This is the excerpt of the course note on ‘NCLEX 30 DAY CHALLENGE’. Get the full course here. [flashcard_set id=’25402′]
| ION | Normal Serum Concentration In mEq/L or mg/dL |
| Sodium | 135 to 145 |
| Potassium | 3.5 to 5.0 |
| Calcium | 9 to10.5 |
| Magnesium | 1.3 to 2.1 |
| Phosphorus | 3 to 4.5 |
Summary EKG Changes with electrolyte imbalance
| Electrolyte Imbalance | EKG interpretation |
| Hypokalemia | ST depression with inverted and flat T wave, see for prominent U wave |
| Hyperkalemia | Tall T waves, flat P waves, Widened PR and QRS |
| Hypocalcemia | Wide ST and QT interval |
| Hypercalcemia | Short ST with wide T |
| Hypomagnesemia | Depressed ST with tall T |
| Hypermagnesemia | Wide QRS and PR |
Important Points for flashcards
Metabolic acidosis: Decreased pH, pCO2, and decreased bicarbonate
Metabolic alkalosis: Elevated pH, pCO2, and bicarbonate
Respiratory acidosis: Decreased pH and elevated pCO2 and bicarbonate
Respiratory alkalosis: Elevated pH and decreased pCO2 and bicarbonate
Important points to revise for electrolytes
- Potassium shouldn’t be given intramuscular, IV push or subcutaneous.
- A nurse should access renal functions, cardiovascular, neuromuscular, gastrointestinal, respiratory and heart condition before administrating any electrolyte.
- In case of any increase in serum electrolyte, we give diuretics. Care should be taken not to give potassium sparing diuretics in Hyperkalemia or Give Osmotic diuretics in case of Hypernatremia.
- See for the EKG changes in any electrolyte imbalances.
- There is an inverse relation with the serum concentration of calcium and phosphorous, whenever, calcium level is low, phosphorus level is high and vise-versa. So, when taking any nursing management procedures for hypo or hyper calcemia or phosphatemia, you should access the counter electrolye level and condition.
- Chvostek’s sign and Trousseau’s sign are the signs of hypocalcemia in which there is muscle spasm.
- Take care while moving the patients with hypercalcemia as generally in this condition, the calcium is taken from bone and there is chance of fracture.