EM Endocrine, Fluid and Electrolyte Emergencies Flashcards
what is the number one cause of hyperkalemia
bad sample, hemolysis during collection
- if not consistent with story, recheck
- always get EKG
what is true hyperkalemia due to
renal failure
acidosis
rhabdo (crush, other cell death)
meds or drugs
how does hyperkalemia affect electrical conduction
peaked T waves
Loss of P waves
wide QRS
sine wave
what is the treatment of hyperkalemia
push K+ back into the cell
- glucose
- insulin
- albuterol
- if acidotic: bicarb
what are most common causes of hypokalemia
water loss through GI causes
renal loss iwth DM
loop diuretics
malnutrition
ETOH
what should be assumed with hypokalemia
hypomagnesemia
what is seen with hypokalemia
ST depression
T wave inversions
U waves
What is normal magnesium range
1.9 - 2.4
what are causes of hypermagnesemia
typically secondary to exogenous magnesium supplementation
what are symptoms of hypermagnesemia
decreased relfexes, paralysis, cardiac hyperexcitability
what is the treatment of hypermagnesemia
calcium gluconate
calcium chloride
can help flush out with fluids and diuretics
may require hemodialysis
what can hypomagnesemia progress to on EKG
cardiac dysfunction -> torsades do pointes
what are causes of hypernatremia
Hypovolemia
euvolemia: water loss but no real saltloss
Hypervolemic (very uncommon)
what is the treatment of hypernatremia
need volume
(do not shift rapidly)
often require admission for slow replenishment
what is the presentation of hyponatremia
appear dry
may be hypotensive
peripheral edema
watch pt for mentation
