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Electrolyte Imbalances
Hypocalcemia: Ca (4.0-6.0 mg/dl)
Hypocalcemia- a low bood calcium level, occurs when the concentration of free calcium ions in the blood falls below 4.0 mg/dL (dL = one tenth of a liter). The normal concentration of free calcium ions in the blood serum is 4.0-6.0 mg/dL.
Hypocalcaemia: Ca (4.0-6.0mg/dl)
S&S TREATMENT NURSING
Abdominal and muscle cramps
Lethargy BPTetanySeizureECG changes
Calcium gluconate10% : 1 g in 50-100ml of D5W over 1 hr, then infusion of 1-2 mg/kg/hr.
Given by physician or NP on general care units and by RNs in ICU.
Do not infuse too rapidly- is cardiotoxic and can cause BP.
Never given IM or subcutaneously-causes severe sloughing of tissue.
Check calcium and magnesium levels.
Antidote: IV magnesium sulfate.
Hypercalcemia: Ca (9-10.5 mg/Dl)
Hypercalcemia- the presence of abnormally high levels of calcium in the blood.
Hypercalcemia: Ca (9-10.5 mg/dL)S&S TREATMENT NURSING
DehydrationRenal StonesConfusionSevere thirstConstipationPolyuriaShortening of
QT interval BP.
D5NS at 250-500 mL/hr; furosemide 20-80 mg IV over 2 min to bring Ca down with diuresis.
Monitor electrolyte levels.
Encourage fluid intake.
Provide fiber diet and stool softeners.
Potentiate digoxin toxicity; assess as indicated.
Monitor ECG, if available, or assess pulse for irregular beats.
Hypomagnesemia Mg (1.5 - 2.5 mg/dL. )
Hypomagnesemia - abnormally low magnesium content of the blood.
Hypomagnesemia Mg (1.5 - 2.5 mg/dL. )
S&S TREATMENT NURSING
WeaknessVertigoMuscle
twitchingTachycardiaSeizuresTetanyPVCs
2 g magnesium sulfate in D5W over 10-20 min, then 1 g/hr for 3-4 hr.
Check other electrolyte levels
Can have potassium
phosphate calcium Assess reflexes and
monitor Mg levels.
Hypermagnesemia Mg(1.5-2.5 mEq/L.)
Hypermagnesemia- is an electrolyte disturbance in which there is an abnormally elevated level of magnesium in the blood. Usually this results in excess of magnesium in the body.
Hypermagnesemia Mg(1.5-2.5 mEq/L.)
S&S TREATMENT NURSING
NauseaVomiting BPWeaknessHyperreflexia HRComaRespiratory
failure
Calcium gluconate 10%: 1-10ml in 50-100 ml of D5W over 10-20 minutes.
Assess for changes in LOC.
Assess reflexes Hold medications
containing magnesium, especially in patients with renal failure.
Hypophosphatemia (2.5-4.5 mg/dL)
Hypophosphatemia- is an electrolyte disturbance in which there is an abnormally low level of phosphate in the blood
Hypophosphatemia (2.5-4.5 mg/dL)
S&S TREATMENT NURSING
AnorexiaWeakness
muscle painConfusionRhabdomyolys
isHemolysisCardiac and
respiratory failure
Potassium or sodium phosphate 2 mg/kg IV over 6 hr if P04 level is <1-5 mg/Dl.
Too rapid IV administration can cause severe hypocalemia
Assess for tetany
Hyperphosphatemia (2.5-4.5 mg/dL)
Hyperphosphatemia- is an electrolyte disturbance in which there is an abnormally elevated level of phosphate in the blood.
HyperphosphatemiaMg(1.5-2.5 mEq/L.)
S&S TREATMENT NURSING
Limited sypptoms Possible tetany if
calcium is low, which is a result of hyperphosphatermia
Phosphate binders, possibly acetazolamide, low phosphate diet.
Teach patient about avoiding foods and OTC medications high in phosphorus.
Hyperkalemia (3.5 and 5.0 mEq/L)
Hyperkalemia - refers to the condition in which the concentration of the electrolyte potassium (K+) in the blood is elevated
S&S Malaise Palpitations muscle weakness mild hyperventilation
The patient may have:Muscular weaknessCardiac dysrhythmiasECG Abnormalities ( tall, peaked T waves)
Hypokalemia (3.5 to 5.0 mEq/L)Deficiency of potassium in the
bloodstream.
Hypernatremia (136-145 mM)excessive amounts of sodium in
the blood.
Hyponatremia (136-145 mM) is an electrolyte disturbance in
which the sodium ion concentration in the serum is lower than normal
Hyperglycemia is a condition in which an excessive
amount of glucose circulates in the blood plasma
HypoglycemiaDeficiency of glucose in the
bloodstream.