Module 4

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Pharmacology
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Nutrition and Electrolytes
updated 2 years ago by djmordus
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1

Sodium (Na+)

135-145 mEq/L

WATER/Fluid volume balance, nerve conduction

Hyponatremia
Sx: muscle weakness, abdominal cramps
Causes: V/D, thiazide diuretics
Treated: IVF, sodium rich foods

Hypernatremia
Sx: thirst, HTN, dry sticky tongue
Causes: steroids, excess intake, kidney failure, VD
Treated: IVF and diuretics

You may have hyper- or hyponatremia subsequent to VD!

2

Calcium (Ca++)

4.5-5.5 mEq/L
8.5-10.5 mg/dl

Functions-nerve/muscle activity, bones and teeth

Hypocalcemia—
Sx: tetany, muscle irritability
Causes: loop diuretics, poor intake
Rx: supplementation, IV or PO calcium gluconate, IV caustic to veins

Hypercalcemia
Sx: flabby, bone pain, physiologic fractures, fatigue
Causes: immobility, thiazide diuretics, malignancy, parathyroid
Rx: IVF, diuretics
Vitamin D needed to absorb from GI tract

3

Fat-Soluble Vitamins

A D E K

4

Vitamin A

Retinol

Hyper - hair loss, peeling skin

Hypo - night blindness

5

Vitamin D

Calciferol - bones, Ca and P metabolism, Ca absorption

Toxicity: N/V

Hypo - treat w/ Ca, vitamin enrichment, Rickets in children

6

Vitamin E

Alpha-tocopherol - antioxidant, prevent against CAD

Hypo - N/V, fatigue, rbc breakdown

Not to be taken with Iron

7

Vitamin K

Prothrombin formation

Antidote to Coumadin (warfarin) toxicity

Formed in gut from bacteria

Given to newborns due to sterile gut

8

Water Soluble Vitamins

B and C

9

Vitamin B

B Complex ---- stress, energy, tension
B1 (Thiamine)—deficient with alcoholism, beriberi, required for nervous system
B2 (Riboflavin)—cheilosis, migraines
B3 (Niacin)—decreases cholesterol
B6 (Pyridoxine)—used with INH
B12 (Cobalamin)---intrinsic factor necessary to absorb it; pernicious anemia
B9 (Folic Acid)—red blood cell production, myelin of neurons, needed for growth—part of preconception care

10

Vitamin C

Ascorbic acid
Wound healing
Acid ash urine
Megavitamin therapy
Controversy over relationship to infections
Scruvy, bleeding gums, poor wound healing

11

Iron

Production of RBC and hemoglobin
Iron deficiency anemia
Sx-SOB, pallor, elevated HR, N/V/A
Dietary iron—meats, green vegetables, eggs
Incr needs in pregnancy and children

high dose-teratogenic

Black/ green stools-normal

Constipation—especially during pregnancy

Vit C incr absorption

12

Zinc

Colds, URIs, homeopathic remedies

13

Copper

RBCs and connective tissues

14

Chromium

normalize BG levels in T2DM, also weigh loss and muscle development

15

Selenium

Antioxidant, cancer prevention

16

Normal body osm

280-300 mOsm/kg

17

Calculation Serum Osmolality

2xSerum Na + BUN/3 +Glucose/18

18

Potassium (K+)

3.5-5.3 mEq/L

daily, poorly stored
Functions—cardiac and muscle contraction, nerve impulses
Indications: burns/trauma (K+ leaks into the bloodstream and is excreted), NV, K+ wasting medications, renal failure (increased K+ as kidneys can’t excrete)
Hypokalemia—N/V, flabby muscles, dysrhythmias, leg cramps
Hyperkalemia—abdominal cramps, dysrhythmias, paresthesias neck and face

19

Magnesium (Mg++)

1.5-2.5 mEq/l

Functions-neuromuscular function
Drugs effecting Mg++ balance—Milk of Magnesia (MOM), antacids
Hypomagnesemia: tetany, tremors, twitching
Hypermagnesemia: lethargy, weakness, decreased DTRs