Electrolyte Lab Values | Top Tested & Top Missed Questions on NCLEX

Summary

Highlights

• Sodium swells the body with fluid; low levels lead to slow mental status changes, high levels to a bloated state. 🤯
• Potassium imbalances are a top priority due to their impact on heart function and common exam questions. 🫀
• Magnesium is all about keeping muscles mellow; low levels create hyperexcitability, important for NCLEX. 📈
• Remember the 'double C's' for calcium: they help with smooth muscle contractions and for assessing stone risks. 💪
• Educating about potassium-rich food choices is crucial, as is caution with diuretic usage in patient care. 😋

Key Takeaways

• Sodium is all about balancing body fluids and is crucial in preventing low and slow conditions like seizures and coma. 💧
• Potassium is critical for heart muscle function; too much or too little can have serious heart implications. 💓
• Calcium loves contracting muscles; watch out for 'stones, moans, and groans' when levels are high! 🪨
• Magnesium mellows out muscles, with low levels leading to hyperexcitability and deadly cardiac dysrhythmias. 📉
• Prioritize knowledge of dialysis and interventions for treating high potassium in renal failure. 🚑

Overview

Chapters

• 00:00 - 01:00: Introduction to Electrolytes The chapter introduces key concepts about electrolytes, focusing on sodium levels—normal ranges, their effects on the body, and associated symptoms when levels are low. It emphasizes the importance of sodium in regulating body fluids, and highlights critical conditions like mental status changes, seizures, coma, and respiratory arrest that can occur with low sodium levels. This information is deemed essential for understanding electrolyte labs for the ENLEX.
• 00:30 - 01:00: Sodium Overview The chapter discusses the effects of high sodium levels in the body, which include slow respirations, bloating, edema (swelling due to fluid in the body's tissues), increased muscle tone, and flushed, rosy skin. Sodium causes the body to swell with fluid, leading to these symptoms. Additionally, it mentions nursing school resources like simplenursing.com that offer specialized videos and study guides to help students focus on key points needed for testing.
• 01:00 - 03:00: Potassium Overview This chapter covers the key aspects of potassium, emphasizing its critical role as an electrolyte, especially for nursing exams like the NCLEX. It introduces the '3 Ps' of potassium, underscoring its priority in medical studies due to its crucial function in muscle activity. It also makes a reference to additional resources and practice questions available through an app to help consolidate knowledge on this subject.
• 05:00 - 10:00: Potassium Treatment and Considerations The chapter titled 'Potassium Treatment and Considerations' discusses the effects of potassium levels on heart activity. High potassium levels (above 5.0) lead to increased cardiac activity, indicated by peaked T waves and ST elevations. Conversely, low potassium levels (below 3.5) result in decreased activity, characterized by flat T waves, ST depression, and the presence of U waves. Additionally, the chapter covers potassium-wasting and potassium-sparing diuretics, noting that potassium-wasting diuretics often end with the suffix 'ey'.
• 10:00 - 13:00: High Potassium Complications and Treatment The chapter titled 'High Potassium Complications and Treatment' discusses the use of loop diuretics, specifically furosemide and torsemide, in the management of acute or worsening heart failure. It emphasizes the importance of not confusing these medications with nitrates such as isosorbide, which are vasodilators. Loop diuretics are highlighted as the first line of treatment for heart failure exacerbations, and the content warns against common confusions presented in examinations like the NCLEX, particularly stressing the differences between similar-sounding drug names.
• 13:00 - 19:00: Missed NCLEX Questions on Potassium The chapter discusses the administration of potassium-wasting diuretics, particularly focusing on when these drugs should be given. It highlights the mechanism by which diuretics function, specifically by blocking the reabsorption of sodium in the kidneys, which helps to reduce swelling in patients. The importance of monitoring potassium levels is emphasized, noting that these medications should only be administered when potassium levels are within the normal range of 3.5 to 5.0. If potassium levels fall below 3.5, these drugs should not be given.
• 19:00 - 21:00: Calcium Overview This chapter discusses dietary recommendations and precautions, specifically highlighting the role of various foods in maintaining potassium levels. Recommended foods include melons, bananas, green leafy vegetables, and liver. The text advises against consuming licorice root, as it lowers potassium levels, which is a key point to remember for questions regarding potassium management. Additionally, the chapter briefly touches upon potassium-sparing diuretics, using the example of spironolactone, which spares potassium, unlike other medications.
• 21:00 - 25:00: Magnesium Overview The chapter provides an overview of magnesium, focusing on its role in blocking Angiotensin and aldosterone to regulate fluid levels in the body. The information suggests that blocking aldosterone allows the fluid to be released from the body. The chapter also promotes a study guide that accompanies the video to improve study efficiency and retention of key points, especially those crucial for nursing school exams. Additionally, the chapter mentions the availability of 900 more educational videos organized outside of YouTube.
• 25:00 - 27:00: Conclusion The conclusion chapter emphasizes the importance of being cautious with potassium intake when using medication like bronol lactone, which is a potassium-sparing diuretic. It advises patients to steer clear of foods rich in potassium, such as green leafy vegetables, melons, and avocados, as well as avoiding salt substitutes. Furthermore, any potassium abnormality should prompt an immediate nursing response by placing the patient on a cardiac monitor, highlighting this as a vital priority intervention.

Electrolyte Lab Values | Top Tested & Top Missed Questions on NCLEX Transcription

• 00:00 - 00:30 [Music] the top electrolyte Labs that you need to know for the enlex here so sodium 135 to 145 remember the double s's of sodium sodium swells the body with fluid so with low sodium we end up with low and slow signs and symptoms mental status change is a priority as well as seizures and coma and respiratory arrest from low
• 00:30 - 01:00 slow respirations and in high sodium we get big and Bloated since it swells the body with fluid so we see Adema are swollen body increased muscle tone and flushed red and Rosy skin signs nursing school is hard work simplenursing.com makes it simple we take your classroom lectures and notes to create a handcrafted study plan with specialized videos and visual study guides that highlight only the top tested need to know key points coupled with thousands
• 01:00 - 01:30 of practice questions to test your knowledge all neatly organized in our new app try it for free today visit simplenursing.com now for potassium this is 3.5 to 5.0 now this is the number one electrolyte to know for the enlex and nursing exams so just think of the three PS of potassium so potassium is priority since it pumps the muscles so let's cover all the key points from our bed surge video here so
• 01:30 - 02:00 just think High pottassium we have high pumps so we get Peak T waves and St elevations for potassium over 5.0 and the exact opposite for low potassium below 3.5 just think low pumps so we get flat t- waves and ST depression and even this weird little uwave what the heck's a u wave shut up you now we have potassium wasting and potassium sparing diuretics potassium wasting ends in ey
• 02:00 - 02:30 like feros amide or hydrochloride both rhyme with dried but again be careful not isosorbide that's a nitrate guys the enlex will try and trick you so remember the O's in isoo make it a Vaso dilator similar to Nitro now Loop Diuretics like feros amide and torsemide are the first drugs we use in acute or that worsening heart failure so en collects key words
• 02:30 - 03:00 like worsening crackles new edema in the legs and even rapid weight gain guys we give eyes to make the body dried these guys work by blocking the reabsorption of sodium in the kidneys so with less sodium retained we have less swelling retained and our patient is saved now we only give pottassium wasters if potassium is normal between 3.5 and 5.0 anything less than 3.5 is a big no no guys we don't give the drug so
• 03:00 - 03:30 we encourage our patients to eat melons bananas green leafy veggies and even liver and a big no no here we avoid licorice root which lowers pottassium like those found in black licorice candy that's a common select all that apply question so just remember the double L's here licorice lowers pottassium now potassium sparing diuretics s for spironolactone just think s for spares the potassium just like pills and stin this spares potassium too but instead of
• 03:30 - 04:00 blocking the Angiotensin this guy blocks aldosterone directly to let fluid out of the body and into the potty and it ends in tone so think it blocks elosone hey did you see the new study guide that follows along with this video so cut your study time in half and increase your attention of the need to know key points and memory tricks that love to come up on nursing school exams plus get 900 more videos not here on YouTube neatly or organized into
• 04:00 - 04:30 playlist try it for free visit simplenursing.com today since bronol lactone spares the potassium we teach patients to avoid those potassium rich foods guys so we don't eat those green leafy veggies those melons avocados and we avoid that salt substitute and again and again any potassium abnormality the first nursing action is to place them on a cardiac monitor always asked on the end clicks and exams as a priority intervention last lastly since potassium pumps the
• 04:30 - 05:00 muscles and collects keywords like muscle spasm and even muscle cramps this indicates a potassium problem even words like weakness or paresthesias so with potassium wasters that lower potassium think low pumps in the heart we get flat t- waves and ST depression and also this little weird uwave now a little side note if you have to replace potassium via IV well guys don't kill your patient we never push potassium ium IV this
• 05:00 - 05:30 means instant death we always give it IV bag over an hour or more guys never 30 minutes and not even 45 minutes 1 hour or more so the four rules of potassium revolve around protecting the heart with pottassium number one our first action is heart monitor placement and secondly guys we never push pottassium this means sudden death the heart will cramp up and not hump anymore third we
• 05:30 - 06:00 only do 10 to 20 MLS Max per hour not 30 minutes not even 45 minutes guys per hour a full 60 minutes or more usually around 4 hours and lastly we always put potassium on an IV pump never a solo drip guys it's too risky and as always slow the infusion pump if the arm starts burning which is pretty common okay now that you know how to fix the
• 06:00 - 06:30 low pottassium well how do you treat the high potassium over 5.0 with those High pumps in the heart leading to deadly cardiacas rhythmia now this gets a little tricky here the enlex loves to ask about clients with renal failure or chronic kidney failure who have built up a lot of potassium waiting for dialysis since their kidneys are broken and can't urinate out that potassium from the body and into the ptty so let's play a segment from our renal failure videos PS
• 06:30 - 07:00 so key terms to know Peak T waves happens when potassium is 6 to7 micro equiv per liter St elevation happens when potassium is between 7 to 8 and wide cisk complexes is a late sign over8 basically the heart is cramping up from too much potassium too much High pumps makes a very tight heart that is just basically cramping all up you have
• 07:00 - 07:30 to think that the heart's a muscle right so do you really think the heart can pump normal if this muscle is cramping well no so this leads to bra cardia that low heart rate since the heart is too tight and can't beat correctly and which ultimately results in weakness fatigue and lethargy from less cardiac output meaning less oxygen out of the heart into the body and then finally leading to deadly ventric dymas like vtac and V
• 07:30 - 08:00 FIB that ventricular tacac cardia and ventricular fibrillation if not treated immediately this will cause death by Cardiac Arrest basically that stopped heart so that's why potassium is priority on the enlex and nursing exams since it pumps those heart Muses now K had a scenario asking a client with kidney disease is very weak lethargic
• 08:00 - 08:30 and bardic asking for a suspected finding for this patient so the key term here is kidney disease that is weak lethargic and bra cardic that low heart rate so you have to automatically prioritize and think about potassium here so potassium 8.5 is the lab value to be suspected now in terms of treatments the long-term solution is to wash the blood with dialysis but this can take some time to set up so the immediate priority
• 08:30 - 09:00 solution in treatment is to lower the potassium and protect the heart from deadly dysmas we do this with drugs in a very specific order so write this down for priority treatment number one is IV calcium gluconate for the key term write this down dymas just think gluconates helps to glue down those crazy heart muscles preventing deadly dymas like wide CIS complexes which will
• 09:00 - 09:30 eventually progress into deadly vtac and V FIB we must glue down those heart muscles with calcium gluconate now if the key term of dysmas is not involved in the question then we progress to number two which is IV 50% dextrose and regular insulin this helps to lower the potassium so just think insulin puts sugar and potassium into the cell out of the blood and into the cell which
• 09:30 - 10:00 lowers blood serum and potassium most effective way to lower blood potassium very quickly but insulin also lowers blood glucose too basically that blood sugar so that's why we also give dextrose to help prevent that low blood sugar that hypoglycemia now don't let the ankle tricky here what if the key term dymas is not in the question well then we ress to option two which is just to give the
• 10:00 - 10:30 IV dextrose and Insulin first to lower that high pottassium and lastly three and four we can also give K exelate that polystyrene sulfinate as well as dialysis but again these typically take longer to lower potassium so that's why we put them last tier on the list because they take a longer time now for the top two missed enclex questions so question number one a patient with chronic kidney disease disease missed
• 10:30 - 11:00 three dialysis sessions oh with key terms here pottassium level of 8.1 wide QRS complexes a heart rate of 58 and lethargy which order or prescription should the nurse Implement first so the key term here is high potassium with wide QRS complexes that key term indicates dymas so just think you have to give calcium gluconate first to glue down those crazy heart muscles
• 11:00 - 11:30 and prevent the progression into those deadly heart dymas so option number four IV calcium gluconate because the key term was about dymas and high potassium now question number two endstage renal disease with a potassium of 7.2 a bu of 35 creatinine of 38 and urinary output of 300 mls in 24 hours
• 11:30 - 12:00 which order is priority so this question says high potassium right but nothing about ECG dysrhythmias or basically heart dysmas so we need to lower that potassium first with insulin which puts sugar and potassium into the cell so option number one IV regular insulin and 50% dextrose yes we give this first not Loop Diuretics and not dialysis this is
• 12:00 - 12:30 used later and definitely not option number four the vacation time even though it's pretty tempting now next up is calcium 9.0 to 10.5 think of the double C's calcium contracts the muscles with smooth contractions here when it's in Balance so for low calcium we have diarrhea not so smooth contractions of the GI track and we have two dance moves T and C we have truso is a twerking arm
• 12:30 - 13:00 with the BP cuff on and for C we have chiastic or just fosic think C the cheek smile when stroking the face and for high calcium just think High contractions we have Stones moans and groans so all that calcium leads to kidney stones and high contractions inside the GI will lead to constipation next is magnesium 1.3 to
• 13:00 - 13:30 2.1 just think of the double M's magnesium Mellows out the muscles so low magnesium we get low mellow basically hyperexcitability the opposite of mellow so we have torsades de Poes and V FIB two deadly cardiac dis rhythmia that will kill your patient so write those down remember on the enlex the most deadly complication is the most tested complication next is hyper reflexia as
• 13:30 - 14:00 well as increased dtrs those deep tendon reflexes and for high magnesium we have high mellow everything is just mellowed out so decrease dtrs and hypo reflexia here thanks for watching for our full video and new quiz Bank click right up here to access your free trial and please consider subscribing to our YouTube channel last but not least a big thanks to our team of experts helping us make these great videos all right guys
• 14:00 - 14:30 see you next time [Music]