Term
|
Definition
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Term
|
Definition
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Term
|
Definition
| 90% primarily extracellular, regulated by dietary intake and aldosterone secretion. |
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Term
|
Definition
maintain fluid balance, H2o balance & the effect of serum osmolarity.
RDA 500mg NaCl/day.
maintain acid base balance
acts as a buffer base. |
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Term
|
Definition
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Term
|
Definition
< 136 mEq/L
Normal 136-145mEq/L |
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Term
|
Definition
| Na+ deficits: excessive diaphoresis, diuretics, wound drainage, renal disease, hyperlipidemia, dec. secretion of aldosterone. |
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Term
| hyponatremia: manifestations |
|
Definition
does not appear until Na+ <125mEq/L.
pt. having acute dec. in serum Na levels have higher mortality rates than a PT. who more slowly develops hyponatremia.
early s/s: HA, faintness & giddiness
s/s changes in LOC, weakness in the muscle, decrease in dia. BP, severe hypotension, inc. urinary output. |
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Term
|
Definition
*priority NI, monitoring the Pt. response to Tx to prevent hypernatremia & fluid overload.
fluid deficit: IV solutions
fluid excess: osmotic diuretics.
encourage intake of foods c high Na.
SIADH = fluid restriction (fluid restriction 1000ml-1200w 24hrs) |
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Term
|
Definition
sodium > 145mEq/L
normal 136-145mEq/L |
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Term
|
Definition
| hyperaldosteronism, renal failure, corticosteroids, cushing's syndrome; excess intake of Na, excessive intake of Na-containing IV fluids |
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Term
|
Definition
- priority: monitor the Pt. responce to therapy & prevent hyponatremia & dehydration.
- offer pt. fluids hourly - 6-8 8oz glasses daily.
- monitor Na+ I&O |
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Term
| Hypernatremia manifestation |
|
Definition
| c/o thirsty, dry skin, rough red tonge, dry sticky mucos membranes, fever, muscle twitching, distended neck veins. |
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Term
|
Definition
3.5-5mEq/L
found primarily intracellular. |
|
|
Term
| Potassium (K): FxN and elimination |
|
Definition
| maintain normal HR, transmission and condition of nerve impulses, contraction of skeletal and smooth muscle, excreted by the kidneys. regulation of protein synthesis. |
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Term
|
Definition
<3.5 mEq/L
normal 3.5-5mEq/L |
|
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Term
|
Definition
| excessive use of diuretics, digitalis, corticosteroids; D.V. and wound drainage, prolonged NG suction,, inadequate intake of K, NPO status, excess heath--> diaphorosis. |
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|
Term
| Hypokalemia: relative K+ deficits |
|
Definition
| alkalosis, hyperinsulinism, hyeralimentation, TPN, excessive diaphoresis,, H2O intoxication, IV Tx c inadequate K+ solutions. |
|
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Term
|
Definition
early s/s: hypotension, lethargy, mental confusion, muscle weakness.
variable P rate, EKG changes, irregular HR, shallow breaths, diminished breath sounds. |
|
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Term
|
Definition
K+ supplements, uses K+ sparing diuretics.
infusion device MUST be used and NO FASTER than 5-10mEq/L. |
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Term
|
Definition
bananas
cantaloupe
kiwi
oranges
avocados
broccoli
dry beans
peas
mushrooms
soy bean
potatoes |
|
|
Term
|
Definition
> 5mEq/L
normal: 3.5-5mEq/L |
|
|
Term
| hyperkalemia: manifestations |
|
Definition
irregular and bradycardia, hypotension,hyperactive bowel sounds, diarrhea.
early stage: muscle twitching, tingling & burning sensation followed by numbness in hands.
late s/s: muscle weakness in hands and legs by flaccid paralysis. |
|
|
Term
|
Definition
priority: monitor cardiac status, safety, response to therapy and health teachings.
Rx: Lasix to Pt. /c normal renal FxN.
renal given Kayexalate. |
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Term
|
Definition
9.0-10.5mg/L
most frequently preformed labs. |
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Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| calcium FxN & Elimination. |
|
Definition
bone strength & density
skeletal & cardiac muscle contraction
nerve impulse transmission
blood clotting
activates enzymes
excreted in the urine and feces
stored in the bones |
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Term
|
Definition
total serum ca+ level <9.0mg/dL
normal 9.0-10.5mg/dL |
|
|
Term
Hypocalcemia: etiology
actual calcium deficits |
|
Definition
| inadequate intake, lactose intolerance, malabsorption syndromes, ESRD, renal failure. |
|
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Term
Hypocalcemia: etiology
relative ca+ deficits |
|
Definition
| hyperproteinemia, alkalosis, immobility, acute pancreatitis. |
|
|
Term
| hypocalcemia: manifestations |
|
Definition
| arrythmias, thready pulse, severe hypotension, muscle spaisms, osteoporosis, dec. bone density, positive chvostek's sign, trousseau's sign. |
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Term
|
Definition
| contraction of facial muscles response to tap over facial nerve. |
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Term
|
Definition
| carpal spasms induced by inflating BP cuff on arm above systolic BP 3 min spasms r/t inc. neuromuscular activity. |
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Term
|
Definition
Ca+ replacement PO or IV Rx that enhance absorption (aluminum hydroxide & vitamin D).
monitor airway, as laryngeal stridor can occur, seizure precautions, edu. osteoporosis. |
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Term
|
Definition
|
|
Term
|
Definition
total serum Ca+ >10.5
normal 9.0-10.5mg/dL |
|
|
Term
hypercalcemia: etiology
actual ca+ excesses |
|
Definition
| excessive intake of calcium or vitamin d, renal failure, use of thiazide diuretics (HZTZ) |
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|
Term
hypercalcemia: etiology
relative ca+ excesses |
|
Definition
| hyperparathyroidism, malignancy, hyperthyroidism, immobility, use glucocorticoids, hemoconcertration c dehydration. |
|
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Term
| hypercalcemia: manifestations |
|
Definition
| inc. HR&BP, depression of electrical conduction slowing the HR, muscle weakness, ALOC, lethargy & coma, decreased peristalsis, hyperactive bowel sounds, N., abd. distention, constipation. |
|
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Term
|
Definition
fluid replacement NS
mobilize pt asap.
force fluid to eliminate Ca+ & prevent renal calculi.
Rx: Ph+, ASA
v/s
check cap refill
assess LOC.
cranberry juice keeps urine acid- low pH favors Ca+ solubility. |
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Term
|
Definition
Phosphorus 3.0-4.5 mg/dL
found in bones, regulated by diet intake, renal excretion, intestinal absorption, and PTH. |
|
|
Term
| Phosphorus/phosphate: fXn and elimination |
|
Definition
needed for activating b-complex vitamins, forming & activating ATP, cell divsion, CHO PRO & Fat metabolism.
FxN of muscle, RBC & nervous system
deposited c Ca+ in the bones and teeth |
|
|
Term
| when PO4 (phosphorus)level is high, Ca+ is.. |
|
Definition
| low, inverse relationship. |
|
|
Term
| when Ca+ level is high, PO4 is.. |
|
Definition
| low, inverse relationship. |
|
|
Term
|
Definition
<3.0mg/dL
normal 3.0-4.5mg/dL |
|
|
Term
| hypophosphatemia: etiology |
|
Definition
| malnutrition, starvation, use of aluminum hydroxide-base antacids and Mg based antacids, hyperparathyroidism, hypercalcemia, renal failure, hyperalimentation, resp. alkalosis, uncontrolled DM, hyperglycemia, ETOH |
|
|
Term
| hypophosphatemia: manifestations |
|
Definition
| Dec. CO, peripheral pulses are slow, shallow resp., muscle weakness, dec. tendon reflexes, dec. bone density, confusion, seizures |
|
|
Term
|
Definition
foods c high PO4:
fish, beef, chicken, nuts, whole-grain breads&cereal.
PO replacements
IV Ph if Ph fall < 1mg/dL |
|
|
Term
|
Definition
>4.5mg/dL
normal 3.0-4.5mg/dL |
|
|
Term
| hyperphosphatemia: etiology |
|
Definition
reduce renal Ph excretion r/t renal failure
shift of pH from the intracellular space into ECF r/t lysis of tumor cells i.e. secondary to chemotherapy
high Ph intake or hypocalcemia. |
|
|
Term
| hyperphosphatemia: manifestations |
|
Definition
s/s of hypocalcemia & tetany, numbness 7 muscle spasms.
long term - soft tissue calcification |
|
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Term
|
Definition
1.3-2.1mEq/L
second most abundant intracellular ion |
|
|
Term
|
Definition
skeletal musclar contractions
ATP formation
vitamin activation
CHO metabolism
cell growth & coagulation |
|
|
Term
|
Definition
<1.3mEq/L
normal 1.3-2.1mEq/L |
|
|
Term
|
Definition
| insufficient Mg intake: malnutrition, starvation, d., steatorrhea, crohn's & celiac dez. |
|
|
Term
| hypomagnesemia: mainfestations |
|
Definition
| dysrhytmias, HTN< anorexia, N. abd distention, dec. bowel sounds, shallow resp. hyperactive deep tendon reflexes, numbness &tingling. |
|
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Term
|
Definition
Mg is replaced c MgSO4, oral Mg can cause D. & worsen the problem.
d/c Rx that promotes Mg loss e.g. loopdiuretics &aminoglycoside. |
|
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Term
|
Definition
| tuna, raisins, beef, pork, milk, peanut butter, avocado, peas, spinach, potatoes, nuts, legumes. |
|
|
Term
|
Definition
>2.1mEq/L
normal 1.3-2.1mEq/L |
|
|
Term
| hypermagnesemia: etiology |
|
Definition
| excessive Mg intake c renal insuficiencyor failure. elderly are more prone because of inc. intake antacids & dec. renal function, almost the use of Mg+ salts. |
|
|
Term
| hypermagnesemia: manifestations |
|
Definition
| bradycardia, peripheral vasodilation, hypotension, drowsy, lethargic, coma, deep tendon reflexes are dec. or absent, weakness. |
|
|
Term
|
Definition
d/c Rx /cMg, administer loop diuretics
HD pt. if pt has renal failure.
dietary restrictions. |
|
|
Term
| hypermagnesemia: food to advoid |
|
Definition
| meat, nuts, legumes, fish |
|
|
Term
|
Definition
Cl 98-106mEq/L
80% of Cl in ECF |
|
|
Term
|
Definition
regulation of H2O
production of HCL needed for digestion
Maintenance of pH |
|
|
Term
|
Definition
<98mEq/dL
normal 98-106meq/dL |
|
|
Term
|
Definition
D.V.
diaphoretic
GI suctioning
diuretics
dec. intake |
|
|
Term
| hypochloremia: mainfestations |
|
Definition
hypoventilation
tetany
restlessness
confustion
convulsions
paresthsia of extremities |
|
|
Term
|
Definition
assess labs
encourage high NA+ foods
Rx: anti-emetics & foods
Rx: anti-emetics & diarrheal
d/c the use of diuretics. |
|
|
Term
|
Definition
> 106mEq/L
normal: 98-106mEq/L |
|
|
Term
|
Definition
very rare disorder
may occure c dehydration, bicarbonate deficieny, hypernatremia, metabolic acidosis. |
|
|
Term
| hyperchloremia: manifestations |
|
Definition
hyperventilation
hypotension
dec. CO
HA
lethargy |
|
|
Term
|
Definition
correct the fluid balance: IV hydrations and replace bicarbonate /c Nas bicarb
continually monitor LOC and labs. |
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