N105: Essentials of Nursing Care - Health Differences

Essentials of Nursing Study Guide

Normal Range Calcium (Ca): 8.5-10.5 mg/dL Hypercalcemia:

Cause of Elevation Excessive vitamin D; immobility; hyperparathyroidism; potassium- sparing diuretics; ACE inhibitors; malignancy of bone or blood : Excessive use of magnesium-containing antacids and laxatives; untreated diabetic ketoacidosis; excessive magnesium infusions

Causes of Decline

Hypocalcemia: Hypoparathyroidism; malabsorption; insufficient or inactivated vitamin D or inadequate intake of calcium; hypoalbuminemia; diuretic therapy; diarrhea; acute pancreatitis; bone cancer; gastric surgery Hypomagnesemia: Malabsorption related to GI disease; excessive loss of GI fluids; acute alcoholism/cirrhosis; diuretic therapy; hyper or hypothyroidism; pancreatitis; preeclampsia; nasogastric suctioning; fistula drainage

Magnesium (Mg): 1.5-2.5 mg/dL Hypermagnesemia

©2017 Achieve Test Prep Page 90 of 160 Factors Influencing the Patient’s Fluid and Electrolyte Balance • Age/development level : Infants/growing children have greater fluid turnover than adults because of higher metabolic rates that increase fluid loss. Young kidneys are less able to conserve water than the adult kidney. More rapid respirations will increase insensible fluid loss. Elderly clients have blunted thirst responses. The nephrons are less able to conserve water in response to ADH. Normal changes of age increase the risk of dehydration. • Gender/body size: Lean tissue contains higher water content; fat cells contain little or no water. Water accounts for 60% of male weight and 52% of female weight. • Environmental: Increased temperature increases fluid loss through sweating. Both salt and water are lost through sweating. If only water is replaced, salt depletion is at risk. • Lifestyle/individual preferences and patterns: Stress increases cellular metabolism and can increase production of ADH. The response is to increase blood volume. Malnourishment (anorexia, bulimia) decreases serum albumin levels causingedema because the osmotic draw of fluid into the vascular compartment is reduced. Heavy alcohol consumption increases the risk of hypocalcemia, hypomagnesium, and hypophosphatemia, as well as acidosis; this is associated with fat tissue breakdown. General adaptation syndrome (stress) causes increased production of ADH which increases blood volume, and decreases urine output. Altered level of consciousness (bedrest) will produce hypercalcemia. Vomiting leads to metabolic alkalosis (loss of stomach acid), diarrhea leads to metabolic acidosis (loss of base in feces), and other electrolyte balances depending on type. Increased body temperature increases insensible fluid