This is the excerpt of the course note on ‘NCLEX 30 DAY CHALLENGE’. Get the full course here. [flashcard_set id=’25402′]

IONNormal Serum Concentration In mEq/L or mg/dL
Sodium135 to 145
Potassium3.5 to 5.0
Calcium9 to10.5
Magnesium1.3 to 2.1
Phosphorus3 to 4.5

Summary EKG Changes with electrolyte imbalance

Electrolyte ImbalanceEKG interpretation
HypokalemiaST depression with inverted and flat T wave, see for prominent U wave
HyperkalemiaTall T waves, flat P waves, Widened PR  and QRS
HypocalcemiaWide ST and QT interval
HypercalcemiaShort ST with wide T
HypomagnesemiaDepressed ST with tall T
HypermagnesemiaWide 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

  1. Potassium shouldn’t be given intramuscular, IV push or subcutaneous.
  2. A nurse should access renal functions, cardiovascular, neuromuscular, gastrointestinal, respiratory and heart condition before administrating any electrolyte.
  3. 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.
  4. See for the EKG changes in any electrolyte imbalances.
  5. 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.
  6. Chvostek’s sign and Trousseau’s sign are the signs of hypocalcemia in which there is muscle spasm.
  7. 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.

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