Electrolyte Imbalances Review Questions
with Right Answers
Your client's lab results show that the client's serum calcium level is very elevated.
What signs and symptoms would the client exhibit? Select all that apply.
Dizziness
Diarrhea
Muscle spasms
Muscle weakness
Edema
- ✅✅ Muscle weakness
While working in the emergency room, you are called to help a patient named
Francis who believes he is having a heart attack. He states that his heart rate "feels
different." He states also that his fingers feel as if they are going numb.
The results of a preliminary ECG show wide QRS complexes; tall, peaked T
waves; and bradycardia.
Blood analysis reveals metabolic acidosis, with elevated ketones. This is most
likely due to Francis having type 1 diabetes. Francis is also being managed for
diabetic nephropathy and shows decreased renal function.
What electrolyte abnormality due would account for Francis' ECG results?
Hypernatremia
Hyperkalemia
Hypokalemia
Hypercalcemia
Hypophosphatemia
- ✅✅ Hyperkalemia
Early symptoms of hyperkalemia include numbness or tingling of the extremities,
muscle cramping, diarrhea, apathy, and mental confusion. The ECG will show
wide QRS complexes and tall, peaked T waves. As the potassium level rises, the
ECG will show bradycardia, irregular pulse rate and, ultimately, cardiac arrest
How may metabolic acidosis play a role in Francis' condition?
Acidosis causes sodium to shift into cells.
Acidosis causes calcium to shift out of cells.
Acidosis causes potassium to shift out of cells.
Acidosis inhibits calcium transporters.
, Acidosis elevates serum sodium. - ✅✅ Acidosis causes potassium to shift out of
cells.
Potassium will move from intracellular fluid (ICF) to extracellular fluid (ECF)
based on changes in the hydrogen ion (H+) concentration in the bloodstream.
During acidosis, extracellular H+ exchanges with intracellular K+. H+ ions enter
the cells, while K+ leaves the cells and enters the plasma. The shift in K+ to the
plasma appears as hyperkalemia.
How may Francis’ renal issues play a role in the electrolyte imbalance?
Increased sodium reabsorption by the kidneys
Decreased potassium excretion by the kidneys
Increased calcium reabsorption by the kidneys
Increased phosphate excretion by the kidneys
Decreased sodium filtration by the kidneys - ✅✅ Decreased potassium excretion
by the kidneys
In acidosis, hydrogen ions enter the cells, causing potassium ions to leave the cells
and enter into the plasma. The elevation in plasma potassium concentration can be
compounded by poorly functioning kidneys, as the kidneys normally filter excess
potassium into the urine.
Signs and Symptoms of Hypomagnesemia - ✅✅ Value below 1.3 mg/dl
1. Hallucinations, seizures, increased deep tendon reflexes, paresthesias
2. Tremors, muscle spasms
3. Arrhythmias
Signs and Symptoms of Hypercalcemia - ✅✅ Value above 10.2 mg/dl
1. Cardiac dysrhythmias (Blocks), shortening of QT interval and ST segment
2. Muscle weakness, incoordination
3. Anorexia, constipation
4. Increased calcium aggravates digoxin toxicity
Signs and Symptoms of Hyperphosphatemia - ✅✅ Value above 4.5 mg/dl
1. Hypocalcemia
2. Tetany
3. Mental changes
Signs and Symptoms of Hypophosphatemia - ✅✅ Value below 2.5 mg/dl
1. Affects CNS, cardiac, neuro and blood
with Right Answers
Your client's lab results show that the client's serum calcium level is very elevated.
What signs and symptoms would the client exhibit? Select all that apply.
Dizziness
Diarrhea
Muscle spasms
Muscle weakness
Edema
- ✅✅ Muscle weakness
While working in the emergency room, you are called to help a patient named
Francis who believes he is having a heart attack. He states that his heart rate "feels
different." He states also that his fingers feel as if they are going numb.
The results of a preliminary ECG show wide QRS complexes; tall, peaked T
waves; and bradycardia.
Blood analysis reveals metabolic acidosis, with elevated ketones. This is most
likely due to Francis having type 1 diabetes. Francis is also being managed for
diabetic nephropathy and shows decreased renal function.
What electrolyte abnormality due would account for Francis' ECG results?
Hypernatremia
Hyperkalemia
Hypokalemia
Hypercalcemia
Hypophosphatemia
- ✅✅ Hyperkalemia
Early symptoms of hyperkalemia include numbness or tingling of the extremities,
muscle cramping, diarrhea, apathy, and mental confusion. The ECG will show
wide QRS complexes and tall, peaked T waves. As the potassium level rises, the
ECG will show bradycardia, irregular pulse rate and, ultimately, cardiac arrest
How may metabolic acidosis play a role in Francis' condition?
Acidosis causes sodium to shift into cells.
Acidosis causes calcium to shift out of cells.
Acidosis causes potassium to shift out of cells.
Acidosis inhibits calcium transporters.
, Acidosis elevates serum sodium. - ✅✅ Acidosis causes potassium to shift out of
cells.
Potassium will move from intracellular fluid (ICF) to extracellular fluid (ECF)
based on changes in the hydrogen ion (H+) concentration in the bloodstream.
During acidosis, extracellular H+ exchanges with intracellular K+. H+ ions enter
the cells, while K+ leaves the cells and enters the plasma. The shift in K+ to the
plasma appears as hyperkalemia.
How may Francis’ renal issues play a role in the electrolyte imbalance?
Increased sodium reabsorption by the kidneys
Decreased potassium excretion by the kidneys
Increased calcium reabsorption by the kidneys
Increased phosphate excretion by the kidneys
Decreased sodium filtration by the kidneys - ✅✅ Decreased potassium excretion
by the kidneys
In acidosis, hydrogen ions enter the cells, causing potassium ions to leave the cells
and enter into the plasma. The elevation in plasma potassium concentration can be
compounded by poorly functioning kidneys, as the kidneys normally filter excess
potassium into the urine.
Signs and Symptoms of Hypomagnesemia - ✅✅ Value below 1.3 mg/dl
1. Hallucinations, seizures, increased deep tendon reflexes, paresthesias
2. Tremors, muscle spasms
3. Arrhythmias
Signs and Symptoms of Hypercalcemia - ✅✅ Value above 10.2 mg/dl
1. Cardiac dysrhythmias (Blocks), shortening of QT interval and ST segment
2. Muscle weakness, incoordination
3. Anorexia, constipation
4. Increased calcium aggravates digoxin toxicity
Signs and Symptoms of Hyperphosphatemia - ✅✅ Value above 4.5 mg/dl
1. Hypocalcemia
2. Tetany
3. Mental changes
Signs and Symptoms of Hypophosphatemia - ✅✅ Value below 2.5 mg/dl
1. Affects CNS, cardiac, neuro and blood
