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Hyponatremia
Muscle weakness, muscle twitching,decreased skin tugor, headache, tremor, seizures, coma.
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Hypernatremia
Thirst, fever, flushed skin, oliguria, disorientation, dry, sticky membranes
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Hypokalemia
Decreased GI, skeletal muscle and cardiac muscle function, decreased reflexes, rapid, weak, irregular pulse, muscle irritability, fatigue, decreased BP, decreased bowel motility, paralytic ileus
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Hyperkalemia
muscle weakness, nausea, diarrhea, oliguria, paresthesia (altered sensation) of the face, tongue, hands, and feet.
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Hypocalcemia
Muscle tremor, muscle cramps, tetany, tonis-clonic seizures, paresthesia, bleeding, arrhythmias, hypotension, numbness or tingling in fingers, toes, and area surrounding the mouth
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Hypercalcemia
Lethargy, headache, muscle flacidity, nausea, vomiting, anorexia, constipation, hypertension, polyuria.
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Hypochloremia
Increased muscle excitability, tetany, decreased respirations
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Hyperchloremia
Stupor, rapid, deep breathing, muscle weakness
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Hypophosphatemia
Paresthesia (circumoral and peripheral), lethargy, speech defects (such as stuttering or stammering), muscle pain and tenderness
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Hyperphosphatemia
Renal failure, vague neuroexcitibility to tetany and seizures, arrhythmias and muscle twitching with sudden rise in phosphate level
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Hypomagnesemia
Dizziness, confusion, seizures, tremor, leg and foot cramps, hyperirritability, arrhythmias, vasomotor changes, anorexia, nausea
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Hypermagnesemia
Drowsiness, lethargy, coma, arrhythmias, hypotension, vague neuromuscular changes (such as tremor), vague GI symptoms (such as nausea), peripheral vasodilation, facial flushing, sense of warmth, slow, weak pulse
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Diffusion
decends (high to low)
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Active transport
Ascends (Low to high)
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Isotonic
- Stays where its infused
- Normal saline
- Lactated Ringers
- D5W
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Hypertonic
- Higher than serum osmolarity
- Initially increases osmolarity causing fluid to be pulled from the interstitial and intracellular compartments into the blood vessels.
- It reduces rick of edema, stabalizes BP, regulates urine output
- D5 in half NS
- D5NS
- D5 in LR
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Hypotonic
- Lower than serum osmolarity
- Fluid shifts out of the blood vessels and into the cells and interstitial spaces
- Hydrates celss while reducung fluid in the circulatory system
- Used when diuretic therapy dehydrates cells, diabetic ketoacidosis, and hyperosmolar hyperglycemic nonketotic syndrome.
- Half NS
- 0.33% NaCl
- Dextrose 2.5% in H2O
- Dextrose 2.5%
- NEVER FOR Pts with Cerebral edema, increased ICP
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