NGN NCLEX Review
Normal Sodium level - 135-145
Hyponatremia - low sodium in the blood
Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability
Severe: gait changes, stupor, seizures, coma
causes of hyponatremia - Causes of hyponatremia:
Diuretics-Thiazide Drugs
Dietary Changes,Low Na diet,
Excessive water intake with sweating
Fad diets, Anorexia nervosa.
GI vomiting, diarrhea, GI suctioning,
Tap water enemas,diuretics, kidney disease
Treatments for hyponatremia - 0.9% NaCl, accurate I&O, vitals (pulse), watch for signs of water
intoxication, monitor blood gases, watch for respiratory difficulties
Hypernatremia - high sodium in the blood
Mild: thirst, rough dry tongue, dry sticky mucous membranes, tachycardia, fever, flushed dry skin
Severe: disorientation, hallucinations, lethargy, irritability, seizure, coma
causes of hypernatremia - Causes:
Dietary Changes-Excessive Salt intake
Excessive IV Saline
,Deprivation of water
GI Disorders (Watery Diarrhea)
Decreased Renal Function
Insensible Water Loss
Heat Stroke
Salt water drowning
Head Injury Trauma
treatments for hypernatremia - restrict sodium intake, identify drugs that are sodium retaining, monitor
Na levels daily, check for rales, edema in lower extremities, I&O, Urine specific gravity
urine specific gravity level - >1.015
normal potassium levels - 3.5-5.0 mEq/L
hypokalemia - low potassium
nausea, vomiting, diarrhea, vertigo, ventricular arrhythmias, hypotension, polyuria, muscle cramps,
alkalosis, lethargy
causes of hyponatremia - Malnutrition; Alcoholism
Potassium wasting diuretics
Renal Failure, Hyperaldosteronism
Steroids
GI Losses;laxative abuse,diarrhea,vomiting,
gastric suctioning
Trauma & injury, excessive sweating
, Alkalosis, Insulin
treatments for hypokalemia - oral supplements or food replacement, K Cl(20-40) meq, Kay Ciel,
Kaochlor, oral potassium is extremely irritating to the stomach and should be diluted in water
hyperkalemia - high potassium
Abd cramps
Tachycardia
Widened QRS
Ventricular arrhythmia
Cardiac Arrest
Oliguria
Numbness face, tongue, feet , hands
causes of hyperkalemia - Excessive K intake, IV K Infusions
Decreased renal function
K sparing diuretics -Aldactone,Dyrenium
Metabolic Acidosis,Hypergylcemia
Addisons disease
Hemolysis, Chemotherapy
Tissue damage, crush injuries, burns
Drugs: Capotril,Cyclosporin, Heparin, Dig toxicity,Penicillin Salts, Beta Blockers
treatments for hyperkalemia - Potassium restriction
IV sodium bicarb
Kayexalate (sodium polystyrene sulfonate)
Normal Sodium level - 135-145
Hyponatremia - low sodium in the blood
Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability
Severe: gait changes, stupor, seizures, coma
causes of hyponatremia - Causes of hyponatremia:
Diuretics-Thiazide Drugs
Dietary Changes,Low Na diet,
Excessive water intake with sweating
Fad diets, Anorexia nervosa.
GI vomiting, diarrhea, GI suctioning,
Tap water enemas,diuretics, kidney disease
Treatments for hyponatremia - 0.9% NaCl, accurate I&O, vitals (pulse), watch for signs of water
intoxication, monitor blood gases, watch for respiratory difficulties
Hypernatremia - high sodium in the blood
Mild: thirst, rough dry tongue, dry sticky mucous membranes, tachycardia, fever, flushed dry skin
Severe: disorientation, hallucinations, lethargy, irritability, seizure, coma
causes of hypernatremia - Causes:
Dietary Changes-Excessive Salt intake
Excessive IV Saline
,Deprivation of water
GI Disorders (Watery Diarrhea)
Decreased Renal Function
Insensible Water Loss
Heat Stroke
Salt water drowning
Head Injury Trauma
treatments for hypernatremia - restrict sodium intake, identify drugs that are sodium retaining, monitor
Na levels daily, check for rales, edema in lower extremities, I&O, Urine specific gravity
urine specific gravity level - >1.015
normal potassium levels - 3.5-5.0 mEq/L
hypokalemia - low potassium
nausea, vomiting, diarrhea, vertigo, ventricular arrhythmias, hypotension, polyuria, muscle cramps,
alkalosis, lethargy
causes of hyponatremia - Malnutrition; Alcoholism
Potassium wasting diuretics
Renal Failure, Hyperaldosteronism
Steroids
GI Losses;laxative abuse,diarrhea,vomiting,
gastric suctioning
Trauma & injury, excessive sweating
, Alkalosis, Insulin
treatments for hypokalemia - oral supplements or food replacement, K Cl(20-40) meq, Kay Ciel,
Kaochlor, oral potassium is extremely irritating to the stomach and should be diluted in water
hyperkalemia - high potassium
Abd cramps
Tachycardia
Widened QRS
Ventricular arrhythmia
Cardiac Arrest
Oliguria
Numbness face, tongue, feet , hands
causes of hyperkalemia - Excessive K intake, IV K Infusions
Decreased renal function
K sparing diuretics -Aldactone,Dyrenium
Metabolic Acidosis,Hypergylcemia
Addisons disease
Hemolysis, Chemotherapy
Tissue damage, crush injuries, burns
Drugs: Capotril,Cyclosporin, Heparin, Dig toxicity,Penicillin Salts, Beta Blockers
treatments for hyperkalemia - Potassium restriction
IV sodium bicarb
Kayexalate (sodium polystyrene sulfonate)
