NUR 521: Exam 1 Study Guide Fluid, Electrolyte,
n7 n7 n7 n7 n7 n7 n7 n7
and Acid-Base Balance with complete solution.
n7 n7 n7 n7 n7 n7
Exam 1 Study Guide NUR 521 n7 n7 n7 n7 n7
(Chapters 10, 34, 35, 36, 37) n7 n7 n7 n7 n7
Chapter 10 (20 questions)
n7 n7 n7
1. Understand the special needs of the older adult pertaining to fluid and electrolytes
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
a. Impact of water loss including “insensible fluid loss”
n7 n7 n7 n7 n7 n7 n7
i. Water makes up most of our bodies. An older adult’s water percentage n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
(45% for women and 55% for men) is about 10% less than a young adult.
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
ii. they have less body reserve (meaning that interruptions with body fluids
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
are more severe for the geriatric population & imbalances with fluids
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
always affect electrolytes [less water means more electrolytes; less
n7 n7 n7 n7 n7 n7 n7 n7 n7
electrolytes means more water] → thus interrupting homeostasis all
n7 n7 n7 n7 n7 n7 n7 n7 n7
together) n7
b. Organ function n7
i. Sodium and water regulation become less efficient w/ aging n7 n7 n7 n7 n7 n7 n7 n7
ii. Kidneys (less able to concentrate urine and conserve H2O and Na), Renal n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
blood flow and glomerular filtration decline
n7 n7 n7 n7 n7 n7
iii. Thirst Mechanism (hypothalamus is the thirst center in brain) Perception of n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
thirst decrease n7 n7
c. Muscle mass n7
i. skeletal muscle retains the most water (men have more skeletal muscle so n 7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
they have a higher percentage than women [they hold more fat and
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
adipose tissue does not retain much water])
n7 n7 n7 n7 n7 n7 n7
ii. In this population: Lean muscle mass is decreased, and body fat is
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
increased. n7
d. Increased risks (e.g. dehydration) n7 n7 n7
i. (Risk factors for FVD) Those with a: self-care deficit, confused, n7 n7 n7 n7 n7 n7 n7 n7 n7
depressed, tube fed on bed rest, in extremely hot weather, taking
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
medications. n7
ii. Dehydration: can cause fever and further dehydration n7 n7 n7 n7 n7 n7
iii. Functional impairments- (arthritis or stroke) can impair ability to access n7 n7 n7 n7 n7 n7 n7 n7 n7
fluids n7
iv. Cognitive impairment- interferes with recognition of thirst and ability to n 7 n7 n7 n7 n7 n7 n7 n7 n7
respond to it n7 n7 n7
v. Early manifestation for dehydration in older adult: change in mental status n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
2. Review the natural compensatory mechanisms within the body as it attempts to shift
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
fluids to maintain homeostasis
n7 n7 n7 n7
a. ADH-
i. released by the posterior pituitary gland, regulates water excretion from n7 n7 n7 n7 n7 n7 n7 n7 n7
the kidneys. Increased response to stress such as nausea, pain, surgery
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
anesthesia. Inhibited amount byalcohol and medications like phenytoin
n7 n7 n7 n7 n7 n7 n7 n7 n7
and increased blood volume and decreased osmolality. Pg 232
n7 n7 n7 n7 n7 n7 n7 n7 n7
b. Renin
, i.
angiotensin helps maintain intravascular fluid balance and blood pressure. n7 n7 n7 n7 n7 n7 n7 n7
A decrease in blood flow or BP stimulates receptors to produce renin. Pg.
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
232 n7
c. Aldosterone
i. Aldosterone promotes sodium and water retention in the distal nephron of n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
the kidney, restoring blood volume. Pg 232
n7 n7 n7 n7 n7 n7 n7
d. Vital signs and physical presentation
n7 n7 n7 n7
i. When blood pressure and blood volume are low → the body’s heart rate n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
will increase and vessels will constrict to compensate for the depressed
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
BP/BV so it increases to put out the little blood available to distribute
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
3. Memorize the information pertaining to each electrolyte posted to include the
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
following: (all from the powerpoint)
n7 n7 n7 n7 n7
a. Possible causes of the deficit or excess (study the slides)
n7 n7 n7 n7 n7 n7 n7 n7 n7
b. Clinical manifestations (it is important that you recognize signs and symptoms a
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
patient is having to correlate with disease and priority interventions)
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
c. Possible treatment n7
d. Nursing responsibilities and intervention n7 n7 n7
e. Expand your knowledge on specific foods that are high and low in each
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
electrolyte so that you may choose the correct items to teach your patient. For
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
example: high phosphorus categories aside from what is listed in the PowerPoint
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
include protein-rich foods such as meats, chicken, fish, nuts, beans and dairy
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
products.n7
Electrolyte: Sodium ir
n7 Hyponatremia <135 ir
n7 Hypernatremia >145 ir
n7
Normal: 135-145
n7ir n7ir
Symptoms Poor skin turgor, Dry mucosa, Headache,
ir
n7 n7 ir n7 ir ir
n7 ir
n7 Thirst, Elevated temperature, Dry, swollen tongue, ir
n7 ir
n7 n7 ir ir
n7 ir
n7
Decreased salivation, Decreased BP,
n7 ir n7ir n7ir n7 ir Sticky mucosa, Neuro symptoms, Restlessness,
n7 ir n7ir n7ir n7 ir n7 ir
Nausea, Abdominal cramping, Neuro
n7 ir n7 ir n7ir n7 ir Weakness, Seizures or coma
n7 ir n7 ir ir
n7 ir
n7
changes, Muscle weakness
n7 ir n7 ir n7 ir
Causes adrenal insufficiency, water intoxication,
n7 ir n7 ir n7 ir Excess water loss, Excess Na admin. Diabetes ir
n7 ir
n7 n7 ir ir
n7 n7 ir ir
n7
vomiting, diarrhea, sweating, diuretics
n7 ir n7 ir n7 ir ir
n7 insipidus, Heat stroke, Hypertonic IV
n7 ir ir
n7 ir
n7 ir
n7 n7 ir
solution
n7 ir
Treatment Water restriction, Sodium replacement
ir
n7 ir
n7 n7ir Hypotonic solution (0.45 NaCl, D5w) ir
n7 n7 ir ir
n7 ir
n7
Responsibilities/Inter Monitor sodium, Assessment, n7ir n7 ir Assess OTC sodium, Mental status, Prevention, n7 ir n7 ir ir
n7 ir
n7 ir
n7
vention
ir
n7 prevent cerebral edema, Teach about
n7 ir ir
n7 ir
n7 ir
n7 n7 ir Encourage fluids, H20 via tube feeding
n7 ir n7 ir ir
n7 ir
n7 n7 ir ir
n7
effects
ir
n7 of medication and ir
n7 ir
n7 n7 ir
manifestations
n7 ir
2
,Foods Fresh, frozen or dried fruits: Berries,
n7ir ir
n7 ir
n7 n7ir n7ir Smoked, cured, salted, or canned meat, fish or
n7 ir n7ir n7 ir n7 ir n7ir n7ir n7ir
apples, bananas, pears, etc. Grains and
n7ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7 poultry including bacon, cold cuts, ham,
n7ir n7 ir n7 ir n7ir n7ir n7 ir
beans: Dried beans, brown rice, farro,
n7ir n7ir ir
n7 ir
n7 n7 ir n7ir frankfurters, sausage, sardines, caviar and
n7ir ir
n7 n7ir ir
n7 ir
n7
quinoa and whole wheat pasta. Starchy
n7ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7 anchovies. Frozen breaded meats and dinners, such
n7ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7 ir
n7
vegetables: Potatoes, sweet potatoes,
n7ir ir
n7 ir
n7 n7 ir as burritos and pizza. Canned entrees, such as
n7ir ir
n7 n7 ir n7 ir n7ir ir
n7 n7ir n7 ir
butternut squash and parsnips. Fresh or
n7ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7 ravioli, spam and chili. Salted nuts. Beans
n7ir n7 ir ir
n7 n7ir n7ir n7 ir ir
n7
canned with salt added.
n7ir ir
n7 n7 ir n7ir
2
, frozen meat and poultry: Chicken, turkey,
ir
n7 ir
n7 ir
n7 ir
n7 ir
n7
beef or pork.
n7 ir n7 ir n7 ir
Electrolyte: Hypokalemia <3.5 n7 ir Hyperkalemia >5.3 n7 ir
Potassium
ir
n7
Normal: 3.5 - 5.3
n7ir n7ir ir n7ir
n7
Symptoms Fatigue , N/V / anorexia Dysrhythmias, ir n7ir
n7 ir n7ir
n7 ir
n7 Cardiac changes, Dysrhythmias, Possible cardiac
ir
n7 n7 ir ir
n7 n7 ir
Muscle weakness, Leg cramps /
n7 ir n7 ir n7 ir n7 ir n7 ir arrest, Potential respiratory impairment, Muscle
n7 ir n7ir n7 ir n7 ir n7ir
paresthesia, Glucose intolerance, ↓
n7 ir n7 ir ir
n7 n7ir weakness, Paresthesia, Tremors, twitching,
n7 ir n7 ir n7 ir n7ir
muscle strength, ↓ cardiac output,
n7 ir ir
n7 ir
n7 n7ir n7 ir Anxiety, GI manifestations
n7 ir n7 ir n7 ir
Polyuria / altered renal function
n7 ir n7ir n7 ir ir
n7 n7ir Treatment-Monitor EKG, Kayexalate, IV sodium ir
n7 n7 ir n7 ir n7ir
bicarbonate, IV calcium gluconate, Regular
n7 ir ir
n7 n7 ir n7ir n7 ir
insulin, D50 (hypertonic), b -2 agonists, Limit
n7 ir n7 ir n7 ir n7 ir n7 ir n7 ir n7ir
dietary K+
n7 ir n7 ir
Causes GI losses, Medications, Alterations of
n7ir n7 ir n7ir ir
n7 treatment related, Impaired renal fx, n7 ir n7 ir n7ir n7 ir
acid-base balance,
n7 ir n7ir Hyperaldosteronism, Tissue trauma, Acidosis
n7 ir n7 ir ir
n7 n7 ir
Hyperaldosteronism, Poor dietary
n7 ir ir
n7 ir
n7
intake
n7 ir
Treatment Increase dietary K+, K+ replacement, ir
n7 ir
n7 ir
n7 ir
n7 Monitor EKG, Kayexalate, IV sodium bicarbonate, ir
n7 ir
n7 ir
n7 ir
n7 n7 ir
D5W
n7 ir IV calcium gluconate, Regular insulin, D50
n7 ir n7ir n7ir ir
n7 n7ir n7ir
(hypertonic), b -2 agonists, Limit dietary K+
n7 ir n7 ir ir
n7 n7 ir n7 ir ir
n7 n7 ir
Responsibilities/Inter Assessment, health history, physical, ir
n7 n7 ir ir
n7 Assess serum K+, Monitor medication effects,
ir
n7 ir
n7 n7ir ir
n7 ir
n7
vention
ir
n7 Monitor EKG, ABG’s, Dietary
n7 ir ir
n7 n7 ir ir
n7 Initiate dietary K+ restriction, Dietary teaching
n7 ir ir
n7 ir
n7 n7 ir ir
n7 ir
n7
K+, Watch IV site
ir
n7 n7ir n7ir n7 ir
Foods cherries, tangerine, lettuce, peppers, beef, n7 ir ir
n7 ir
n7 ir
n7 Dried fruits (raisins, apricots), Beans, lentils,
n7 ir n7 ir n7ir n7ir ir
n7
egg, peanut butter, rice, tea, noodles
n7 ir n7ir n7 ir n7 ir n7ir ir
n7 Potatoes, Winter squash (acorn, butternut),
n7 ir n7 ir n7 ir n7 ir n7 ir
Spinach, broccoli, Beet greens, Avocado, Bananas,
n7 ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7
Cantaloupe, Oranges, orange juice, Coconut water,
n7 ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7
Tomatoes, Dairy and plant milks (soy,
n7 ir n7 ir n7 ir n7ir n7 ir n7 ir
almond), Yogurt, Cashews, almonds, Chicken,
n7 ir n7 ir n7 ir n7 ir n7 ir
Salmon
n7 ir
Electrolyte: Calcium ir
n7 Hypocalemia <9 ir
n7 Hyper
Normal: 9 - 11
n7ir n7 ir ir
n7 ir
n7
Symptoms Tetany (spasms), Circumoral numbness, ir
n7 ir
n7 ir
n7 H/A – Anorexia, N/V, Dehydration,
n7ir n7 ir n7 ir n7ir
Paresthesia, Hyperactive DTR’s,
n7 ir n7 ir n7 ir Constipation, Abdominal/bone pain, Excessive
n7 ir n7 ir ir
n7 n7 ir
Trousseau’s sign, Chvostek’s sign,
n7 ir n7 ir n7 ir n7ir urination, Severe thirst, Confusion, impaired
ir
n7 ir
n7 ir
n7 n7ir n7 ir
Seizures, Respiratory symptoms,
n7 ir n7ir n7 ir memory, slurred speech, lethargy, acute
n7 ir n7 ir n7 ir n7 ir ir
n7
Dyspnea
n7 ir psychotic behavior or coma
ir
n7 n7 ir ir
n7 ir
n7
3
n7 n7 n7 n7 n7 n7 n7 n7
and Acid-Base Balance with complete solution.
n7 n7 n7 n7 n7 n7
Exam 1 Study Guide NUR 521 n7 n7 n7 n7 n7
(Chapters 10, 34, 35, 36, 37) n7 n7 n7 n7 n7
Chapter 10 (20 questions)
n7 n7 n7
1. Understand the special needs of the older adult pertaining to fluid and electrolytes
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
a. Impact of water loss including “insensible fluid loss”
n7 n7 n7 n7 n7 n7 n7
i. Water makes up most of our bodies. An older adult’s water percentage n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
(45% for women and 55% for men) is about 10% less than a young adult.
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
ii. they have less body reserve (meaning that interruptions with body fluids
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
are more severe for the geriatric population & imbalances with fluids
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
always affect electrolytes [less water means more electrolytes; less
n7 n7 n7 n7 n7 n7 n7 n7 n7
electrolytes means more water] → thus interrupting homeostasis all
n7 n7 n7 n7 n7 n7 n7 n7 n7
together) n7
b. Organ function n7
i. Sodium and water regulation become less efficient w/ aging n7 n7 n7 n7 n7 n7 n7 n7
ii. Kidneys (less able to concentrate urine and conserve H2O and Na), Renal n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
blood flow and glomerular filtration decline
n7 n7 n7 n7 n7 n7
iii. Thirst Mechanism (hypothalamus is the thirst center in brain) Perception of n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
thirst decrease n7 n7
c. Muscle mass n7
i. skeletal muscle retains the most water (men have more skeletal muscle so n 7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
they have a higher percentage than women [they hold more fat and
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
adipose tissue does not retain much water])
n7 n7 n7 n7 n7 n7 n7
ii. In this population: Lean muscle mass is decreased, and body fat is
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
increased. n7
d. Increased risks (e.g. dehydration) n7 n7 n7
i. (Risk factors for FVD) Those with a: self-care deficit, confused, n7 n7 n7 n7 n7 n7 n7 n7 n7
depressed, tube fed on bed rest, in extremely hot weather, taking
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
medications. n7
ii. Dehydration: can cause fever and further dehydration n7 n7 n7 n7 n7 n7
iii. Functional impairments- (arthritis or stroke) can impair ability to access n7 n7 n7 n7 n7 n7 n7 n7 n7
fluids n7
iv. Cognitive impairment- interferes with recognition of thirst and ability to n 7 n7 n7 n7 n7 n7 n7 n7 n7
respond to it n7 n7 n7
v. Early manifestation for dehydration in older adult: change in mental status n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
2. Review the natural compensatory mechanisms within the body as it attempts to shift
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
fluids to maintain homeostasis
n7 n7 n7 n7
a. ADH-
i. released by the posterior pituitary gland, regulates water excretion from n7 n7 n7 n7 n7 n7 n7 n7 n7
the kidneys. Increased response to stress such as nausea, pain, surgery
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
anesthesia. Inhibited amount byalcohol and medications like phenytoin
n7 n7 n7 n7 n7 n7 n7 n7 n7
and increased blood volume and decreased osmolality. Pg 232
n7 n7 n7 n7 n7 n7 n7 n7 n7
b. Renin
, i.
angiotensin helps maintain intravascular fluid balance and blood pressure. n7 n7 n7 n7 n7 n7 n7 n7
A decrease in blood flow or BP stimulates receptors to produce renin. Pg.
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
232 n7
c. Aldosterone
i. Aldosterone promotes sodium and water retention in the distal nephron of n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
the kidney, restoring blood volume. Pg 232
n7 n7 n7 n7 n7 n7 n7
d. Vital signs and physical presentation
n7 n7 n7 n7
i. When blood pressure and blood volume are low → the body’s heart rate n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
will increase and vessels will constrict to compensate for the depressed
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
BP/BV so it increases to put out the little blood available to distribute
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
3. Memorize the information pertaining to each electrolyte posted to include the
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
following: (all from the powerpoint)
n7 n7 n7 n7 n7
a. Possible causes of the deficit or excess (study the slides)
n7 n7 n7 n7 n7 n7 n7 n7 n7
b. Clinical manifestations (it is important that you recognize signs and symptoms a
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
patient is having to correlate with disease and priority interventions)
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
c. Possible treatment n7
d. Nursing responsibilities and intervention n7 n7 n7
e. Expand your knowledge on specific foods that are high and low in each
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
electrolyte so that you may choose the correct items to teach your patient. For
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
example: high phosphorus categories aside from what is listed in the PowerPoint
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
include protein-rich foods such as meats, chicken, fish, nuts, beans and dairy
n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7 n7
products.n7
Electrolyte: Sodium ir
n7 Hyponatremia <135 ir
n7 Hypernatremia >145 ir
n7
Normal: 135-145
n7ir n7ir
Symptoms Poor skin turgor, Dry mucosa, Headache,
ir
n7 n7 ir n7 ir ir
n7 ir
n7 Thirst, Elevated temperature, Dry, swollen tongue, ir
n7 ir
n7 n7 ir ir
n7 ir
n7
Decreased salivation, Decreased BP,
n7 ir n7ir n7ir n7 ir Sticky mucosa, Neuro symptoms, Restlessness,
n7 ir n7ir n7ir n7 ir n7 ir
Nausea, Abdominal cramping, Neuro
n7 ir n7 ir n7ir n7 ir Weakness, Seizures or coma
n7 ir n7 ir ir
n7 ir
n7
changes, Muscle weakness
n7 ir n7 ir n7 ir
Causes adrenal insufficiency, water intoxication,
n7 ir n7 ir n7 ir Excess water loss, Excess Na admin. Diabetes ir
n7 ir
n7 n7 ir ir
n7 n7 ir ir
n7
vomiting, diarrhea, sweating, diuretics
n7 ir n7 ir n7 ir ir
n7 insipidus, Heat stroke, Hypertonic IV
n7 ir ir
n7 ir
n7 ir
n7 n7 ir
solution
n7 ir
Treatment Water restriction, Sodium replacement
ir
n7 ir
n7 n7ir Hypotonic solution (0.45 NaCl, D5w) ir
n7 n7 ir ir
n7 ir
n7
Responsibilities/Inter Monitor sodium, Assessment, n7ir n7 ir Assess OTC sodium, Mental status, Prevention, n7 ir n7 ir ir
n7 ir
n7 ir
n7
vention
ir
n7 prevent cerebral edema, Teach about
n7 ir ir
n7 ir
n7 ir
n7 n7 ir Encourage fluids, H20 via tube feeding
n7 ir n7 ir ir
n7 ir
n7 n7 ir ir
n7
effects
ir
n7 of medication and ir
n7 ir
n7 n7 ir
manifestations
n7 ir
2
,Foods Fresh, frozen or dried fruits: Berries,
n7ir ir
n7 ir
n7 n7ir n7ir Smoked, cured, salted, or canned meat, fish or
n7 ir n7ir n7 ir n7 ir n7ir n7ir n7ir
apples, bananas, pears, etc. Grains and
n7ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7 poultry including bacon, cold cuts, ham,
n7ir n7 ir n7 ir n7ir n7ir n7 ir
beans: Dried beans, brown rice, farro,
n7ir n7ir ir
n7 ir
n7 n7 ir n7ir frankfurters, sausage, sardines, caviar and
n7ir ir
n7 n7ir ir
n7 ir
n7
quinoa and whole wheat pasta. Starchy
n7ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7 anchovies. Frozen breaded meats and dinners, such
n7ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7 ir
n7
vegetables: Potatoes, sweet potatoes,
n7ir ir
n7 ir
n7 n7 ir as burritos and pizza. Canned entrees, such as
n7ir ir
n7 n7 ir n7 ir n7ir ir
n7 n7ir n7 ir
butternut squash and parsnips. Fresh or
n7ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7 ravioli, spam and chili. Salted nuts. Beans
n7ir n7 ir ir
n7 n7ir n7ir n7 ir ir
n7
canned with salt added.
n7ir ir
n7 n7 ir n7ir
2
, frozen meat and poultry: Chicken, turkey,
ir
n7 ir
n7 ir
n7 ir
n7 ir
n7
beef or pork.
n7 ir n7 ir n7 ir
Electrolyte: Hypokalemia <3.5 n7 ir Hyperkalemia >5.3 n7 ir
Potassium
ir
n7
Normal: 3.5 - 5.3
n7ir n7ir ir n7ir
n7
Symptoms Fatigue , N/V / anorexia Dysrhythmias, ir n7ir
n7 ir n7ir
n7 ir
n7 Cardiac changes, Dysrhythmias, Possible cardiac
ir
n7 n7 ir ir
n7 n7 ir
Muscle weakness, Leg cramps /
n7 ir n7 ir n7 ir n7 ir n7 ir arrest, Potential respiratory impairment, Muscle
n7 ir n7ir n7 ir n7 ir n7ir
paresthesia, Glucose intolerance, ↓
n7 ir n7 ir ir
n7 n7ir weakness, Paresthesia, Tremors, twitching,
n7 ir n7 ir n7 ir n7ir
muscle strength, ↓ cardiac output,
n7 ir ir
n7 ir
n7 n7ir n7 ir Anxiety, GI manifestations
n7 ir n7 ir n7 ir
Polyuria / altered renal function
n7 ir n7ir n7 ir ir
n7 n7ir Treatment-Monitor EKG, Kayexalate, IV sodium ir
n7 n7 ir n7 ir n7ir
bicarbonate, IV calcium gluconate, Regular
n7 ir ir
n7 n7 ir n7ir n7 ir
insulin, D50 (hypertonic), b -2 agonists, Limit
n7 ir n7 ir n7 ir n7 ir n7 ir n7 ir n7ir
dietary K+
n7 ir n7 ir
Causes GI losses, Medications, Alterations of
n7ir n7 ir n7ir ir
n7 treatment related, Impaired renal fx, n7 ir n7 ir n7ir n7 ir
acid-base balance,
n7 ir n7ir Hyperaldosteronism, Tissue trauma, Acidosis
n7 ir n7 ir ir
n7 n7 ir
Hyperaldosteronism, Poor dietary
n7 ir ir
n7 ir
n7
intake
n7 ir
Treatment Increase dietary K+, K+ replacement, ir
n7 ir
n7 ir
n7 ir
n7 Monitor EKG, Kayexalate, IV sodium bicarbonate, ir
n7 ir
n7 ir
n7 ir
n7 n7 ir
D5W
n7 ir IV calcium gluconate, Regular insulin, D50
n7 ir n7ir n7ir ir
n7 n7ir n7ir
(hypertonic), b -2 agonists, Limit dietary K+
n7 ir n7 ir ir
n7 n7 ir n7 ir ir
n7 n7 ir
Responsibilities/Inter Assessment, health history, physical, ir
n7 n7 ir ir
n7 Assess serum K+, Monitor medication effects,
ir
n7 ir
n7 n7ir ir
n7 ir
n7
vention
ir
n7 Monitor EKG, ABG’s, Dietary
n7 ir ir
n7 n7 ir ir
n7 Initiate dietary K+ restriction, Dietary teaching
n7 ir ir
n7 ir
n7 n7 ir ir
n7 ir
n7
K+, Watch IV site
ir
n7 n7ir n7ir n7 ir
Foods cherries, tangerine, lettuce, peppers, beef, n7 ir ir
n7 ir
n7 ir
n7 Dried fruits (raisins, apricots), Beans, lentils,
n7 ir n7 ir n7ir n7ir ir
n7
egg, peanut butter, rice, tea, noodles
n7 ir n7ir n7 ir n7 ir n7ir ir
n7 Potatoes, Winter squash (acorn, butternut),
n7 ir n7 ir n7 ir n7 ir n7 ir
Spinach, broccoli, Beet greens, Avocado, Bananas,
n7 ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7
Cantaloupe, Oranges, orange juice, Coconut water,
n7 ir ir
n7 ir
n7 ir
n7 ir
n7 ir
n7
Tomatoes, Dairy and plant milks (soy,
n7 ir n7 ir n7 ir n7ir n7 ir n7 ir
almond), Yogurt, Cashews, almonds, Chicken,
n7 ir n7 ir n7 ir n7 ir n7 ir
Salmon
n7 ir
Electrolyte: Calcium ir
n7 Hypocalemia <9 ir
n7 Hyper
Normal: 9 - 11
n7ir n7 ir ir
n7 ir
n7
Symptoms Tetany (spasms), Circumoral numbness, ir
n7 ir
n7 ir
n7 H/A – Anorexia, N/V, Dehydration,
n7ir n7 ir n7 ir n7ir
Paresthesia, Hyperactive DTR’s,
n7 ir n7 ir n7 ir Constipation, Abdominal/bone pain, Excessive
n7 ir n7 ir ir
n7 n7 ir
Trousseau’s sign, Chvostek’s sign,
n7 ir n7 ir n7 ir n7ir urination, Severe thirst, Confusion, impaired
ir
n7 ir
n7 ir
n7 n7ir n7 ir
Seizures, Respiratory symptoms,
n7 ir n7ir n7 ir memory, slurred speech, lethargy, acute
n7 ir n7 ir n7 ir n7 ir ir
n7
Dyspnea
n7 ir psychotic behavior or coma
ir
n7 n7 ir ir
n7 ir
n7
3
