N200 - ELECTROLYTES

Hypernatremia Hyponatremi Hypokalemia Hyperkalemia Hypercalcemia Hypocalcemia Hypomagnesemia Hypermagnesemia

a (greater than 5)
Signs and want water, confusion, Arrhythmias, cardiac lethargy and weak bones, Neuromuscular Vasodilation,
Symptoms thirst, dry and weakness, Leg Cramps, arrhythmias, arrest, weakness, poor dentition, irritability with nausea and
sticky mucus abdominal Fatigue, muscle weakness, decrease in circumoral tremors, vomiting, muscle
membranes cramping, Lethargy, irregular pulses, GI reflexes, bone signs and increased weakness or
(cracked more Decrease Hyperactivity, pain, symptoms reflexes, paralysis,
tongue), urination to Bowel Diarrhea, Renal constipation, (numbness tachycardia, hypotension and
weakness get rid of fluid Sounds, Failure (can’t kidney stones, around mouth confusion, bradycardia,
severe case = to increase Depressed excrete k+), heart block and fingers), disorientation, decreased deep
convulsions, ratio sodium, T-Wave on Hypoaldosteronism, severe muscle anorexia, tendon reflexes,
decrease level wanting salty EKG cramping, dysphagia (give resp depression or
of food; urine muscle them seafood, coma
consciousness osmolality is tremors, beans for diet
lower convulsions, replacement),
decrease CO, respiratory
cardiac difficulties
dysthymias, Extreme Hypo:
hyperactive Maternity patient
deep tendon with convulsions
reflexes (Tetany
– Trosseau and
Chavastic (facial
nerve spasm)
Interventions restrict salt give patient Give Food: limit k+ intake, limit calcium Diet: increase foods high in don’t give foods
intake (no salt table salt, potatoes, increase fluids, Give intake, increase dairy intake, mag: green, leafy, high in mag, give
on tray), give bacon, ham, carrots, Kayexolate Enema, fluid intake for dark, green vegetables, fish, fluids, safety
water, K+ canned foods meats, fish, K+ diuerectic, fluid intake, leafy legumes, whole precautions such
tomato's, Dialysis (for renal increase fiber, vegetables, grains, DRIED as bed rest, fall
avocados patient) encourage Vitamin D FRUITS (don’t precautions (don’t
movement, Diet supplement, give patient with want them to lose
Changes: Acid Estrogen dysphagia) consciousness),
Ash Diet Replacement close monitoring
(Cranberries, for women (risk of vital signs
prunes) of cancer),
prevents stone encourage
formation exercise
 N200 - ELECTROLYTES
Resp Acidosis (pH Decreases,
CO2 Increases)
Signs and Symptoms or Patient Hypoventilation, Patient does
not ventilate adequately, acute
resp diseases: pneumonia,
choking, asthma,
COPD/Emphysema, OD on
narcotics or sedatives, Patients
with brain injuries that are
affected to resp center of brain,
chest injury during trauma
Manifestations headaches, dizziness,
convulsions, increased pulse and
resp rate, warm and flushed
skin,
Interventions Mechanically ventilated, Deep
Breathing, Coughing, Chest Pt,
Bronchodilators, Reverse drugs
that they OD on, increase fluids,
frequently re-assess
Resp. Alkalosis (pH increases,
CO2 decreases)
Patient is hyperventilated – seen
in patient on vent whose lungs
are being overinflated, patient
with temp, patient with brain
stem injury, anyone with
increased BMR (athlete or
illness) or family member who is
freaking out
SOB, chest tightness, circumoral
parathesia, difficulty
concentrating, restlessness,
bag breathing, decrease temp,
get them to calm down
(distractions, guided imagery), if
on vent decrease volume and
rate, use a re-breather mask
(instead of bag)
Metab. Acidosis (pH decreases,
HCO2 decreases)
Patients with: Renal Disease,
severe diarrhea, uncontrolled
DM, starvation, excessive
infusion of chloride-containing
IV fluids, Cardiac arrest patient
(heart and blood stop, can’t get
rid of acids and waste so they
build up)
Kussmaul’s Resp – deep and
rapid with fruity odor, lethargy
and confusion, headache and
weakness, nausea and vomiting,
(drunk like – even though they
aren’t it kind of seems like they
are)
Give insulin to diabetic, or treat
underlying cause (dialyse patient
with renal failure), give them
Bicarb,
Metab. Alkalosis (pH increases,
HCO3 increases)
decrease resp rate and depth,
circumoral parathesia,
hypertonic muscles/tetany
vomiting or over suctioning (due
to loss of bases), Excess use of
K+, excessive Bicarb intake (most
common way of getting Bicarb is
antacid use)
IV fluids, monitor I&Os, monitor
Vital signs closely, treat
underlying problem