Post on 30-Jun-2015
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Fill in the “EMIA”
Name That Imbalance
HYPO- “termic”
F – E Jive Just Sign Here
Hyper – “Bully”
Often found in Fluid Volume Deficit.
A 100
What is hypernatremia?
A 100
Classic signs of this are those of the neuromuscular system,
including tetany and hyperactive DVRs.
A 200
What is hypercalcemia?
A 200
Patient may show signs of lethargy, headaches,
personality changes, and confusion.
A 300
What is hypercalcemia?
(Tried to trick you here – these symptoms may be
exhibited, in part, with other electrolyte imbalances, but this combo points to excess
calcium.)
A 300
Patient may demonstrate anemia, bruising, or bleeding
and spasms.
A 400
What is hyperphosphatemia?
(including associated anxiety and slurred speech)
A 400
Patient presents a slow, irregular heartbeat with ECG changes of a tall peaked T- wave and a prolonged PR-
interval.
A 500
What is hyperkalemia?
(may include nausea and diarrhea).
A 500
Flattened “T” waves and “ST” segment depression, if patient is hooked to a heart
monitor.
B 100
What is hypokalemia?
B 100
Causes bone pain and the formation of kidney stones.
B 200
What is hypercalcemia?
B 200
A blood pressure cuff is applied to the arm and
inflated at least 20 mm Hg greater than the systolic blood
pressure.
B 300
What is the method for checking for Trousseau’s
sign?
(seen in patients with HYPOcalcemia)
B 300
General manifestations may include hyperactive bowel
sounds and increased bleeding and bruising.
B 400
What is HYPOcalcemia?
B 400
As blood volume decreases, heart rate increases and pulse
is weak and thready.
B 500
What is FVD?
(also note flattened veins in the neck and hands)
B 500
Total serum level falls below 8.9 mg/dL.
C 100
What is HYPOcalcemia?
(ionized Ca2+ falls below 4.5 mg/dL)
C 100
Serum levels are less than 1.4 mEq/L.
C 200
What is HYPOmagnesemia?
(Symptoms may not appear until levels fall below 1.0
mEq/L)
C 200
Serum levels are less than 2.5 mg/dL (note slurred speech)
C 300
What is HYPOphosphatemia?
(with fingertip numbness, tremors, and generalized
muscle weakness)
C 300
DAILY DOUBLE
C 400
DAILY DOUBLE
Place A Wager
Serum levels fall below 135mEq/L and affect mostly the neurological system. (a
major as-SALT on the body!)
C 400
What is HYPOnatremia?
(may include nausea, diarrhea, cramps, tremors,
and particularly headaches)
C 400
FVD leads to this tendency to become lightheaded (dizzy)
upon rising to stand up.
C 500
What is postural HYPOtension?
(related to a decrease in blood pressure)
C 500
FVE
D 100
What is Fluid Volume Excess (Overload)?
D 100
CVP
D 200
What is Central Venous Pressure?
(It reflects the amount of blood returning to the heart – a good approximation of right
atrial pressure)
D 200
Value of deepest assessed edema.
D 300
What is +4?
(That would be the “pits”!)
D 300
Tap on a patient’s cheek and a contraction of the upper lip,
nose and cheek occurs.
D 400
What is a positive Chvostek’s sign? (seen in
HYPOcalcemia, but also in HYPOmagnesemia)
D 400
Note its location, amount, bilateral status and capillary
refill.
D 500
What are the documentation values for edema?
D 500
Full and bounding pulse, increased blood pressure, brisk capillary refill, and
distended neck veins.
E 100
What is Fluid Volume Overload (Excess)?
E 100
With FVE, the percentage weight gain related to the
renal system that is considered “severe”.
E 200
What is 8%?
(causing edema – gravity dependent and first appears
distally in a patient’s extremities)
E 200
The best places for this assessment are the forehead, sternum, and the inner thigh. (Should we “canvass” all the
student nurses?)
E 300
What is skin “tenting”?
(Maybe we should take a “pole” instead!)
E 300
1.003 – 1.035.
E 400
What is the normal range for urine specific gravity?
(optimal range is 1.010 – 1.025)
(I was pissed when I missed this one!)
E 400
A “cuffed” patient demonstrates a spasm with a
flexed wrist and extended fingers.
E 500
What is a positive Trousseau’s sign?
(seen in HYPOcalcemia)
E 500
Blood serum level exceeds 145 mEq/L.
F 100
What is HYPERnatremia?
F 100
Blood values are greater than 4.5 mg/dL (anorexia and tachycardia may also be
present).
F 200
What is HYPERphosphatemia?
(“I have a “stinging” sensation it includes
paresthesias and tetany,” he said jerkily.)
F 200
Patient complains of thirst and has dry, sticky mucous
membranes, plus some muscle twitching.
F 300
What is HYPERnatremia?
(may also have flushed skin and increased body
temperature)
F 300
Total electrolyte level is greater than 10.1 mg/dL or (ionized) greater than 5.1
mg/dL.
(Really trying to “milk” this one…)
F 400
What is HYPERcalcemia?
F 400
Serum levels are greater than 2.1 mEq/L (including muscle
twitching and decreased DTRs).
F 500
What is HYPERmagnesemia?
(also note a prolonged “P-R” level and a slow heart rate)
F 500
The Final Jeopardy Category is:
Fluid Volume Deficit
Please record your wager.
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Cultural phenomenon that explains why certain patients do
NOT remedy a dehydrated condition.
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What is perceiving thirst as “hunger” and thereby seeking
food, rather than liquids in order to rehydrate themselves.
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