2.  Most abundant electrolyte in the ECF
 135 to 145 mEq/L
 Has a major role in controlling water
distribution throughout the body
 Regulated by ADH, thirst and the renin-
angiotensin-aldosterone system

3.  Primary regulator of ECF volume
 Also functions in establishing the
electrochemical state necessary for muscle
contraction and the transmission of nerve
impulses

4.  Butter, bacon, canned food, cheese, ketchup,
frankfurters, processed food, soy sauce, table
salt

5.  Serum sodium level lower than 135 mEq/L
 Causes include: increased sodium excretion
(excessive diaphoresis, diuretics, vomiting,
diarrhea, wound drainage, decreased
secretion of aldosterone); inadequate sodium
intake; dilution of serum sodium (freshwater
drowning, SIADH)

6.  Rapid pulse rate
 Generalized skeletal muscle weakness
 Headache
 Diminished deep tendon reflexes
 Confusion
 Seizures
 Nausea
 Decreased urinary specific gravity
 Increased urine output

7.  Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
 If hyponatremia is accompanied by a fluid
deficit, IV sodium chloride infusions are
administered
 If hyponatremia is accompanied by a fluid
excess, osmotic diuretics are administered

8.  Instruct client to increase oral sodium intake
and inform the client about the foods to
include in the diet
 If the client is taking lithium, monitor the
lithium level, because hyponatremia can
cause diminished lithium excretion, resulting
in toxicity

9.  Is a serum sodium level that exceeds 145
mEq/L
 Causes include: decreased sodium excretion,
increased sodium intake, decreased water
intake, increased water loss

10.  Heart rate and BP that respond to vascular
volume status
 Pulmonary edema if hypervolemia is present
 Spontaneous muscle twitches, irregular
muscle contractions (early)
 Skeletal muscle weakness (late)
 Altered cerebral function is the most
common manifestation
 Increased urinary specific gravity; decreased
urine output

11.  Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
 If the cause is fluid loss, prepare to administer
IV infusions
 If the cause is inadequate renal excretion of
sodium, prepare to administer diuretics
 Restrict sodium as prescribed

12.  Is the major intracellular electrolyte
 Ranges from 3.5 to 5.1mEq/L
 98% of the body’s potassium is inside the
cells, the remaining 2% is in the ECF that is
important in neuromuscular function
 Influences both skeletal and cardiac muscle
activity

13.  Avocado, banana, cantaloupe, carrots, fish,
mushroom, oranges, potatoes, raisins,
spinach, strawberries, tomatoes, pork, beef

14.  Is a serum potassium level lower than 3.5meq/L
 Potassium deficit is potentially life-threatening
because every body system is affected
 Causes include: excessive use of medications
such as diuretics, vomiting, diarrhea, inadequate
potassium intake, hyperinsulinism

15.  Weak peripheral pulses
 FUS – flattened T wave, U wave, ST segment
depression in ECG
 Shallow
respirations, anxiety, lethargy, confusion
 Skeletal muscle weakness
 Deep tendon hyporeflexia
 Hypoactive to absent bowel sounds
 Nausea and vomiting

16.  Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
 Monitor electrolyte values
 Administer potassium supplements orally or
intravenously

17.  Oral potassium supplements may cause
nausea and vomiting and they should not be
taken on an empty stomach
 Liquid potassium chloride has an unpleasant
taste and should be taken with juice or
another liquid
 Potassium is never given by IV push or by the
IM or SQ route

18.  After adding potassium to an IV solution, rotate
and invert the bag to ensure that the potassium
is distributed evenly
 Label IV bag containing potassium properly
 Potassium infusion can cause phlebitis; thus the
nurse should assess the IV site frequently
 Monitor renal function and I&O before
administering potassium

19.  Institute safety measures for the client
experiencing muscle weakness
 Potassium sparing diuretic may be prescribed
instead
 Instruct the client about foods that are high in
potassium content

20.  Is a serum potassium level that exceeds
5.1mEq/L
 Is caused by: excessive potassium
intake, decreased potassium excretion, tissue
damage, hypercatabolism

21.  Slow, weak, irregular heart rate
 Decreased BP
 TWiFP – Tall peaked T waves, widened QRS
complexes, flat P waves, widened QRS
complexes
 Muscle twitches, cramps (early)
 Profound weakness (late)
 Diarrhea

22.  Monitor
cardiovascular, respiratory, neuromuscular, c
erebral, renal, and GI status
 Discontinue IV potassium and hold oral
potassium supplements
 Initiate a potassium-restricted diet
 Prepare to administer potassium-excreting
diuretics if renal function is not impaired

23.  Prepare to administer sodium polysterene
sulfonate (Kayexalate), cation exchange resin
that promotes GI sodium absorption and
potassium excretion
 Prepare the client for dialysis if potassium levels
are critically high
 Prepare for the IV administration of hypertonic
glucose with regular insulin to move excess
potassium into the cells

24.  Monitor renal function
 When blood transfusions are prescribed for a
client with a potassium imbalance the client
should receive fresh blood
 Teach the client to avoid foods high in potassium
 Instruct the client to avoid the use of salt
substitutes

25.  Major component of bones and teeth
 Plays a major role in transmitting nerve
impulses and helps regulate muscle
contraction and relaxation, including cardiac
muscle, also plays a role in blood coagulation
 8.6 to 10mg/dL

26.  The serum calcium level is controlled by
parathyroid hormone and calcitonin
 Cheese, milk, soy
milk, sardines, spinach, tofu, yogurt

27.  Is a serum calcium level lower than 8.6 mg/dL
 Causes include: inadequate oral intake of
calcium, lactose intolerance, inadequate
intake of vitamin D, diarrhea, steatorrhea,
hyperphosphatemia, , acute pancreatitis,
removal or destruction of the parathyroid
glands

28.  Decreased heart rate
 Hypotension
 Diminsihed peripheral pulses
 Prolonged ST interval, prolonged QT interval
 Twitches, cramps
 Painful muscle spasms during periods of
inactivity
 Positive Trousseau’s and Chvostek’s sign

29.  Inflate a blood pressure cuff around the
client’s upper arm for 1 to 4 minutes above
the systolic pressure
 In a client with hypocalcemia, the hand and
fingers become spastic and go into palmar
flexion

30.  Tap the face just below and in front of the ear
 Facial twitching on that side of the face
indicates a positive test

31.  Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
 Administer calcium supplements orally or
calcium intravenously
 When administering calcium IV, warm the
injection solution to body temperature
before administration and administer slowly

32.  Monitor for ECG changes, observe for
infiltration, and monitor for hypercalcemia
during therapy
 Administer medications that increase calcium
absorption (aluminum hydroxide, vitamin D)
 Provide a quiet environment to reduce stimuli

33.  Initiate seizure precautions
 Move the client carefully, and monitor for
signs of a fracture
 Keep 10% calcium gluconate available for
treatment of acute calcium deficit
 Instruct client to consume foods high in
calcium

34.  Is a serum calcium level that exceeds
10mg/dL
 Causes include: increased calcium
absorption, decreased calcium excretion (use
of thiazide
diuretics), hyperparathyroidism, malignancy,
immobility

35.  Increased heart rate in early
phase, bradycardia that can lead to cardiac
arrest in late phases
 Increased BP
 Shortened ST segment, widened T wave
 Profound muscle weakness
 Increased urinary output
 Formation of renal calculi

36.  Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
 Discontinue IV infusions of solutions
containing calcium and oral medications
containing calcium or vitamin D
 Discontinue thiazide diuretics and replace
with diuretics that enhance the excretion of
calcium

37.  Prepare client with severe hypercalcemia for
dialysis
 Move client carefully and monitor for signs of
fracture
 Monitor for flank or abdominal pain, and strain
the urine to check for the presence of urinary
stones
 Instruct client to avoid calcium rich foods

38.  Acts as an activator for many intracellular
enzyme systems and plays a role in both
carbohydrate and protein metabolism
 Acts peripherally to produce vasodilation
 Affect neuromuscular irritability and
contractility

39.  1.6 to 2.6 mg/dL
 Avocado, canned white tuna, cauliflower,
milk, green leafy vegetables, oatmeal, peanut
butter, peas, pork, beef, chicken, potatoes,
raisins, yogurt

40.  Is a serum magnesium level lower than 1.6
mg/dL
 Causes include: insufficient magnesium
intake, chronic alcoholism, malnutrition and
starvation, insulin administration

41.  Tall T waves, depressed ST segments
 Tachycardia
 Twitches
 Hyperreflexia
 Seizures
 Irritability
 Confusion

42.  Monitor cardiovascular, respiratory,
neuromuscular, cerebral, renal, and GI status
 Monitor serum magnesium levels frequently
 Initiate seizure precautions
 Instruct client to increase intake of foods that
contain magnesium

43.  Is a serum magnesium level that exceeds 2.6
mg/dL
 Causes include: increased magnesium intake,
decreased renal excretion of magnesium

44.  Bradycardia
 Hypotension
 Prolonged PR interval, widened QRS
complexes
 Skeletal muscle weakness
 Drowsiness and lethargy

45.  Monitor
cardiovascular, respiratory, neuromuscular, c
erebral, renal, and GI status
 Diuretics are prescribed to increase renal
excretion
 Instruct client to restrict dietary intake of
magnesium-containing foods

46.  Intravenously administered calcium chloride
or calcium gluconate may be prescribed to
reverse the effects of magnesium on cardiac
muscle
 Instruct the client to avoid the use of laxatives
and antacids containing magnesium

47.  Essential to the function of muscle and red
blood cells, formation of ATP, maintenance of
acid base balance
 Provides structural support to bones and
teeth
 2.7 to 4.5 mg/dL

48.  Fish, organ meats, nuts, pork, beef, chicken,
whole grain breads and cereals

49.  Is a serum phosphorus level lower than
2.7mg/dL
 A decrease in the serum phosphorus level is
accompanied by an increase in the serum
calcium level
 Causes include: insufficient
intake, malnutrition, starvation, hyperparath
yroidism

50.  Decreased contractility and cardiac output
 Weakness
 Decreased bone density
 Irritability
 Confusion
 seizures

51.  Monitor
cardiovascular, respiratory, neuromuscular, c
erebral, renal, and GI status
 Administer phosphorus orally along with
vitamin D supplement
 Prepare to administer phosphorus IV
 Assess renal system before administering
phosphorus

52.  Move client carefully, and monitor for signs of
fracture
 Instruct client to increase intake of
phosphorus containing foods while
decreasing the intake of calcium-containing
foods

53.  Serum phosphorus level that exceeds
4.5mg/dL
 Increase in serum phosphorus is accompanied
by a decrease in serum calcium
 Causes include: decreased renal
excretion, increased intake of
phosphorus, hypoparathyroidsm

54.  Same as assessment of hypocalcemia

55.  Entails management of hypocalcemia
 Instruct client to avoid phosphate containing
medications
 Instruct client to decrease the intake of food
that