NUR1460 Final Exam questions and
answers with solutions
Potassium - ANSWER 3.5-5.0 (cardiac)
Calcium - ANSWER 8.5-10.5
Sodium - ANSWER 135-145 (neuro)
Magnesium - ANSWER 1.3-2.1 (muscular)
Chloride - ANSWER 99-109
Albumin - ANSWER 3.5-5.5
Phosphorus - ANSWER 2.7-4.5
pH - ANSWER 7.35-7.45
<7.35 ACIDOTIC
>7.45 ALKALOTIC
HCO3 - ANSWER 22-26
<22 ACIDOTIC
>26 ALKALOTIC
PCO2 - ANSWER 35-45
,>45 ACIDOTIC
<35 ALKALOTIC
what are some causes of electrolyte imbalances? - ANSWER diarrhea, vomiting, trauma, MI,
excessive sweating, CHF, renal disease/failure, dehydration, acid-base imbalance, cancer
treatments, overuse of laxatives or diuretics, bulimia
causes of hypokalemia (alkalotic) - ANSWER D-drugs (laxatives, diuretics)
I-inadequate amount of potassium in diet
T-too much water intake (dilutes)
C-Cushing's syndrome
H-heavy fluid loss
s/s hypokalemia - ANSWER Weak pulses, shallow respirations with diminished breath sounds
(due to weakness of accessory muscle movement to breath), confusion, weakness, decreased
DTR, decreased bowel sounds. 7 L's: lethargy, low shallow respirations, lethal cardiac
dysrhythmias, lots of urine, leg cramps, limp muscles, low BP & heart. Abnormal rhythm,
irritability, nausea/vomiting
foods high in potassium - ANSWER potatoes, pork, oranges, tomatoes, avocados, strawberries,
spinach, fish, mushrooms, musk melons, cantaloupe, carrots, raisins, bananas
causes of hyperkalemia - ANSWER C-cellular movement of potassium from intracellular to
extracellular (burns, tissue damage)
A-adrenal insufficiency w/ Addison's disease
R-renal failure
E-excessive potassium intake
D-drugs (K sparing diuretics, NSAIDS)
,s/s hyperkalemia - ANSWER irritability and anxiety, hypotension, abdominal cramping, diarrhea,
muscle weakness/twitching, little to no urine production, rhythm changes in EKG
interventions for hyperkalemia - ANSWER Prepare patient for dialysis if they are renal failure
and get dialysis regularly as they will have high potassium. Kayexalate is sometimes ordered,
promotes GI sodium absorption which causes potassium excretion, give potassium wasting
diuretics like Lasix or hydrochlorothiazide, administer hypertonic solution of glucose and regular
insulin to pull potassium into cell (glucagon and insulin). Cut back on foods that are high in
potassium
causes of hypocalcemia - ANSWER L-low parathyroid hormone
O-oral intake inadequate
W-wound drainage
C-celiac's and Crohn's
A-acute pancreatitis
L-low vitamin D levels
C-chronic kidney issues
I-increased phosphorus levels in the blood
U-using medications like magnesium supplements, laxatives, loop diuretics, calcium binder
drugs
M-mobility issues
s/s hypocalcemia - ANSWER C-confusion
R-reflexes hyperactive
A-arrhythmias
M-muscle spasms in calves or feet, tetany, seizures
P-positive Trousseau (see before tetany or Chvostek)
, food high in calcium - ANSWER yogurt, sardines, cheese, spinach, collard greens, tofu, rhubarb,
milk
causes of hypercalcemia - ANSWER H-hyperparathyroidism
I-increased intake of calcium
G-glucocorticoids usage
H-hyperthyroidism
C-calcium excretion decreased with thiazide diuretics and renal failure, cancer of the bones
A-adrenal insufficiency w/ Addison's disease
L-lithium usage
s/s hypercalcemia - ANSWER W-weakness of muscles
E-EKG changes
A-absent reflexes, absent minded (disoriented), abdominal distention from constipation
K-kidney stone formation (renal calculi)
interventions for hypercalcemia - ANSWER keep patient safe from falls, assess for complaints of
flank or abdominal pain and strain urine to look for stone formation
causes of hyponatremia - ANSWER N-Na+ excretion increased with renal problems, NG
suctioning, vomiting, diuretics, sweating, diarrhea, diabetes insipidus
O-overload of fluid with CHF (dilutes), renal failure
N-sodium intake low through salt diet or NPO
A-antidiuretic hormone over secreted (SIADH-retains water in body and dilutes sodium)
s/s hyponatremia - ANSWER S-seizures and stupor
answers with solutions
Potassium - ANSWER 3.5-5.0 (cardiac)
Calcium - ANSWER 8.5-10.5
Sodium - ANSWER 135-145 (neuro)
Magnesium - ANSWER 1.3-2.1 (muscular)
Chloride - ANSWER 99-109
Albumin - ANSWER 3.5-5.5
Phosphorus - ANSWER 2.7-4.5
pH - ANSWER 7.35-7.45
<7.35 ACIDOTIC
>7.45 ALKALOTIC
HCO3 - ANSWER 22-26
<22 ACIDOTIC
>26 ALKALOTIC
PCO2 - ANSWER 35-45
,>45 ACIDOTIC
<35 ALKALOTIC
what are some causes of electrolyte imbalances? - ANSWER diarrhea, vomiting, trauma, MI,
excessive sweating, CHF, renal disease/failure, dehydration, acid-base imbalance, cancer
treatments, overuse of laxatives or diuretics, bulimia
causes of hypokalemia (alkalotic) - ANSWER D-drugs (laxatives, diuretics)
I-inadequate amount of potassium in diet
T-too much water intake (dilutes)
C-Cushing's syndrome
H-heavy fluid loss
s/s hypokalemia - ANSWER Weak pulses, shallow respirations with diminished breath sounds
(due to weakness of accessory muscle movement to breath), confusion, weakness, decreased
DTR, decreased bowel sounds. 7 L's: lethargy, low shallow respirations, lethal cardiac
dysrhythmias, lots of urine, leg cramps, limp muscles, low BP & heart. Abnormal rhythm,
irritability, nausea/vomiting
foods high in potassium - ANSWER potatoes, pork, oranges, tomatoes, avocados, strawberries,
spinach, fish, mushrooms, musk melons, cantaloupe, carrots, raisins, bananas
causes of hyperkalemia - ANSWER C-cellular movement of potassium from intracellular to
extracellular (burns, tissue damage)
A-adrenal insufficiency w/ Addison's disease
R-renal failure
E-excessive potassium intake
D-drugs (K sparing diuretics, NSAIDS)
,s/s hyperkalemia - ANSWER irritability and anxiety, hypotension, abdominal cramping, diarrhea,
muscle weakness/twitching, little to no urine production, rhythm changes in EKG
interventions for hyperkalemia - ANSWER Prepare patient for dialysis if they are renal failure
and get dialysis regularly as they will have high potassium. Kayexalate is sometimes ordered,
promotes GI sodium absorption which causes potassium excretion, give potassium wasting
diuretics like Lasix or hydrochlorothiazide, administer hypertonic solution of glucose and regular
insulin to pull potassium into cell (glucagon and insulin). Cut back on foods that are high in
potassium
causes of hypocalcemia - ANSWER L-low parathyroid hormone
O-oral intake inadequate
W-wound drainage
C-celiac's and Crohn's
A-acute pancreatitis
L-low vitamin D levels
C-chronic kidney issues
I-increased phosphorus levels in the blood
U-using medications like magnesium supplements, laxatives, loop diuretics, calcium binder
drugs
M-mobility issues
s/s hypocalcemia - ANSWER C-confusion
R-reflexes hyperactive
A-arrhythmias
M-muscle spasms in calves or feet, tetany, seizures
P-positive Trousseau (see before tetany or Chvostek)
, food high in calcium - ANSWER yogurt, sardines, cheese, spinach, collard greens, tofu, rhubarb,
milk
causes of hypercalcemia - ANSWER H-hyperparathyroidism
I-increased intake of calcium
G-glucocorticoids usage
H-hyperthyroidism
C-calcium excretion decreased with thiazide diuretics and renal failure, cancer of the bones
A-adrenal insufficiency w/ Addison's disease
L-lithium usage
s/s hypercalcemia - ANSWER W-weakness of muscles
E-EKG changes
A-absent reflexes, absent minded (disoriented), abdominal distention from constipation
K-kidney stone formation (renal calculi)
interventions for hypercalcemia - ANSWER keep patient safe from falls, assess for complaints of
flank or abdominal pain and strain urine to look for stone formation
causes of hyponatremia - ANSWER N-Na+ excretion increased with renal problems, NG
suctioning, vomiting, diuretics, sweating, diarrhea, diabetes insipidus
O-overload of fluid with CHF (dilutes), renal failure
N-sodium intake low through salt diet or NPO
A-antidiuretic hormone over secreted (SIADH-retains water in body and dilutes sodium)
s/s hyponatremia - ANSWER S-seizures and stupor
