Electrolyte Imbalances Galen College of Nursing
Questions With Complete Solutions
S/S Dehydration - ANSWER - low grade fever
- tachycardia
- weak thready pulse
- hypotension
- orthostatic hypotension
- decreased CVP
- tachypnea
- dizziness
- sunken eyeballs
S/S Fluid Overload - ANSWER -Changes in pulse rate and respiratory rate
-Lung sounds-crackles
-Edema
-Weight gain
-Neck and hand vein distention
-Confusion
-Decreased Hgb, Hct, and Protein
Sodium (Na) - ANSWER 135-145 mEq/L
Causes of Hyponatremia - ANSWER Diuretics
GI fluid loss/ suction
Diet
S/S Hyponatremia - ANSWER S tupor/coma
A norexia, N&V
L ethargy
T endon reflexes decreased
L imp muscles (weakness)
O rthostatic hypotension
S eizures/headache
S tomach cramping
Tx of Hyponatremia - ANSWER - give Na
- pt does not need water
- if having neuro problems: needs hypertonic saline (3% or 5% NS)
Causes of Hypernatremia - ANSWER MODEL:
Medications, meals
Osmotic diuretics
Diabetes insipidus
Excessive water loss
Low water intake
, S/S of Hypernatremia - ANSWER FRIED or SALTIER
--
Fever (low grade), flushed
Restless (irritable)
Increased fluid retention and increased BP
Edema (peripheral and pitting)
Decreased urinary output, dry mouth
SALTIER
--
Skin flushed, dry, flaky / Seizures
Agitation / Attention span decreased
Lethargy; Low grade fever
Thirst / twitching
Increased urine specific gravity
Edema (pulmonary)
Reduce cardiac contractility, urine output
Tx of Hypernatremia - ANSWER - restrict sodium
- dilute pt with fluids
- daily weights, I&Os, labs
Potassium (K) - ANSWER 3.5-5.0 mEq/L
Causes of Hypokalemia - ANSWER Actual total body potassium loss
~excessive use of meds such as diuretics and corticosteroids
~increased secretion of aldosterone (Cushing's Syndrome)
~Vomiting, diarrhea
~Wound drainage (gastrointestinal)
~Prolonged nasogastric suction
~Excessive diaphoresis
~Renal disease impairing reabsorption of potassium
Inadequate intake of potassium: NPO
Movement of potassium from the extracellular fluid to intracellular fluid
~alkalosis
~hyperinsulinism
Dilution of serum potassium
~Water intoxication
~IV therapy with potassium poor solutions
S/S of Hypokalemia - ANSWER Alkalosis
Shallow Respirations
Irritability
Confusion/Drowsiness
Weakness/ Fatigue
Arrhythmias/ Irregular Rate/ Tachycardia
Questions With Complete Solutions
S/S Dehydration - ANSWER - low grade fever
- tachycardia
- weak thready pulse
- hypotension
- orthostatic hypotension
- decreased CVP
- tachypnea
- dizziness
- sunken eyeballs
S/S Fluid Overload - ANSWER -Changes in pulse rate and respiratory rate
-Lung sounds-crackles
-Edema
-Weight gain
-Neck and hand vein distention
-Confusion
-Decreased Hgb, Hct, and Protein
Sodium (Na) - ANSWER 135-145 mEq/L
Causes of Hyponatremia - ANSWER Diuretics
GI fluid loss/ suction
Diet
S/S Hyponatremia - ANSWER S tupor/coma
A norexia, N&V
L ethargy
T endon reflexes decreased
L imp muscles (weakness)
O rthostatic hypotension
S eizures/headache
S tomach cramping
Tx of Hyponatremia - ANSWER - give Na
- pt does not need water
- if having neuro problems: needs hypertonic saline (3% or 5% NS)
Causes of Hypernatremia - ANSWER MODEL:
Medications, meals
Osmotic diuretics
Diabetes insipidus
Excessive water loss
Low water intake
, S/S of Hypernatremia - ANSWER FRIED or SALTIER
--
Fever (low grade), flushed
Restless (irritable)
Increased fluid retention and increased BP
Edema (peripheral and pitting)
Decreased urinary output, dry mouth
SALTIER
--
Skin flushed, dry, flaky / Seizures
Agitation / Attention span decreased
Lethargy; Low grade fever
Thirst / twitching
Increased urine specific gravity
Edema (pulmonary)
Reduce cardiac contractility, urine output
Tx of Hypernatremia - ANSWER - restrict sodium
- dilute pt with fluids
- daily weights, I&Os, labs
Potassium (K) - ANSWER 3.5-5.0 mEq/L
Causes of Hypokalemia - ANSWER Actual total body potassium loss
~excessive use of meds such as diuretics and corticosteroids
~increased secretion of aldosterone (Cushing's Syndrome)
~Vomiting, diarrhea
~Wound drainage (gastrointestinal)
~Prolonged nasogastric suction
~Excessive diaphoresis
~Renal disease impairing reabsorption of potassium
Inadequate intake of potassium: NPO
Movement of potassium from the extracellular fluid to intracellular fluid
~alkalosis
~hyperinsulinism
Dilution of serum potassium
~Water intoxication
~IV therapy with potassium poor solutions
S/S of Hypokalemia - ANSWER Alkalosis
Shallow Respirations
Irritability
Confusion/Drowsiness
Weakness/ Fatigue
Arrhythmias/ Irregular Rate/ Tachycardia
