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NGN NCLEX Review 2024 Verified Guide
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NGN NCLEX Review 2024 Verified Guide Normal Sodium level Hyponatremia 135-145 low sodium in the blood Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability Severe: gait changes, stupor, seizures, coma causes of hyponatremia Diuretics-Thiazide Drugs Causes of h...

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  • February 16, 2024
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  • 2023/2024
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NGN NCLEX Review 2024 Verified Guide
Normal Sodium level 135-145



Hyponatremia low sodium in the blood

Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability

Severe: gait changes, stupor, seizures, coma



causes of hyponatremia 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 0.9% NaCl, accurate I&O, vitals (pulse), watch for signs of water
intoxication, monitor blood gases, watch for respiratory difficulties



Hypernatremia 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 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 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



urine specific gravity level >1.015



normal potassium levels 3.5-5.0 mEq/L



hypokalemia low potassium

nausea, vomiting, diarrhea, vertigo, ventricular arrhythmias, hypotension, polyuria, muscle cramps,
alkalosis, lethargy



causes of hyponatremia Malnutrition; Alcoholism

Potassium wasting diuretics

Renal Failure, Hyperaldosteronism

Steroids

GI Losses;laxative abuse,diarrhea,vomiting,

gastric suctioning

Trauma & injury, excessive sweating

Alkalosis, Insulin



treatments for hypokalemia 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



hyperkalemia high potassium

Abd cramps

Tachycardia

Widened QRS

Ventricular arrhythmia

Cardiac Arrest

, Oliguria

Numbness face, tongue, feet , hands



causes of hyperkalemia 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 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



normal calcium levels 9.0-10.5 mEq/l



hypocalcemia low calcium in blood

Tetany

Prolonged Q-T wave

Anxiety

Irritability

Confusion

Convulsions

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