliguria Postural Hypotension causes of fluid volume deficit Diarrhea GI suction Fever Sweating Hemorrhage Vomiting will lab values by high or low with fluid volume deficit?