Study 4 Electrolyte Assessment and Replacement with 12 free online flashcards. Review key terms, definitions, and concepts with this interactive flashcard deck.
What should electrolyte assessment include?
Assess symptoms, mental status, strength, vital signs, fluid balance, kidney function, medications, and recent losses. Review lab trends and obtain an ECG when the imbalance is severe, symptomatic, or may affect cardiac conduction.
When is oral electrolyte replacement generally preferred?
Oral replacement is generally preferred when the patient is stable and can take and absorb medication. IV replacement is reserved for severe or symptomatic abnormalities, inability to use the oral route, or urgent treatment.
How does volume status guide hyponatremia treatment?
Treatment depends on volume status and cause. Hypovolemic hyponatremia may require isotonic saline, while dilutional hyponatremia may require fluid restriction and treatment of the underlying condition.
Why must severe hyponatremia be corrected carefully?
Overly rapid correction can injure the brain. Severe hyponatremia requires carefully controlled treatment, close neurologic observation, and frequent checks of serum sodium.
How should chronic or unknown-duration hypernatremia be corrected?
Replace water orally or enterally when safe, or choose IV fluid according to volume status. If hypernatremia is chronic or of unknown duration, lower sodium gradually because rapid correction can cause cerebral edema.
What is a critical safeguard for IV potassium?
Never give IV potassium by direct injection or rapid undiluted infusion. Use an infusion pump and follow institutional limits for concentration and rate.
Does IV calcium lower serum potassium in hyperkalemia?
No. IV calcium protects the heart from the effects of hyperkalemia when indicated, but it does not lower serum potassium. Other treatment is needed to shift or remove potassium.
What should be checked when hypokalemia is difficult to correct?
Check magnesium. Magnesium deficiency can promote ongoing potassium loss and make potassium replacement less effective until the magnesium deficiency is treated.
How should calcium results be interpreted when albumin is abnormal?
Hypocalcemia may cause tingling, cramps, hyperreflexia, tetany, seizures, and QT prolongation. Interpret total calcium in the context of albumin; ionized calcium may be needed when results or symptoms are unclear.
What treatment consideration matters when hydrating hypercalcemia?
Hydration with isotonic saline is often part of treatment, but it must be individualized for patients with heart or kidney failure. Severe cases may require calcium-lowering medication or dialysis.
What should be monitored during IV magnesium replacement?
Monitor blood pressure, respiratory status, reflexes, urine output, serum magnesium, and renal function. Renal impairment increases the risk of magnesium accumulation and toxicity.
What serious effects can hypermagnesemia cause?
Hypermagnesemia can diminish reflexes and cause hypotension, respiratory depression, and cardiac arrest. Risk is higher with impaired kidney function or magnesium-containing medicines.
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