Key Electrolyte Information for NCLEX

Oct 12, 2024

Electrolyte Labs for NCLEX

Sodium (Na)

  • Normal Range: 135 to 145 mEq/L
  • Functions: Sodium swells the body with fluid.
  • Low Sodium Symptoms:
    • Low and slow signs
    • Mental status changes
    • Seizures, coma, respiratory arrest
  • High Sodium Symptoms:
    • Big and bloated appearance
    • Edema, increased muscle tone
    • Flushed red skin

Potassium (K)

  • Normal Range: 3.5 to 5.0 mEq/L
  • Importance: Key electrolyte for muscle function, especially cardiac muscles.
  • High Potassium (>5.0) Signs:
    • High pumps: Peak T waves, ST elevation
  • Low Potassium (<3.5) Signs:
    • Low pumps: Flat T waves, ST depression, U wave
  • Potassium Wasting Diuretics:
    • Ends in "-ide" (e.g., furosemide)
    • Used in acute/worsening heart failure
    • Avoid in low potassium
  • Potassium Sparing Diuretics:
    • Spironolactone: Spares potassium
    • Avoid potassium-rich foods
  • IV Potassium Replacement:
    • Never push IV (instant death risk)
    • Administer via IV bag over 1 hour or more
    • Place patient on cardiac monitor for abnormalities

Potassium Treatment for High Levels:

  • Priority Treatment Order:
    1. IV Calcium Gluconate (prevents dysrhythmias)
    2. IV 50% Dextrose and Insulin (lowers potassium quickly)
    3. Kayexalate or Dialysis (slower)
  • NCLEX Tip: Look for signs like bradycardia, weakness, lethargy, VTAC, VFIB

Case Scenarios:

  • High Potassium (8.1), Wide QRS, and Bradycardia:
    • First action: IV Calcium Gluconate
  • End-Stage Renal Disease with High Potassium (7.2):
    • First action: IV Regular Insulin and 50% Dextrose

Calcium (Ca)

  • Normal Range: 9.0 to 10.5 mg/dL
  • Functions: Calcium contracts muscles.
  • Low Calcium Symptoms:
    • Diarrhea, Trussos (twerking arm), Chvostek's sign (cheek twitch)
  • High Calcium Symptoms:
    • Kidney stones, constipation

Magnesium (Mg)

  • Normal Range: 1.3 to 2.1 mEq/L
  • Functions: Magnesium mellows muscles.
  • Low Magnesium Symptoms:
    • Hyperexcitability, Torsades de Pointes, VFib
  • High Magnesium Symptoms:
    • Hyporeflexia, decreased DTRs

Additional Resources

  • SimpleNursing.com: Offers study plans, videos, practice questions.
  • YouTube: Subscribe for more educational videos.
  • Expert Team: Thanks to the team for content creation.

These notes provide a comprehensive overview of key electrolyte information crucial for NCLEX preparation.