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GMPS
Fluid & Electrolyte Imbalances
47
Other
Graduate
01/15/2015

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Cards

Term
Na
Definition
135-145 mEq/L
Term
hyponatremia
Definition
lethargy
nausea
apathy
muscle cramps
muscular twitching
confusion (if severe)
Term
hypernatremia
Definition
associated with surgery and febrile illnesses
results from dehydration, limited water intake (leads to hypovolemia), and increased Na intake with normal fluid volumes (resulting in intracellular dehydration)
Term
hyperkalemia
Definition
muscle weakness, flaccid paralysis
parasthesis
initial tachycardia followed by brachycardia
ventricular fibrillation
cardiac arrest
irritability
anxiety
Term
hypokalemia
Definition
extremity weakness
fatigue
slow/weak pulse
paresthesias
leg cramp
ventricular fibrillation
cardiac arrest
hypotension
diminished bowel function- constipation, abdominal dissension, paralytic ileus
Term
Ca
Definition
8.5-12 mg/dl
Term
Hypercalcemia
Definition
due to: hyperparathyroidism, cancer involving bone, sarcoidosis, excess Vitamin D

fatigue
weakness
lethargy
anorexia
nausea
constipation
Term
hypocalcemia
Definition
due to: hypoparathyroidism, inadequate intake/absorption of Ca, bone or soft tissue deposition, blood transfusion, decreased vitamin D

confusion
paresthesias
muscle spasms
hyperreflexia
Term
phosphate
Definition
2.0-4.5 mg/dl
Term
hyperphosphatemia
Definition
associated with renal failure and uremia, hypocalcemia, hypoparathyroidism, and chemotherapies

confusion
paresthesias
muscle spasms
hyperreflexia
Term
Hypophosphatemia
Definition
associated with hypercalcemia, hyperparathyroidism, possible complications of diabetes management, mental status changes, bone and muscle pain, neuromuscular irritability, seizures, tremors
Term
hypervolemia
Definition
excess fluid in the extracellular space
pt. thirsty byt fluids are being restricted

dyspnea
orthopnea
increased BP
bounding pulse (too much blood)
presence of S3 heart sound & cough if heart is failing
dependent edema
increased pulmonary artery pressure
jugular vein distention
elevated central venous pressure
Term
hypovolemia
Definition
hypernatremia from decreased water intake

weak/rapid pulse
decreased BP
dizziness
thirst
extremities cool/pale
confusion
muscle cramps
Term
hypervolemic
Definition
diagnositic test findings:

decreased Hct
decreased BUN
normal serum Na levels
decreased K levels
x-ray will indiciate pulmonary edema
Term
hypovolemic
Definition
diagnostic test findings:

decreased Hgb & Hct (with whole blood loss)
increased Hct (with plasma fluid shift from intravascular to interstitial spaces)
increased BUN
increased serum Na levels
Term
K
Definition
3.5-5.0 mEq/l
Term
hyperkalemia
Definition
causes:
enhanced K intake combined with renal insufficiency
shift of K from ICF to ECF from cellular damage, hypoxia, acidosis, insulin deficiency, muscle damage and some meds
Term
hypokalemia
Definition
due to:
loss of K (diarrhea, vomiting, GI drainage tubes)
reduced intake (malnutrition)
increased cellular uptake (from alkalosis and excessive insulin administration)
enhanced renal exertion of K
Term
hypermagnesemia
Definition
diaphoresis
warm/flushed appearance
nausea/vomiting
drowsiness/lethargy
weakness/flaccidity
diminished deep tendon reflexes
hypotension
bradycardia
Term
hypomagnesemia
Definition
noticed in chronic alcoholism, eating disorders, may be connected with increased urinary excretion as seen with diabetic crisis

neuromuscular irritabiity
hyperreflexia
tremors/twitching
spasticity
seizures
nystagmus
ECG changes
emotional lability
Term
BUN (blood urea nitrogen)
Definition
10-20 mg/dl
Term
Ceatinine
Definition
0.6-1.2 mg/dl
Term
Cl-
Definition
104-110 mEq/l
Term
hyperchloremia
Definition
associated with:
anemia
dehydration
hypernatremia
hyperventilation

lethargy
reduced level of consciousness
weakness
edema
tachypnea, dyspnea
hypertension
tachycardia
Term
hypochloremia
Definition
results from:
GI loss (severe vomiting and diarrhea), burns and acidosis and often associated with hyponatremia

agitation/irritability
hypertonicity
hyperreflexia
cramping
twitching
tetany
Term
Mg
Definition
1.5-2.5 mEq/l
Term
glucose
Definition
70-110 mg/dl
Term
hypoglycemia
Definition
low exercise tolerance
overexertion can lead to headache, shakiness, weakness, irritatbility, cold sweats, decreased muscle control, psychosis
Term
hyperglycemia
Definition
300-350 level
risk of diabetic ketoacidosis
weak/rapid pulse
stupor, coma
Term
Hct (hematocrit)
Definition
male 42-52%
female 36-48%
Term
Hgb (hemoglobin)
Definition
male 14-18g/100ml
female 12-16g/100ml
Term
MCV (mean corpuscular volume)
Definition
average size of RBC in a sample of blood
Term
MCH (mean corpuscular hemoglobin)
Definition
average amount of oxygen-carrying hemoglobin inside one RBC
Term
MCHC (mean corpuscular hemoglobin concentration)
Definition
proportion of each RBC occupied by Hgb
Term
elevated Hct
Definition
can indicate polycythemia

headache
dizziness
blurred vision
decreased mental acuity
sensory changes in distal extremities

can indicate dehydration
Term
depressed Hct
Definition
can indicate anemia
can indicate acute blood loss
can indicate hemodilution
Term
thrombocytopenia
Definition
PLT < 140,000

decreased production of PLT
increased destruction of PLT
aggregation in microvasculature

pt at risk of bleeding
Term
thrombocytosis
Definition
PLT> 400,000
Term
leukocytosis
Definition
WBC> 11,000
Term
leukopenia
Definition
WBC < 4,000
reverse isolation

WBC <5,000 with accompany fever
Term
INR (international normalization ration)
Definition
1.0-1.5
Term
values indicate metabolic changes that may alter the performance of the patient: fatigue, muscle weakness, MS changes

CAUTION
Definition
Na < 120
BUN > 20 rising
Creatinine > 1.2 rising
Term
hold treatment till resolved/consult with RN
RED FLAG
Definition
>5.1 K <3.2
glucose <30; 300-350
Term
microcytic anemia
Definition
iron deficiency
chronic disease
decreased MCV
Term
macrocytic anemia
Definition
not enough vitamin B12
increased MCV
body cannot make enough healthy RBCs
Term
aplastic anemia
Definition
bone marrow fails to produce sufficient new cells
due to loss of RBC
Term
hemolytic anemia
Definition
RBCs are destroyed and removed from blood stream before their normal life span is over
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