electrolytes imbalances, Study Guides, Projects, Research of Capstone Design

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ELECTROLYTE

IMBALANCES

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NurseInTheMaking LLC are simply guides and should not be used over and above your course material and teacher instruction in nursing school.

When details contained within these guides and other media differ, you will defer to your nursing school’s faculty/staff instruction. Hospitals and

universities may differ on lab values; you will defer to your hospital or nursing school’s faculty/staff instruction. These guides and other media

created by NurseInTheMaking LLC are not intended to be used as medical advice or clinical practice; they are for educational use only. You also agree

to not distribute or share these materials under any circumstances; they are for personal use only.

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CALCIUM IMBALANCE

Calcium is found in the body’s cells, bones, and teeth. Needed for

proper functioning of the CARDIOVASCULAR, NEUROMUSCULAR,

ENDOCRINE systems, blood clotting & teeth formation

9 - 11 mg/dL

MANAGEMENT

✹ D/C IV or PO calcium

✹ D/C Thiazide diuretics

✹ Administer phosphorus, calcitonin,

bisphosphonates, & prostaglandin

synthesis inhibitors (NSAIDs)

✹ Avoid foods high in calcium

✹ Adm. calcium PO or IV

➥ For IV, warm before & adm. slowly

✹ Adm. aluminum hydroxide & Vit D

✹ Initiate seizure precautions

✹ 10% calcium (acute calcium deficit)

✹ Consume foods high in calcium

11 mg/dL

HYPERCALCEMIA HYPOCALCEMIA

< 9 mg/dL

SIGNS & SYMPTOMS

one pain

B

A rrhythmias

uscle weakness ↓ (DTR)

M

ardiac arrest (bounding pulses)

xcessive urination

E

C

idney stones

K

onvulsions

C

A rrhythmias (diminished pulses)

etany

T

pasms & stridor

S

ness in the fingers, face, & limbs

GO NUMB

RISK FACTORS

✹ Inhibition of calcium absorption from the GI tract

✹ Increased calcium excretion

➥ Kidney disease, diuretic phase

➥ Diarrhea & steatorrhea

➥ Wound drainage

✹ Conditions that decrease

the ionized fraction of calcium

Increased calcium absorption

Decreased calcium excretion

Kidney disease

Thiazide diuretics

Increased bone resorption of calcium

Hyperparathyroidism / Hyperthyroidism

Malignancy

(bone destruction from metastatic tumors)

Hemoconcentration

A client with a calcium imbalance is at risk for a

pathological fracture. Move the client carefully and slowly

Calcium & phosphate = Inverse

Example: ↑ Ca+ = ↓ Po

POSITIVE

TROUSSEAU’S:

Carpal spasm caused

by inflating a

blood pressure cuff

CHVOSTEK’S

SIGNS:

Contraction of facial

muscles w/ light tap

over the facial nerve.

Think “C”

for Cheesy smile

MEMORYMEMORY

TRICKTRICK

MAGNESIUM IMBALANCE

Most of the magnesium found in the body is found in the bones.

Regulates BP, blood sugar, muscle contraction & nerve function.

1.5 - 2.5 mg/dL

MANAGEMENT

✹ Diuretics

✹ IV adm. calcium chloride or calcium gluconate

✹ Restrict dietary intake of Mg containing foods

✹ Avoid the use of laxatives & antacids

containing magnesium

✹ Hemodialysis

✹ Magnesium sulfate IV or PO

✹ Seizure precautions

✹ Instruct the client to increase

magnesium-containing foods

HYPERMAGNESEMIA HYPOMAGNESEMIA

2.5 mg/dL < 1.5 mg/dL

RISK FACTORS

✹ Insufficient magnesium intake

➥ Malnutrition/vomiting/diarrhea

➥ Malabsorption syndrome

➥ Celiac & Crohn’s disease

✹ Increased magnesium excretion

➥ Diuretics or chronic alcoholism

✹ Intracellular movement of magnesium

➥ Hyperglycemia & Insulin adm.

➥ Sepsis

✹ Increased magnesium intake

➥ Magnesium-containing antacids (TUMS)

& laxatives

➥ Excessive adm. of magnesium IV

✹ Renal insufficiency

➥ ↓ renal excretion of Mg = ↑ Mg in the blood

✹ DKA (Diabetic Ketoacidosis)

SIGNS & SYMPTOMS

✹ LOW EVERYTHING AKA SEDATED

✹ Low energy (drowsiness / coma)

✹ Low HR (bradycardia)

✹ Low BP (hypotension)

✹ Low RR (bradypnea)

✹ ↓ Respirations (shallow)

✹ ↓ Bowel sounds

✹ ↓ DTR’s (deep tendon reflex)

✹ HIGH EVERYTHING AKA NOT SEDATED

✹ High HR (tachycardia)

✹ High BP (hypertension)

✹ Increased deep tendon reflex (hyperreflexia)

✹ Shallow respirations

✹ Twitches, paresthesias

✹ Tetany & seizures

✹ Irritability & confusion

POSITIVE TROUSSEAU’S:

Carpal spasm caused by inflating a blood pressure cuff

CHVOSTEK’S SIGNS:

Contraction of facial muscles w/ light tap over the facial nerve

Magnesium & Calcium = SAME

Example: ↑ Mg = ↑ Ca+

REMEMBER:REMEMBER:

Also seen in

hypocalcemia.

Ca & Mg rise

and fall

together!

MAGNESIUM IS A SEDATIVE!

MEMORYMEMORY

TRICKTRICK

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By purchasing this material, you agree to the following terms and conditions: you agree that this ebook and all other media produced by

NurseInTheMaking LLC are simply guides and should not be used over and above your course material and teacher instruction in nursing

school. When details contained within these guides and other media differ, you will defer to your nursing school’s faculty/staff instruction.

Hospitals and universities may differ on lab values; you will defer to your hospital or nursing school’s faculty/staff instruction. These

guides and other media created by NurseInTheMaking LLC are not intended to be used as medical advice or clinical practice; they are for

educational use only. You also agree to not distribute or share these materials under any circumstances; they are for personal use only.

© 2021 NurseInTheMaking LLC. All content is property of NurseInTheMaking LLC and www.anurseinthemaking.com. Replication and

distribution of this material is prohibited by law. All digital products (PDF files, ebooks, resources, and all online content) are subject to

copyright protection. Each product sold is licensed to an individual user and customers are not allowed to distribute, copy, share,

or transfer the products to any other individual or entity, they are for personal use only. Fines of up to $10,000 may apply and

individuals will be reported to the BRN and their school of nursing.

Dear future nurse,

You may be stressed, you may feel red,

and you may want to give up. Nursing school is

hard, there's no doubt about it. Everyone cries,

everyone has meltdowns, and there will be

moments you don't feel qualified for the task at

hand. But take heart, the challenge only makes

you stronger. Put in the work, show up on me,

and find an amazing study group. You got this!

• Krisne Tuttle, BSN, RN

You

got this,

future

nurse!