NGN NCLEX Review
Normal Sodium level - ANS135-145
Hyponatremia - ANSlow sodium in the blood
Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability
Severe: gait changes, stupor, seizures, coma
causes of hyponatremia - ANSCauses 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 - ANS0.9% NaCl, accurate I&O, vitals (pulse), watch for signs of
water intoxication, monitor blood gases, watch for respiratory difficulties
Hypernatremia - ANShigh 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 - ANSCauses:
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 - ANSrestrict 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 - ANS>1.015
normal potassium levels - ANS3.5-5.0 mEq/L
, hypokalemia - ANSlow potassium
nausea, vomiting, diarrhea, vertigo, ventricular arrhythmias, hypotension, polyuria, muscle
cramps, alkalosis, lethargy
causes of hyponatremia - ANSMalnutrition; 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 - ANSoral 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 - ANShigh potassium
Abd cramps
Tachycardia
Widened QRS
Ventricular arrhythmia
Cardiac Arrest
Oliguria
Numbness face, tongue, feet , hands
causes of hyperkalemia - ANSExcessive 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 - ANSPotassium restriction
IV sodium bicarb
Kayexalate (sodium polystyrene sulfonate)
Orally given every 4-6 hours and results occur in 1-2 hours
Rectally given has a retention enema every 2-4 hours
Enema removes K in 30-60 minutes
Monitor labs and EKG
Normal Sodium level - ANS135-145
Hyponatremia - ANSlow sodium in the blood
Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability
Severe: gait changes, stupor, seizures, coma
causes of hyponatremia - ANSCauses 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 - ANS0.9% NaCl, accurate I&O, vitals (pulse), watch for signs of
water intoxication, monitor blood gases, watch for respiratory difficulties
Hypernatremia - ANShigh 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 - ANSCauses:
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 - ANSrestrict 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 - ANS>1.015
normal potassium levels - ANS3.5-5.0 mEq/L
, hypokalemia - ANSlow potassium
nausea, vomiting, diarrhea, vertigo, ventricular arrhythmias, hypotension, polyuria, muscle
cramps, alkalosis, lethargy
causes of hyponatremia - ANSMalnutrition; 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 - ANSoral 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 - ANShigh potassium
Abd cramps
Tachycardia
Widened QRS
Ventricular arrhythmia
Cardiac Arrest
Oliguria
Numbness face, tongue, feet , hands
causes of hyperkalemia - ANSExcessive 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 - ANSPotassium restriction
IV sodium bicarb
Kayexalate (sodium polystyrene sulfonate)
Orally given every 4-6 hours and results occur in 1-2 hours
Rectally given has a retention enema every 2-4 hours
Enema removes K in 30-60 minutes
Monitor labs and EKG
