Fluid & Electrolytes - NSG 170 Test Review
With Complete Solutions
Potassium - ANSWER -Major cation in the ICF.
-Normal lab values in ECF 3.5-5.0 mEq/L
-Basic function: intracellular excitation
-Crucial to heart function & can cause arrhythmias if levels are too high/low
-conduction of the nerve impulses
Hyperkalemia - ANSWER -Greater than 5.0 mEq/L (too much potassium)
-TALL peaked T waves (over excitement of cardiac tissue)
-muscle twitching/cramps (early stages)
-muscle weakness/paralysis (late stages)
-cardiac dysrhythmias
-associated w/ renal disease b/c not excreting out potassium properly, but can
also be due to salt substitutes & medications such as potassium sparing
diuretics.
Treatment of hyperkalemia - ANSWER -renal dialysis
- potassium lowering medications
-restricting potassium containing foods
Hypokalemia - ANSWER -less than 3.5 mEq/L (not enough potassium)
-comes from fluid loss, vomiting/diarrhea, sweating; meds: diuretics, laxatives,
steroids
-muscle weakness/spasms/leg
-cramping
-numbness
-tingling
-fatigue
-lightheadedness
-heart palpitations
-bradycardia
-cardiac arrest
-FLATTENED T WAVES
-u waves
Treatment of hypokalemia - ANSWER -Supplementing foods-bananas, melons,
raw spinach
-oral potassium supplements
-IV fluids w/ potassium
, -switching to potassium sparing diuretics
Administration of IV potassium - ANSWER Make sure IV potassium is diluted and
administer with an IV pump because potassium can burn the vein and overdose
can cause arrhythmia's and death,
Calcium (CA++) - ANSWER -8.5-10.5 mg/dL
-found primarily in bones and teeth (99%) w/ remaining 1% dissolved in the
blood.
-half of the normal range (8.5-10.5 mg/dL) is bound to plasma proteins, mainly
albumin and the other half is ionized or free floating
Simplified body function: neuronal excitability (motor neurons sending signals to
muscles, causing them to contract)
Hypercalcemia - ANSWER -Causes DECREASED muscle contraction
-over 10.5 mg/dL
-excess calcium stabilizing membrane channels
-constipation from decreased GI tract motility
-decreased DTRs
-lethargy
-bone pain
-decreased activity of cardiovascular system resulting in dysrhythmias and
cardiac arrest
Treatment for hypercalcemia - ANSWER Hydrate w/ fluids
Cardiac monitoring
Loop diuretics to promote calcium excretion
Hypocalcemia - ANSWER -EXCESS muscles contractions
-a lot of easily excitable muscles but not enough calcium to stabilize membrane
channels
-not enough calcium causes tetany (involuntary contractions of the muscles),
causes vomiting/diarrhea (GI muscles are going crazy), convulsions, heart
dysrhythmias
- less than 8.5
2 signs of Tetany - ANSWER -Trousseau's sign- inflate blood pressure cuff above
systolic BP on arm for 2 min. & hand develops contracted position (more
accurate than chvosteks)
-Chvostek's sign- elicited by tapping the pt's face over the facial nerve just
below the temple, and the result is facial muscle twitching.
So if they have hypocalcemia, check for tetany using these two methods
Treatment for hypocalcemia - ANSWER -high calcium diet
-calcium supplements w/ vitamin D to enhance absorption
With Complete Solutions
Potassium - ANSWER -Major cation in the ICF.
-Normal lab values in ECF 3.5-5.0 mEq/L
-Basic function: intracellular excitation
-Crucial to heart function & can cause arrhythmias if levels are too high/low
-conduction of the nerve impulses
Hyperkalemia - ANSWER -Greater than 5.0 mEq/L (too much potassium)
-TALL peaked T waves (over excitement of cardiac tissue)
-muscle twitching/cramps (early stages)
-muscle weakness/paralysis (late stages)
-cardiac dysrhythmias
-associated w/ renal disease b/c not excreting out potassium properly, but can
also be due to salt substitutes & medications such as potassium sparing
diuretics.
Treatment of hyperkalemia - ANSWER -renal dialysis
- potassium lowering medications
-restricting potassium containing foods
Hypokalemia - ANSWER -less than 3.5 mEq/L (not enough potassium)
-comes from fluid loss, vomiting/diarrhea, sweating; meds: diuretics, laxatives,
steroids
-muscle weakness/spasms/leg
-cramping
-numbness
-tingling
-fatigue
-lightheadedness
-heart palpitations
-bradycardia
-cardiac arrest
-FLATTENED T WAVES
-u waves
Treatment of hypokalemia - ANSWER -Supplementing foods-bananas, melons,
raw spinach
-oral potassium supplements
-IV fluids w/ potassium
, -switching to potassium sparing diuretics
Administration of IV potassium - ANSWER Make sure IV potassium is diluted and
administer with an IV pump because potassium can burn the vein and overdose
can cause arrhythmia's and death,
Calcium (CA++) - ANSWER -8.5-10.5 mg/dL
-found primarily in bones and teeth (99%) w/ remaining 1% dissolved in the
blood.
-half of the normal range (8.5-10.5 mg/dL) is bound to plasma proteins, mainly
albumin and the other half is ionized or free floating
Simplified body function: neuronal excitability (motor neurons sending signals to
muscles, causing them to contract)
Hypercalcemia - ANSWER -Causes DECREASED muscle contraction
-over 10.5 mg/dL
-excess calcium stabilizing membrane channels
-constipation from decreased GI tract motility
-decreased DTRs
-lethargy
-bone pain
-decreased activity of cardiovascular system resulting in dysrhythmias and
cardiac arrest
Treatment for hypercalcemia - ANSWER Hydrate w/ fluids
Cardiac monitoring
Loop diuretics to promote calcium excretion
Hypocalcemia - ANSWER -EXCESS muscles contractions
-a lot of easily excitable muscles but not enough calcium to stabilize membrane
channels
-not enough calcium causes tetany (involuntary contractions of the muscles),
causes vomiting/diarrhea (GI muscles are going crazy), convulsions, heart
dysrhythmias
- less than 8.5
2 signs of Tetany - ANSWER -Trousseau's sign- inflate blood pressure cuff above
systolic BP on arm for 2 min. & hand develops contracted position (more
accurate than chvosteks)
-Chvostek's sign- elicited by tapping the pt's face over the facial nerve just
below the temple, and the result is facial muscle twitching.
So if they have hypocalcemia, check for tetany using these two methods
Treatment for hypocalcemia - ANSWER -high calcium diet
-calcium supplements w/ vitamin D to enhance absorption
