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Flashcards in Electrolytes Deck (45)
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1
Q

What is the PRINCIPLE behind KALEMIA (Potassium) in Electrolyte Imbalance?

A

Do the same as the “PREFIX” except for HR and URINE OUTPUT
⏫HYPER = ⬆SYMPTOMS except
HEART RATE⬇ and URINE OUTPUT⬇

2
Q

What happens to the SYMPTOMS in HYPERKALEMIA?

A

Goes ⬆UP. As it follows the PREFIX “HYPER”

When you see KALEMIA, you look at the Prefix
⬆HYPER KALEMIA = ⬆SYMPTOMS
except for HR / URINE OUTPUT
“ If Everything is High, Symptoms will go High except
HR and Urine Output “

example: HYPERKALEMIA = Agitation, Restlessness, Irritability
Heart: Tachycardia, weak pulse, Peak T-wave, ST-elevation
Urine: Decrease renal function

3
Q

What happens to the SYMPTOMS in HYPOKALEMIA?

A

Goes ⬇DOWN. As it follows the PREFIX “HYPO”

⬇HYPO KALEMIA = ⬇ SYMPTOMS
except for HR / URINE OUTPUT
“ If Everything is LOW, Symptoms will go Low except
HR and Urine Output “
example: HYPOKALEMIA = weakness, tiredness
Heart: Dyspnea, Irregular rhytm, ST-depression
Urine: Diuresis

4
Q

What is Adynamic Ileus?

A

A pathological OBSTRUCTION of the BOWEL due to failure of the smooth muscle to contract

5
Q

What is OBTUNDATION & how are they similar to STUPOR?

A

Refers to LESS THAN FULL ALERTNESS. They are both similar

6
Q

What does CLONUS means?

A

Is a set of INVOLUNTARY and Rhythmic muscular CONTRACTION and RELAXATION; IRRITABILITY

7
Q

Where can you typically find the U-WAVE in Electrolyte Imbalance?

A

HYPOKALEMIA (Sign of Cardiac Depression

8
Q

What will you do if you will be ask or if you see the word “MOST LIKELY” with the Signs and Symptoms in a question?

A

Narrow the answer into 2 and give EDGE (Importance) to the HEART in POTASSIUM, but give EDGE to the MUSCLES and NERVES in CALCIUM
Make sure symptoms go to the RIGHT DIRECTION (Principles of Prefixes)

9
Q

What is the PRINCIPLE behind CALCIUM (Calcemia) in Electrolyte Imbalance?

A

CALCEMIA: DO the OPPOSITE of the PREFIX

⏫HYPER = ⬇SYMPTOMS

10
Q

What happens to the SYMPTOMS in HYPERCALCEMIA?

A

Goes LOW⬇
⏫HYPER ⬇CALCEMIA = means
“If Calcium goes ⬆HIGH, EVERYTHING goes LOW⬇”

e.g. Bradycardia, flaccid muscle, hypoactive reflexes, lethargy, constipation

11
Q

What happens to the SYMPTOMS in HYPOCALCEMIA?

A

Goes HIGH⬆
⏬HYPO ⬆CALCEMIA - meaning
“If Calcium goes ⬇LOW..EVERYTHING goes HIGH⬆”
e.g. Agitation, irritability spasm, cloneness, seizure

12
Q

A SIGN that you commonly see in HYPOCALCEMIA that results to FACIAL TWITCHING & MUSCLE SPASM when you tap the face?

A

CHEVOSTEK SIGN

Sign of Neuromuscular Irritability associated with LOW calcium

13
Q

A SIGN that you commonly see in HYPOCALCEMIA that results to HAND/CARPAL SPASM when you apply a BP cuff to the arm & INFLATE for 5-10 minutes?

A

TROUSSEAU SIGN

14
Q

What is the PRINCIPLE behind MAGNESIUM (Magnesemia)

A

MAGNESEMIA: DO the OPPOSITE of the PREFIX

⏫HYPER = ⬇SYMPTOMS

15
Q

What happens to the SYMPTOMS in HYPERMAGNESEMIA?

A

Goes LOW⬇
⏫HYPER ⬇MAGNESEMIA
“If Magnesium goes ⬆HIGH..EVERYTHING goes LOW⬇”

16
Q

What happens to the SYMPTOMS in HYPOMAGNESEMIA?

A

Goes HIGH⬆
⏬HYPO ⬆MAGNESEMIA
“If the Magnesium goes ⬇LOW..EVERYTHING goes HIGH⬆”

17
Q

What is the CONDITION that HYPOMAGNESEMIA associated with?

A

HYPERTENSION

18
Q

How can you BREAK a TIE if there is a certain SYMPTOM caused by MAGNESIUM IMBALANCE, CALCIUM IMBALANCE or POTASSIUM IMBALANCE?

A

DROP Mg+ (bec. it’s not a Major Electrolyte), ARROW the choices basing on the PRINCIPLES (Is the condition High or Low?), then APPLY EXCEPTIONS (Is the symptom a skeletal muscle or nerve? Is it a HR or Urinary Output?) If YES = CHOOSE; if NO = CHOOSE THE OTHER

19
Q

What is the PRINCIPLE behind CALCEMIA to break a TIE?

A

” If it is SKELETAL or NERVE, BLAME it on CALCIUM. For EVERYTHING ELSE, BLAME it on POTASSIUM”

20
Q

A patient developed a TETANY. Which ELECTROLYTE IMBALANCE cause the condition? (Basing on Electrolyte Principles)

a) High Potassium
b) High Calcium
c) High Magnesium

A
Answer: High Potassium (Hyperkalemia)
TETANY is a ⏫
a) Hyperkalemia⬆
b) Hypercalcemia⬇
c) Hypermagnesemia⬇
21
Q

What is the PRINCIPLE behind SODIUM (Natremia) in Electrolyte Imbalance?

A

“HYPERNATREMIA is associated with DEHYDRATION”
“HYPONATREMIA is associated with OVERLOAD”

DEHYDRATION = ⬆s/sx HYPERnatremia
OVERLOAD = ⬇s/sx HYPOnatremia
22
Q

A student ran towards you saying “OMG! I just ran a Liter of I.V. in 10 minutes” What Electrolyte Imbalance would you expect to see?

A

HYPONATREMIA (because it is an I.V. OVERLOAD)

23
Q

What should you THINK once you see DEHYDRATION and OVERLOAD?

A

DEHYDRATION always think HYPERNATREMIA

OVERLOAD always think HYPONATREMIA

24
Q

In addition to Increase POTASSIUM, What other ELECTROLYTE IMBALANCE is possible in D.K.A.?

A

HYPERNATREMIA (because of DEHYDRATION)
“Whenever you see DEHYDRATION, you can throw in the word HYPERNATREMIA. Anywhere you see HYPERNATREMIA, you throw in the word DEHYDRATION”
(same with OVERLOAD & HYPONATREMIA)

25
Q

What is the MAJOR NURSING DIAGNOSIS for HYPONATREMIA?

A

FLUID VOLUME EXCESS

26
Q

What ELECTROLYTE IMBALANCE is possible in SIADH?

A

HYPONATREMIA

27
Q

what ELECTROLYTE IMBALANCE do you see in DIABETES INSIPIDUS?

A

HYPERNATREMIA

28
Q

What ELECTROLYTE IMBALANCE HHNK/HHNS have?

A

HYPERNATREMIA because Hyperglycemia and Ketoacidosis are the same as DEHYDRATION

29
Q

What are the EARLY SIGNS of ELECTROLYTE DISORDER?

A

NUMBNESS & TINGLING (Paresthesia)

30
Q

What is the UNIVERSAL SIGN of ELECTROLYTE IMBALANCE?

A

MUSCLE WEAKNESS (all electrolyte imbalance causes this)

31
Q

What is a fancy word for MUSCLE WEAKNESS

A

PARESIS

32
Q

What is the VERY EARLY SIGN of ELECTROLYTE DISORDER which means NUMB & TINGLING OF LIPS and also SIDE EFFECT of HYPOCALCEMIA

A

CIRCUMORAL PARESTHESIA (spreads to face, neck & extremities)

33
Q

What is the most IMPORTANT KEY POINT that you have to remember in giving POTASSIUM

A

NEVER PUSH POTASSIUM I.V.

34
Q

What is the MAXIMUM DOSE you can give for POTASSIUM per liter of IVF?

A

40 mg/L

35
Q

What would you do if HCP orders 60 mg/L of KCL for patient with HYPOKALEMIA?

A

CALL and CLARIFY order

36
Q

What wll result to a person’s HEART when you give too mcuh POTASSIUM?

A

It STOPS resulting to CARDIAC ARREST

37
Q

What is the FASTEST WAY to LOWER POTASSIUM inside the body?

A

Give D5W with REGULAR INSULLIN

38
Q

How does D5W with REGULAR INSULIN get rid of POTASSIUM in the blood?

A

It will HIDE POTASSIUM INTO THE CELL

- it’s the potassium in the blood that will kill the person, but not when it’s inside the cell

39
Q

What is the DOWNSIDE of giving D5W with REGULAR INSULIN in HYPERKALEMIA?

A

It’s only TEMPORARY

- just to save the heart but leaks back into the blood after 8 hours where it could kill you again.

40
Q

What is another treatment for HYPERKALEMIA?

A

KAYEXALATE

41
Q

What are the ROUTES in giving KAYEXALATE?

A

Goes into the gut through the MOUTH (ingestion); ENEMA (rectum)

42
Q

What is the DOWNSIDE in giving KAYEXALATE?

A

It’s full of SODIUM. A CHOLK (wedge/block) full of Na+
- Liberates Sodium into the blood
LONG TIME EFFECT (takes awhile to take efect)

43
Q

What is the GOOD SIDE of giving KAYEXALATE?

A

Gets RID (eliminate) of POTASSIUM

44
Q

What treatments are GIVEN SIMULTANEOUSLY in HYPERKALEMIA?

A

D5W with REGULAR INSULIN & KAYEXALATE

45
Q

What ELECTROLYTE does KAYEXALATE work with?

A

POTASSIUM
- If you see KAYEXALATE, think: K - EXITS - LATE
If you see D5W with REG INSULIN think:
K-Enters-Early