Electrolyte Balance

ALWAYS assess ____ before/during IV potassium administration?

ALWAYS assess URINE OUTPUT before/during IV potassium administration! (Need good UO - if UO drops, they may be retaining K+)

S/S of Magnesium deficit?

Anorexia, N/V, distention, meuromuscular irritability, seizures, dysrhythmias, depression, disorientation, increased DTR, positive trousseau's sign, pos chvostek's sign.

Signs and symptoms of sodium deficit?

Anorexia, N/V, weakness, lethargy, confusion, muscle cramps, twitching, & seizures.

S/S of Calcium deficit?

Diarrhea, numbness, tingling of extremities, and around mouth, painful muscle spasms, seizures, increased DTR, positive trousseau's sign, pos chvostek's sign, cardiac rate changes.

S/S of a potassium deficit?

Fatigue, anorexia, N/V, muscle weakness, decreased GI motility, dysrhythmias, parasthesia, flat T-waves on EKG.

S/S of Magnesium excess?

Flushing, hypotension, drowsiness, lethargy, decreased DTR, depressed respiration's, bradycardia.

S/S of Potassium excess?

Muscle weakness, bradycardia, dysrhythmias, muscle twitching to flaccid paralysis, intestinal colic, diarrhea, tall peaked T-waves on EKG.

S/S of Calcium Excess?

Muscle weakness, lack of coordination, decreased DTR, constipation, anorexia, N/V, polyuria, polydipsia, neurosis, dysrhythmias.

S/S of Phosphate deficit?

Parasthesias, muscle weakness, muscle or bone pain, mental changes and respiratory failure.

S/S of Phosphate excess?

Tetany, long term can cause calcium leaching from bone.

What is The Chvostek sign?

The Chvostek sign is one of the signs of tetany seen in hypocalcemia. It refers to an abnormal reaction to the stimulation of the facial nerve. When the facial nerve is tapped at the angle of the jaw (i.e. masseter muscle), the facial muscles on the same side of the face will contract momentarily (typically a twitch of the nose or lips) because of hypocalcemia with resultant hyperexcitability of nerves.

S/S of excess sodium?

Thirst, tachycardia, sticky mucous membranes, dry mouth, change in LOC, hallucinations, lethargy, irritability, & seizures.

What is the Trousseau sign?

Trousseau sign of latent tetany is a medical sign observed in patients with low calcium. This sign may become positive before other gross manifestations of hypocalcemia such as hyperreflexia and tetany, as such it is generally believed to be more sensitive (94%) than the Chvostek sign (29%) for hypocalcemia. To elicit the sign, a blood pressure cuff is placed around the arm and inflated to a pressure greater than the systolic blood pressure and held in place for 3 minutes. This will occlude the brachial artery. In the absence of blood flow, the patient's hypocalcemia and subsequent neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and metacarpophalangeal joints flex, the DIP and PIP joints extend, and the fingers adduct.