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Sodium normal range
135-145
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Hypernatremia causes
- Excess salt intake
- Excess aldosterone
- Diabetes insipidus
- Water deprivation
-
Hyponatremia causes
- GI loss
- Renal loss
- Skin loss
- SIADH – Don’t go into memorizing mechanism of this.
- Most of these are seen in a hospital setting.Esp if these fluids aren’t being replaced with IV fluid
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Hypernatremia S&S
- Extreme thirst
- Dry flushed skin
- Fever
- Agitation
- Convulsions
- NA>145
- Osmolality 300mOsm/kg (solute concentration in urine is going to be higher)
- Urine SG 1.030
-
Hyponatremia S&S
- Personality changes
- Abdominal cramping
- Nausea/Vomit
- Tachycardia
- Convulsions
- Coma
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Potassium normal levels
3.0-5.0
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Causes of hyperkalemia
- Renal failure – kidneys aren’t filtering
- Fluid volume deficit – severely dehydrated, too much extracellular potassium. Cells are unlocked.
- Cellular damage (Burns) cells are unlocked and potassium going out of cells
- Use of potassium sparing diuretics
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Hypokalemia
- Use of potassium wasting diuretics
- Extreme sweating
- Excessive use of potassium free IV solutions, pts probably need potassium replacement.
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Hyperkalemia
- Anxiety
- Dysrhthmias (peak T waves)
- Weakness
- Abdominal Cramps
- K>5 (or so)
- ECG abnormalities
- Cardiac Arrest
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Hypokalemia S&S
- Weakness, fatigue
- ECG changes (depressed or flattened T wave)
- Decreased deep tendon reflexes
- Irregular pulse
- K<3.5 or so
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Calcium normal levels
8.5-10.5, 4.5-5.5
-
Hypercalcemia causes
- Hyperparathyroidism (increase in parathyroid activity)
- Prolonged immobilization
- Thiazide diuretics (potassium sparing)
-
Hypocalcemia causes
- Vitamin D deficiency
- Chronic renal failure
- Pancreatitis
- Hypoparathyroidism
-
Hypercalcemia S&S
- Anorexia
- N/V
- Flank pain
- Decreased LOC
- Cardiac Arrest
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Hypocalcemia S&S
- Numbness
- Hyperactive reflexes
- Positive Trousseau’s sign (ticking in face )
- Positive Chvostek’s sign (put blood pressure cuff on, will make vessels become hypoic and hand will twitch)
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Magnesium normal levels
1.5-2.5
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Hypermagnesia causes
- Renal failure
- Excess ingestion of Mg
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Hypomagnesia causes
- Malnutrition
- ETOH ecessive alcohol intake
- Inadequate absorption or loss: diarrhea, vomiting, NG drainage
-
Hypermagnesia S&S
- Hypoactive deep tendon reflexes
- Decreased depth or respirations
- Hypotensions
- Mg>2.5
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Hypomagnesia S&S
Hypoactive deep tendon reflexes Decreased depth or respirations Hypotensions Mg>2.5
-
Hypomagnesia S&S
- Tremors
- Hyperactive deep tendon reflexes
- Confusion
- Hypertension
-
FVE causes
- CHF
- Renal failure
- Cirrhosis
- Excess sodium intake
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FVD causes
- GI losses
- Fever (gi and fever more of an effect on elderly and very young)
- Decreased oral intake
- Use of diuretics
-
FVE S&S
- Rapid weight gain
- Neck vein distention
- Crackles
- Hypertension
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FVD S&S
- Tachycardia
- Poor skin turgor
- Flat neck veins
- Lethargy
- Oliguria
-
Resp Acidosis causes
- Hypoventilation Resulting from Primary Resp. Problems
- Atelectasis
- Pneumonia
- Airway Obstruction
- Chest wall injury
- COPD
-
Resp alkalosis causes
- Hyperventilation
- Anxiety
- Fever, excerise
- Salicylate overdose
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Metabolic acidosis causes
- Starvation
- Diabetic Ketoacidosis
- Renal failure
- Use of drugs
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Metabolic alkalosis causes
- Excessive vomiting
- Prolonged suctioning
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