NGN NCLEX Review 2023
Normal Sodium level - ANS-135-145
Hyponatremia - ANS-low sodium in the blood
Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability
Severe: gait changes, stupor, seizures, coma
causes of hyponatremia - ANS-Causes of hyponatremia:
Diuretics-Thiazide Drugs
Dietary Changes,Low Na diet,
Excessive water intake with sweating
Fad diets, Anorexia nervosa.
GI vomiting, diarrhea, GI suctioning,
Tap water enemas,diuretics, kidney disease
Treatments for hyponatremia - ANS-0.9% NaCl, accurate I&O, vitals (pulse), watch for
signs of water intoxication, monitor blood gases, watch for respiratory difficulties
Hypernatremia - ANS-high sodium in the blood
Mild: thirst, rough dry tongue, dry sticky mucous membranes, tachycardia, fever, flushed
dry skin
Severe: disorientation, hallucinations, lethargy, irritability, seizure, coma
causes of hypernatremia - ANS-Causes:
Dietary Changes-Excessive Salt intake
Excessive IV Saline
Deprivation of water
GI Disorders (Watery Diarrhea)
Decreased Renal Function
Insensible Water Loss
Heat Stroke
Salt water drowning
Head Injury Trauma
treatments for hypernatremia - ANS-restrict sodium intake, identify drugs that are
sodium retaining, monitor Na levels daily, check for rales, edema in lower extremities,
I&O, Urine specific gravity
treatments for hypokalemia - ANS-oral supplements or food replacement, K Cl(20-40)
meq, Kay Ciel, Kaochlor, oral potassium is extremely irritating to the stomach and
should be diluted in water
causes of hyperkalemia - ANS-Excessive K intake, IV K Infusions
Decreased renal function
K sparing diuretics -Aldactone,Dyrenium
Metabolic Acidosis,Hypergylcemia
Addisons disease
Hemolysis, Chemotherapy
Tissue damage, crush injuries, burns
Drugs: Capotril,Cyclosporin, Heparin, Dig toxicity,Penicillin Salts, Beta Blockers
treatments for hyperkalemia - ANS-Potassium restriction
IV sodium bicarb
Kayexalate (sodium polystyrene sulfonate)
Orally given every 4-6 hours and results occur in 1-2 hours
Rectally given has a retention enema every 2-4 hours
Enema removes K in 30-60 minutes
Monitor labs and EKG
causes of hypocalcemia - ANS-Dietary: Lack of Ca intake, Inadequate Vit D or lack of
protein, malabsorption
Hypomagnesemia,
Hyperphosphatemia
GI: Chronic Diarrhea
Pancreatitis
Calcium Binders
treatments of hypocalcemia - ANS-Oral Calcium with Vit D bid
10% IV Calcium Gluconate in D5W
Monitor serum Ca levels
Monitor ECG, and Vital Signs
Teach foods rich in Calcium
tetany - ANS-nervous disorders marked by intermittent spasms or tingling around mouth
and hands and feet as well as muscle spasms of extremities and face
Chvostek's sign - ANS-a spasm of the facial muscles elicited by tapping the facial nerve
in the region of the parotid gland
HYPOcalcemia
Trousseau's sign - ANS-a muscle spasm elicited by putting pressure on the upper arm
HYPOcalcemia
hypercalcemia - ANS-high calcium
Muscle weakness
Tiredness
Lethargy
Constipation, anorexia, N&V
Depression
Apathy
Deep bone pain
Calcium stones
causes of hypercalcemia - ANS-Increased PTH, Immobility
Metastasis Neoplastic Disease -breast , prostate, melanomas, bone, others
Cellular destruction, bone tumor
Dietary increased calcium salts, or Vit D
Diuretics, Thiazides
Over use of Ca containing antacids
Fluid volume deficit - ANS-too little fluid in the body
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