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35 Cards in this Set
- Front
- Back
Sodium (NA+)
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135-145 mEq/L
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Potassium (K+)
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3.5-5.0 mEq/L
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Calcium (Ca2+)
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4.5-5.5 mEq/L
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Magnesium (Mg2+)
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1.5-2.5 mEq/L
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Bicarbonate (HCO3-)
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Arterial 22-26 mEq/L
Venous 24-30 mEq/L |
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Chloride (Cl-)
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95-105 mEq/L
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Phosphate (PO43-)
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2.8-4.5 mg/dl
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Hyponatremia Signs and Symptoms
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Apprehension, personality change, postural hypotension, postural dizziness, abdominal cramping, nausea and vomiting, diarrhea, tachcardia, dry mucous membranes, convulsions and coma
Laboratory Findings: serum sodium BELOW 135 mEq/L serum osmolality 280 mOsm/kg urine specific gravity BELOW 1.010 |
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Hyponatremia Imbalance and Related Causes
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Vomiting, diarrhea, NG suction, kidney disease resulting in salt wasting, diuretics, adrenal insufficiency, excessive perspiration, burns, polydipsia, Syndrome of inappropriate ADH (SIADH)
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Hypernatremia Imbalance and Related Causes
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excess salt intake
excess aldosterone secretion diabetes insipidus increased sensible and insensible water loss water deprivation |
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Hypernatremia Signs and Symptoms
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extreme thirst, dry and flush skin, dry and sticky tonge and mucous membranes
postural hypotension, fever, agitation, convulsions, restlessness, irritability Laboratory Findings: serum sodium ABOVE 145 mEq/L serum osmolality 300 mOsm/kg urine specific gravity 1.030 |
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Hypokalemia Imbalance and Related Causes
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use of potassium wasting diuretics
diarrhea, vomiting, or other GI losses alkalosis excess aldosterone secretion polyuria extreme sweating excessive use of potassium free IV solutions treatment of diabetic ketoacidosis with insulin |
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Hypokalemia Signs and Symptoms
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weakness and fatigue, muscle weakness, nausea and vomiting, intestinal distention, decreased bowel sounds, decreased deep tendon reflexes, ventricular dysrhythmias, paresthesias and weak, irregular pulse
Laboratory Findings: Serum potassium BELOW 3.5 mEq/L ECG abnormalities: flattened T wave, ST segment depression, U wave, potentiated digoxin effects (Ventricular dysrhythmias) |
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Hyperkalemia Imbalance and Related Causes
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renal failure, fluid volume deficit, massive cellular damage such as from burns and trauma
iatrogenic administration of large amounts of potassium IV acidosis, especially diabetic ketoacidosis rapid infusion of stored blood use of potassium sparing diuretics ingestion of K+ salt substitutes |
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Hyperkalemia Signs and Symptoms
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anxiety, dysrhythmias, paraesthesia, weakness, abdominal cramps, diarrhea
Laboratory Findings: serum potassium level ABOVE 5.0 mEq/L ECG abnormalities: peaked T wave and widened QRS complex (bradycardia, heart block, dysrhythmias) eventually QRS pattern widens and cardiac arrest occurs |
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Hypocalcemia Imbalance and Related Causes
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rapid administration of blood transfusions containing citrate
hypoalbuminemia, hypoparathyroidism, vitamin D deficiency, pancreatitis, alkalosis, chronic renal failure, chronic alcoholism |
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Hypocalcemia Signs and Symptoms
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numbness and tingling of fingers and circumoral (around mouth) region, hyperactive reflexes, positive Trousseau's sign (carpopedal spasm with hypoxia)
positive Chvostek's sign (contraction of facial muscles when facial nerve is tapped) tetany, muscle cramps, and pathological fractures (chronic hypocalemia) Laboratory Findings: serum ionized calcium level BELOW 4.5 mEq/L or total serum BELOW 8.5 mg/dL and ECG abnormalities: ventricular tachycardia |
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Hypercalcemia Imbalance and Related Causes
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hyperparathyroidism, osteometastasis, paget's disease, osteoporosis, prolonged immobilization, acidosis, thiazide diuretics
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Hypercalcemia Signs and Symptoms
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anorexia, nausea and vomiting, weakness, hypoactive reflexes, lethargy, flank pain (from kidney stones) decreased level of consciousness, personality changes and cardiac arrest
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Hypomagnesemia Imbalance and Related Causes
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inadequate intake: malnutrition and alcoholism
inadequate absorption or loss: diarrhea, vomiting, nasogastric drainage, fistulas, diseases of small intestine, excessive loss resulting from thiazide diuretics, aldosterone excess, polyuria |
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Hypomagnesemia Signs and Symptoms
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muscular tremors, hyperactive deep tendon reflexes, confusion and disorientation, tachycardia, hypertension, dysrhythmias, and positive Chvostek's sign and Trousseau's sign
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Hypermagnesemia Imbalance and Related Causes
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renal failure
excess oral or parenteral intake of magnesium |
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Hypermagnesemia Signs and Symptoms
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acute elevations in magnesium levels
hypoactive deep tendon reflexes decreased depth and rate of respirations hypotension and flushing |
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Fluid Volume Deficit Imbalance and Related Causes
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Water and electrolytes lost in equal or isotonic proportions
diarrhea, vomiting, drainage from fistulas or tubes loss of plasma or whole blood, sich as with burns or hemorrhage excessive perspiration, fever decreased oral intake of fluids, confusion or depression use of diuretics |
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Fluid Volume Deficit Signs and Symptoms
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postural hypotension, tachycarida, dry mucous membranes, poor skin turgor, thirst, confusion, rapid weight loss, slow vein filling, flat neck veins, lethary, oliguria (<30mL/hr), weak pulse
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Fluid Volume Excess Imbalance and Related Causes
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water and sodium retained in Isotonic Proprortions
congestive heart failure renal failure cirrhosis of the liver increased serum aldosterone and steroid levels excessive sodium intake or administration |
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Fluid Volume Excess Signs and Symptoms
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rapid weight gain, edema, hypertension, polyuria, neck vein distension, increased blood and venous pressure, crackles in lungs, confusion
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Hyperosmolar Imbalance - Dehydration Related Causes
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diabetes insipidus
interruption of neurologically driven thirst drive diabetic ketoacidosis osmotic diuresis administration of hypertonic parenteral fluids or tube feeding formulas |
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Hyperosmolar Imbalance - Dehydration Signs and Symptoms
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dry and sticky mucous membranes, flushed and dry skin, thirst, elevated body temp, irritability, convulsions, coma
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Hypoosmolar Imbalance - Water Excess Related Causes
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syndrome of inappropriate of antidiuretic hormone (SIADH)
excess water intake |
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Hypoosmolar Imbalance - Water Excess Signs and Symptoms
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decreased level of consciousness, convulsions, coma
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Thiazide Diuretic
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Causes loss of water and potassium
Watch for hypokalemia Can also lower magnesium and increase calcium Eat with food at breakfast to prevent nocturia - don't have diuretic on empty stomach |
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What is likely to be decreased with Chronic Renal Failure?
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Calcium
Would have a high phosphorus level and since they are inverse to each other, calcium would drop Also hemoglobin would decrease because the kidneys would not produce as much as they start to fail |
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pH - 7.35
PO2 - 96 PCO2 - 30 HCO3 - 18 |
Metabolic acidosis (compensated)
Excess bicarbonate is excreted causing HCO3 levels to decrease= metabolic acidosis Compensation is increased resp rate and depth to bring CO2 down and bring pH back to normal |
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End Stage Renal Disease Symptoms
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yellow-gray pallor, anemia, uremia,
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