Nursing: A Concept-Based Approach to Learning, Volume 1, 3rd Ed. | Registered Nurse (RN) School Study Aid
IV Solutions
- Hypotonic (< 280 mOsm/L)
- 1/4 Normal Saline (0.225% NaCl)
- 1/2 Normal Saline (0.45% NaCl)
- Isotonic (280-300 mOsm)
- Normal Saline (0.9% NaCl)
- Lactated Ringer's (LR)
- Dextrose 5% in Water (D5W)
- Hypertonic (> 300 mOsm)
- 3% or 5% NaCl
- Dextrose 5% in 0.45% NaCl
- Dextrose 10% in Water (D10W)
Magnesium (Mg2+) Lab Value
Phosphate (PO43-) Lab Value
Normal Electrolyte Lab Values
- Potassium (K+)
- 3.5 to 5.0 mEq/L
- Calcium (Ca2+)
- 8.5 to 10.5 mg/dL
- Phosphate (PO43–)
- 2.5 to 4.5 mg/dL
- Magnesium (Mg2+)
- 1.5 to 2.5 mEq/L
- Sodium (Na+)
- 135 to 145 mEq/L
- Chloride (Cl–)
- 95 to 105 mEq/L
Spironolactone (Aldactone)
- Inhibition of Aldosterone
- Potassium Retention
- Hypertension
- Edema
- Heart Failure
- Hyperkalemia
- Endocrine Effects
- Avoid Potassium Supplements
Loop Diuretics
- Thick Ascending Limb of Loop of Henle
- Inhibits Na+-K+-2Cl-
- Sulfa Drug
- Furosemide
- Lasix
- Ototoxicity from Rapid Injection
- Gout
- Dehydration
- Hypocalcemia
- Hypokalemia
- Orthostatic Hypotension
Hydrochlorothiazide HCTZ
- Inhibits Reabsorption NaCl and H2O
- Edema
- Mild to Moderate Hypertension
- Hypokalemia
- Hyponatremia
- Dehydration
- Hyperglycemia
- Gout
- Sulfa Allergy
- Pregnancy and Breastfeeding
Types of Heart Failure
- Left Sided
- Pulmonary Congestion
- Right Sided
- Peripheral Edema
- High Output
- Unable to Meet Metabolic Needs
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
Cirrhosis Assessment
- Degeneration and Destruction of Liver Cells
- Jaundice
- Fatigue
- Palmar Erythema
- Spider Angiomas
- Hepatosplenomegaly
- Edema
- Gynecomastia
- Change in LOC
Therapeutic Diets
- High Fiber
- Low Residue (Fiber)
- Low Sodium
- Low Cholesterol
- Diabetic
- Renal
- Dysphagia
- Diet Education
Hypernatremia
- > 145 mEq/L Na+
- Change in LOC
- Extreme Thirst
- Orthostatic Hypotension
- Dry Flushed Skin
- Muscle Twitching
- Seizures
- Treat and Prevent Dehydration
- Hypotonic Solutions (0.225% or 0.45% NaCl)
- Sodium Restriction
- Diuretics
Hyponatremia
- < 135 mEq Na+
- Nausea and Vomiting
- Decreased LOC
- Confusion / Lethargy
- Seizures
- Assess Airway
- Reduce Diuretic Dosage
- Mannitol (Osmitrol)
- Fluid Restriction
- Hypertonic Solution (3% or 5% NaCl)
Hyperkalemia
- > 5.0 mEq/L K+
- Abdominal Cramps
- Muscle Weakness
- Diarrhea
- Arrhythmia
- Tall, Peaked T Waves
- IV Calcium
- Infusion of Glucose and Insulin
- Loop or Thiazide Diuretics
- Kayexalate
- Dialysis
- Prevention Education
Hypokalemia
- < 3.5 mEq/L
- Muscle Weakness
- Arrhythmia
- U Wave
- Ileus
- Hyporeflexia
- IV K+ Infusion at 5-10 mEq/hr
- Give Orally with Food
- Monitor Respiratory Status
Hypercalcemia
- > 10.5 mg/dL Ca2+
- Pathologic Fractures
- Lethargy
- Hypercoagulation
- Constipation
- ECG Changes
- QT Shortening
- No Calcium Intake
- Chelating Drugs
- Calcitonin
- Bisphosphonates
- Loop Diuretics instead of Thiazide Diuretics
- Increased Risk for Renal Calculi
- Increase Fluids
Hypocalcemia
- Muscle Spasms
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Oral and IV Replacement of Ca2+
- Seizure Precautions
Hypocalcemia Causes
- Hypoalbuminemia
- Hypomagnesemia (Less Common Hypermagnesemia)
- Hypovitaminosis D
- Hypoparathyroidism
- Medications
- Hyperphosphatemia
- Malnutrition
- Acute Pancreatitis
- Alkalosis
- Sepsis
- Chronic Kidney Disease
Hypermagnesemia
- Flushing
- Lethargy
- Muscle Weakness
- Decreased Deep Tendon Reflexes (DTRs)
- Decreased Respirations
- Bradycardia
- Hypotension
- Dialysis
- IV Calcium Gluconate
- Diuretics
- Avoid Antacids and Laxatives containing Mg2+
Hypomagnesemia
- Confusion
- Increased Deep Tendon Reflexes (DTRs)
- Neuromuscular Irritability
- Seizures
- Muscle Cramps
- Tremors
- Insomnia
- Tachycardia
- Magnesium Sulfate
- Foods High in Magnesium
Loop Diuretic Education
- Furosemide (Lasix)
- Heart Failure
- Pulmonary Edema
- Acute Renal Failure (ARF)
- Edema
- Notify the provider of weakness, dizziness, or muscle cramping
- Increase Potassium Intake
- Check BP Daily
- Daily Weights and Monitor IandOs
Urinary Excretory Anatomy
- Renal Medulla
- Renal Cortex
- Nephron
- Bowman's Capsule
- Glomerulus
- Proximal Tubule
- Loop of Henle
- Distal Tubule
- Collecting Duct
- Ureter
- Urinary Bladder
- Urethra
K+ Sparing Diuretics
- CHF and Hypertension
- Hypokalemia
- Hyperaldosteronism
- Collecting Tubule
- Spironolactone
- Competitive Aldosterone Receptor Antagonist
- Amiloride and Triamterene
- Block Na+ Channels
- Hyperkalemia
- Gynecomastia
Ethacrynic Acid
- Non-sulfa Drug
- Phenoxyacetic Acid Derivative
- Loop Diuretic
- Inhibits Na+-K+-2Cl- Cotransporter
- Thick Ascending Loop of Henle
- Diuresis
- Hypokalemia
- Ototoxicity
- Gout
Mannitol (Osmitrol)
- Osmotic Diuresis
- Reducing Intracranial Pressure
- Reducing Intraocular Pressure
- Renal Failure Prophylaxis
- Edema
- Fluid and Electrolyte Imbalance
- Avoid Use in Cardiac Patients
- IV Administration
Chronic Kidney Disease Early Symptoms Assessment
- GFR < 60mL/min
- Accumulation of Waste Products
- General Malaise
- Hypertension
- Proteinuria
- Hyperkalemia
- Mineral and Bone Disorders
- Neuropathy
Chronic Kidney Disease Late Symptoms Assessment
- Metabolic Acidosis
- Severe Uremia
- Arrhythmias
- Edema
- CNS Depression
- Anemia
- Oliguria
- Pruritus
- End Stage Renal Disease (ESRD)
- GFR < 15mL/min
Chronic Kidney Disease Interventions
- Daily Weights
- Strict I/O
- Renal Diet
- Strict Medication Regimen
- Erythropoietin
- Manage Hyperkalemia
- Manage CKD-MBD
- Dialysis
- Kidney Transplant