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Fluid and Electrolytes
N/A
36
Nursing
Undergraduate 1
05/16/2013
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Term

Respiratory Acidosis

 

(pH: <7.35; PaCO2: >45; HCO3: 24-30; PaO2: <75)

 Definition

Causes: 

  • Shallow respirations (hypoventilation - retaining CO2)
  • Narcotics/Pain
  • Pneumonia/Atelectasis
  • Asthma/COPD
Term

Respiratory Acidosis

 

(pH: <7.35; PaCO2: >45; HCO3: 24-30; PaO2: <75)

 Definition

S/Sx's: Hypoxia; pain; drowsiness; dizziness; warm/flushed skin; weakness; disoriented

 
Term

Respiratory Acidosis

 

(pH: <7.35; PaCO2: >45; HCO3: 24-30; PaO2: <75)

 Definition
TNI's: TCDB; ambulate; tx pain; lower narcotic dose; O2 prn; check for hyperkalemia
Term

Respiratory Alkalosis 

 

(pH: >7.45; PaCO2: <35; HCO3: 35-45; PaO2: 75-100)

 Definition

Causes:

  • Hyperventilation
  • Anxiety
  • Fever
  • URI's
Term

Respiratory Alkalosis 

 

(pH: >7.45; PaCO2: <35; HCO3: 35-45; PaO2: 75-100)

 Definition
S/sx's: Increased RR; lightheadedness; confusion; anxiety; SOB; parasthesia
Term

Respiratory Alkalosis 

 

(pH: >7.45; PaCO2: <35; HCO3: 35-45; PaO2: 75-100)

 Definition
TNI's: Slow breathing/paper bag breathing; sedatives; Check for hypokalemia and hypocalcemia
Term

Metabolic Acidosis

 

(pH: <7.35; PaCO2: 35-45; HCO3: <24)

 Definition

Causes:

  • Diarrhea
  • DKA
  • Renal failure
Term

Metabolic Acidosis

 

(pH: <7.35; PaCO2: 35-45; HCO3: <24)

 Definition

S/sx's: Kussmaul Respirations; drowsiness; confusion; N/V; abd. pain; flushing skin

 
Term

Metabolic Acidosis

 

(pH: <7.35; PaCO2: 35-45; HCO3: <24)

 Definition

TNI's:

IV Na HCO3; Check for hyperkalemia
Term

Metabolic Alkalosis

 

(pH: >7.45; PaCO2: 35-45; HCO3: >30)

 Definition

Causes: 

  • Vomiting
  • NG Tube
  • Diuretics
Term

Metabolic Alkalosis

 

(pH: >7.45; PaCO2: 35-45; HCO3: >30)

 Definition

S/sx's: dizziness; irritable; tetany; parasthesia; Increased P; hypoventilation

 
Term

Metabolic Alkalosis

 

(pH: >7.45; PaCO2: 35-45; HCO3: >30)

 Definition
TNI's: IVF replacement; Check for hypokalemia and hypocalcemia
Term

Hyponatremia

 

(Na <135)

 Definition

Causes:

  • GI losses (Vomiting/diarrhea)
  • Urinary losses
  • Skin losses
  • H2O gains
Term

Hyponatremia

 

(Na <135)

 Definition
S/sx's: confusion; seizure/coma; brain swelling; Increased BS; Increased UOP; muscled weakness; Increased P; Decreased BP; Decreased RR (r/t muscle weakness); Decreased SG (<1.010)
Term

Hyponatremia

 

(Na <135)

 Definition
TNI's: Diuretics (if H2O gains); NaCl IVF tx (if Na losses); Daily wts; I/O; VS; Safety
Term

Hypernatremia

 

(Na >145)

 Definition

Causes:

  • Na gain
  • H20 loss (High fever, hyperventilation)
Term

Hypernatremia

 

(Na >145)

 Definition
S/sx's: Muscle twitches; agitation; seizures; coma; thirsty; Increased SG (>1.025)
Term

Hypernatremia

 

(Na >145)

 Definition
TNI's: If h20 loss (admin IVF); I/O; daily wts; Teach 5 & 20 rule; oral/skin care
Term

Hypokalemia

 

(K <3.5)

 Definition

Causes: 

  • GI losses (vomiting/diarrhea)
  • Starvation
  • Resp/Met alkalosis
  • Increased insulin
Term

Hypokalemia

 

(K <3.5)

 Definition
S/sx's: Ileus; Decreased BS; N/V; Constipation; muscle weakness; parasthesia; arrythmias
Term

Hypokalemia

 

(K <3.5)

 Definition
TNI's: Never IV push; Periph IV: <10mEq/50-100mL over 1 hour; Central IV:  <20mEq/50-100mL over 1 hour; Dilution solution <40mEq/L
Term

Hyperkalemia

 

(K >5)

 Definition

Causes:

  • Renal failure
  • burns
  • resp/met acidosis
Term

Hyperkalemia

 

(K >5)

 Definition
S/sx's: muscle twitches; Increased BS; abd. cramps; diarrhea; Decreased BP; parasthesia
Term

Hyperkalemia

 

(K >5)

 Definition
TNI's: Admin diuretics/Kayexalate/glucose & insulin (together if pt is NOT DM)/HCO3/calcium gluconate; dialysis
Term

Hypocalcemia

 

(Ca <9)

 Definition

Causes: 

  • Hypoparathyroidism
  • Celica/chrone's disease
  • Acute pancreatitis
  • diarrhea
  • Resp/Met alkalosis
Term

Hypocalcemia

 

(Ca <9)

 Definition
S/sx's: decreased BP; Decreased P; + Trousseau's (BP cuff)/Chvostek's (facial contraction); Increased BS; Laryngeal spasms; parasthesia (around mouth); muscle spasms; tetany; Increased DTR's
Term

Hypocalcemia

 

(Ca <9)

 Definition
TNI's: Admin Ca Orally/IV
Term

Hypercalcemia

 

(Ca >11)

 Definition

Causes:

  • Immobilization
  • Hyperparathyroidism
  • metastasis in bone
  • Increased Ca intake (Tums)
Term

Hypercalcemia

 

(Ca >11)

 Definition
S/sx's: Increased BP; Decreased DTR's; bone pain; pathological fractures; renal colic; Decreased BS; constipation
Term

Hypercalcemia

 

(Ca >11)

 Definition
TNI's: Diruetics; 3,000-4,000mL/day; Admin Calcitonin; Teach pt maintain fluid intake 2500-3000mL/day
Term

Hypomagnesemia

 

(Mg <1.5)

 Definition

Causes:

  • Starvation
  • Chronic alcoholism
  • Diarrhea
  • Ileostomy
  • Diuretics
  • Uncontrolled DM
Term

Hypomagnesemia

 

(Mg <1.5)

 Definition
S/sx's: Increased DTR's; muscle twitches; dig tox; Increased BP; Increased P; tetany
Term

Hypomagnesemia

 

(Mg <1.5)

 Definition
TNI's: Admin Mg IV/Oral; Check for hypocalcemia
Term

Hypermagnesemia

 

(Mg >2.5)

 Definition

Causes:

  • Renal failure
  • Increased Mg laxatives
Term

Hypermagnesemia

 

(Mg >2.5)

 Definition
S/sx's: Decreased DTR's; lethargy; Decreased BP; Decreased P; coma
Term

Hypermagnesemia

 

(Mg >2.5)

 Definition
TNI's: IVF to Increase UOP; Diuretics; Admin Calcium Gluconate for 911 situations
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