Electrolyte Imbalances Study Guide Test
with 100% Solutions
What kind of relationship do calcium and magnesium have? - ✅✅ Parallel (they
tend to run together)
Describe the relationship between magnesium and blood pressure. - ✅✅
Magnesium causes vasodilation and a decrease in peripheral vascular resistance,
thereby decreasing blood pressure
What specific changes would you expect to see on the ECG of a hypomagnesemic
patient? - ✅✅ Premature ventricular contractions, ventricular tachycardia, and/or
ventricular fibrillation
What is Babinski's sign? What is it indicative of? - ✅✅The big toe bends up and
back to the top of the foot and the other toes fan out
Positive Babinski is seen in babies and should always be negative in adults, but can
be positive if there is hypomagnesemia
Describe appropriate interventions for hypomagnesemia. - ✅✅ In mild cases:
promote increased magnesium intake through diet and magnesium salts
In severe cases: MgSO4 IM or slow IV drip
Generally: Monitor LOC, serum levels q12 hours, vital signs, swallow and patellar
reflexes, implement seizure precautions
What specific changes would you expect to see on the ECG of a hypermagnesemic
patient? - ✅✅ Bradycardia, tall T waves
Describe appropriate interventions for hypermagnesemia. - ✅✅ Hold
magnesium-containing products, administer calcium chloride or calcium gluconate
IV for acute symptoms, administer IV fluids and diuretics, monitor vital signs,
LOC, and patellar reflexes
Be able to identify the different areas on the charting "fish" for electrolytes.
1: Sodium (Na+)
,2: Potassium (K)
3: Chloride (Cl)
4: Carbon Dioxide (CO2)
5: Blood Urea Nitrogen (BUN)
6: Creatinine
7: Glucose
The nurse is caring for a patient with a pituitary tumor. The nurse assesses the
urine and reviews the lab results. The urine specific gravity is 1.075 and urine
output is minimal. What would the nurse expect the sodium level to be in this
patient?
A) 140
B) 155
C) 135
D) 125
- ✅✅ D) 125
Which patient is at more risk for an electrolyte imbalance?
A) An 8 month old with a fever of 102.3 'F and diarrhea
B) A 55 year old diabetic with nausea and vomiting
C) A 5 year old with RSV
D) A healthy 87 year old with intermittent episodes of gout
- ✅✅A) An 8 month old with a fever of 102.3 and diarrhea
The 8 month old with a fever of 102.3 ‘F and diarrhea is the correct answer. Infants
(age 1 and under) and older adults are at a higher risk of fluid-related problems
than any other age group. This is because infants have the highest amount of total
body fluid (80% of the body is made up of fluid) and if any type of illness
especially GI effects the body this increases the chances of an electrolyte
imbalance.
A patient is admitted to the ER with the following findings: heart rate of 110
(thready upon palpation), 80/62 blood pressure, 25 ml/hr urinary output, and
Sodium level of 160. What interventions do you expect the medical doctor to order
for this patient?
A) Restrict fluid intake and monitor daily weights
B) Administer hypertonic solution of 5% Dextrose 0.45% Sodium Chloride and
monitor urinary output
C) Administer hypotonic IV fluid and administer sodium tablets
D) No interventions are expected
, - ✅✅ B) Administer hypertonic solution of 5% Dextrose 0.45% Sodium
Chloride and monitor urinary output
The patient must be re-hydrated and the sodium levels should be decreased at the
same time. So a hypertonic solution of 5% dextrose and 0.45% NA will help do
this. The solution is hypertonic because of the 5% Dextrose which will rapidly
metabolize to the cells. When the dextrose metabolizes to the cells it leaves behind
0.9% NA which acts as a isotonic solution. This allows the 0.45% NA to act as a
hypotonic solution to repair the vascular compartment. After these fluids are
infused the patient’s NA level should decrease, BP increase, HR return to normal
etc. It is a complicated physiological process because the Dextrose has unique
capabilities when it is metabolized….although the solution is labeled as hypertonic
it becomes a hypotonic solution when the Dextrose is metabolized by the cells.
After obtaining an EKG on a patient you notice that ST depression is present along
with an inverted T wave and prominent U wave. What lab value would be the
cause of this finding?
A) Magnesium level of 2.2
B) Potassium level of 5.6
C) Potassium level of 2.2
D) Phosphorus level of 2.0
- ✅✅ C) Potassium level of 2.2
Hypokalemia (normal potassium levels are 3.5 to 5.1) will present with these type
of EKG findings.
Which patient below would have a potassium level of 5.5?
A) A 76 year old who reports taking lasix four times a day
B) A patient with Addison's disease
C) A 55 year old woman who have been vomiting for 3 days consistently
D) A patient with liver failure
- ✅✅ B) A patient with Addison’s disease
A patient with Addison disease suffers from increased potassium levels due to
adrenal insufficiency. Therefore, potassium levels higher than 5.1 may present in
patients with Addison’s disease.
with 100% Solutions
What kind of relationship do calcium and magnesium have? - ✅✅ Parallel (they
tend to run together)
Describe the relationship between magnesium and blood pressure. - ✅✅
Magnesium causes vasodilation and a decrease in peripheral vascular resistance,
thereby decreasing blood pressure
What specific changes would you expect to see on the ECG of a hypomagnesemic
patient? - ✅✅ Premature ventricular contractions, ventricular tachycardia, and/or
ventricular fibrillation
What is Babinski's sign? What is it indicative of? - ✅✅The big toe bends up and
back to the top of the foot and the other toes fan out
Positive Babinski is seen in babies and should always be negative in adults, but can
be positive if there is hypomagnesemia
Describe appropriate interventions for hypomagnesemia. - ✅✅ In mild cases:
promote increased magnesium intake through diet and magnesium salts
In severe cases: MgSO4 IM or slow IV drip
Generally: Monitor LOC, serum levels q12 hours, vital signs, swallow and patellar
reflexes, implement seizure precautions
What specific changes would you expect to see on the ECG of a hypermagnesemic
patient? - ✅✅ Bradycardia, tall T waves
Describe appropriate interventions for hypermagnesemia. - ✅✅ Hold
magnesium-containing products, administer calcium chloride or calcium gluconate
IV for acute symptoms, administer IV fluids and diuretics, monitor vital signs,
LOC, and patellar reflexes
Be able to identify the different areas on the charting "fish" for electrolytes.
1: Sodium (Na+)
,2: Potassium (K)
3: Chloride (Cl)
4: Carbon Dioxide (CO2)
5: Blood Urea Nitrogen (BUN)
6: Creatinine
7: Glucose
The nurse is caring for a patient with a pituitary tumor. The nurse assesses the
urine and reviews the lab results. The urine specific gravity is 1.075 and urine
output is minimal. What would the nurse expect the sodium level to be in this
patient?
A) 140
B) 155
C) 135
D) 125
- ✅✅ D) 125
Which patient is at more risk for an electrolyte imbalance?
A) An 8 month old with a fever of 102.3 'F and diarrhea
B) A 55 year old diabetic with nausea and vomiting
C) A 5 year old with RSV
D) A healthy 87 year old with intermittent episodes of gout
- ✅✅A) An 8 month old with a fever of 102.3 and diarrhea
The 8 month old with a fever of 102.3 ‘F and diarrhea is the correct answer. Infants
(age 1 and under) and older adults are at a higher risk of fluid-related problems
than any other age group. This is because infants have the highest amount of total
body fluid (80% of the body is made up of fluid) and if any type of illness
especially GI effects the body this increases the chances of an electrolyte
imbalance.
A patient is admitted to the ER with the following findings: heart rate of 110
(thready upon palpation), 80/62 blood pressure, 25 ml/hr urinary output, and
Sodium level of 160. What interventions do you expect the medical doctor to order
for this patient?
A) Restrict fluid intake and monitor daily weights
B) Administer hypertonic solution of 5% Dextrose 0.45% Sodium Chloride and
monitor urinary output
C) Administer hypotonic IV fluid and administer sodium tablets
D) No interventions are expected
, - ✅✅ B) Administer hypertonic solution of 5% Dextrose 0.45% Sodium
Chloride and monitor urinary output
The patient must be re-hydrated and the sodium levels should be decreased at the
same time. So a hypertonic solution of 5% dextrose and 0.45% NA will help do
this. The solution is hypertonic because of the 5% Dextrose which will rapidly
metabolize to the cells. When the dextrose metabolizes to the cells it leaves behind
0.9% NA which acts as a isotonic solution. This allows the 0.45% NA to act as a
hypotonic solution to repair the vascular compartment. After these fluids are
infused the patient’s NA level should decrease, BP increase, HR return to normal
etc. It is a complicated physiological process because the Dextrose has unique
capabilities when it is metabolized….although the solution is labeled as hypertonic
it becomes a hypotonic solution when the Dextrose is metabolized by the cells.
After obtaining an EKG on a patient you notice that ST depression is present along
with an inverted T wave and prominent U wave. What lab value would be the
cause of this finding?
A) Magnesium level of 2.2
B) Potassium level of 5.6
C) Potassium level of 2.2
D) Phosphorus level of 2.0
- ✅✅ C) Potassium level of 2.2
Hypokalemia (normal potassium levels are 3.5 to 5.1) will present with these type
of EKG findings.
Which patient below would have a potassium level of 5.5?
A) A 76 year old who reports taking lasix four times a day
B) A patient with Addison's disease
C) A 55 year old woman who have been vomiting for 3 days consistently
D) A patient with liver failure
- ✅✅ B) A patient with Addison’s disease
A patient with Addison disease suffers from increased potassium levels due to
adrenal insufficiency. Therefore, potassium levels higher than 5.1 may present in
patients with Addison’s disease.
