Blood Chemistry and Renal function Flashcards

Question

What are the symptoms of Hyperkalemia

Answer 1

Irritability Nausea and vomiting Intestinal colic Diarrhea

Answer 2

Decreased contractility of smooth, skeletal, and cardiac muscles Weakness Paralysis Hyporeflexia Ileus Dysrhythmias

Answer 3

Follow potassium levels closely in uremia, Addison disease, vomiting and diarrhea, and in patients taking steroids, potassium depleting diuretics, and digoxin (hypokalemia can induce arrhythmias)

Answer 4

Opening and closing hand with tourniquet in place may increase levels **Hemolysis of blood** during the draw or in the lab causes increased levels – WHY? **Drugs** may increase levels – antibiotics, some antihypertensives, lithium, potassium sparing diuretics, potassium supplements, and succinylcholine Drugs may decrease levels – antibiotics, diuretics, insulin, laxatives, Kayexalate (sodium polystyrene sulfonate)

Answer 5

**Excessive dietary intake or ****Excessive IV intake** **Acute or chronic renal failure** – most common cause of hyperkalemia – due to decreased excretion **Addison disease, hypoaldosteronism, aldosterone inhibiting diuretics (spironolactone, triamterene)** – Aldosterone enhances potassium excretion but is absent in these states **Crush injury to tissues, hemolysis, transfusion of hemolyzed blood, infection** – cellular injury and lysis causes potassium within the cells to be released **Acidosis** – hydrogen ions are driven from the blood and into the cells to maintain physiologic pH. To maintain electrical neutrality, potassium is released from the cell **Dehydration**

Answer 6

**Deficient dietary intake, deficient IV intake** – kidneys cannot reabsorb potassium to compensate for reduced potassium intake **Burns, GI disorders (vomiting, diarrhea**) – potassium is lost due to ongoing fluid and electrolyte losses **Diuretics** – increase renal excretion of potassium **Hyperaldosteronism** – aldosterone enhances potassium excretion **Cushing syndrome** – glucocorticosteroids have an aldosterone-like effect **Renal tubular acidosis** – increased excretion **Licorice ingestion** – licorice has an aldosterone-like effect **Alkalosis** – to maintain physiologic pH during alkalosis, hydrogen ions are driven out of the cell and into the blood. Potassium is driven into the cell **Insulin administration** – glucose and potassium are driven into the cell\*\*\* **Glucose administration** – causes insulin to be secreted\*\*\* **Ascites** – decreased renal blood flow from reduced intravascular volume from the collection of fluid. Reduced blood flow stimulates secretion of aldosterone which increases potassium excretion **Renal artery stenosis** – reduced renal blood flow **Cystic fibrosis** – increased potassium loss in secretions and sweat **Trauma/burns/surgery** – body’s response mediated by aldosterone which increases potassium excretion

Answer 7

Major extracellular anion, it **maintains electrical neutrality**, mainly as a salt with sodium. Water moves with sodium and chloride, so chloride also **affects water balance**. Chloride acts as a **buffer to assist in acid base balance**. As carbon dioxide and hydrogen increase, bicarbonate must move from the intracellular space to the extracellular space. To maintain neutrality, chloride shifts back into the cell

Answer 8

With other electrolytes, chloride gives an indication of acid base status and hydration status Normal: 98-106 mEq/L Critical values: \< 80 or \> 115

Answer 9

lethargy weakness deep breathing.

Answer 10

Hyperexcitability of the nervous system and muscles shallow breathing hypotension tetany

Answer 11

Excessive infusions of saline can increase chloride levels Drugs may increase or decrease levels

Answer 12

**Dehydration** **Excessive infusion of normal saline** **Metabolic acidosis, renal tubular acidosis, Cushing syndrome, kidney dysfunction, hyperparathyroidism, eclampsia** –urinary excretion of chloride is decreased **Respiratory alkalosis** – chloride is driven out of cells in place of bicarbonate

Answer 13

**Overhydration, Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)** – chloride is diluted **Congestive heart failure** – chloride is diluted by excess total body water **Vomiting or prolonged gastric suction, chronic diarrhea or high output GI fistula** – chloride cation is high in the stomach and GI tract due to HCl acid produced **Chronic respiratory acidosis, metabolic alkalosis** – chloride is driven into the cell to compensate for the bicarbonate that leaves the cell – this maintains pH neutrality **Salt losing nephritis, Addison disease, diuretic therapy, hypokalemia, aldosteronism** – chloride excretion increased **Burns** – sodium and chloride losses

Answer 14

It is used to assist in evaluating the pH status of the patient and to assist in electrolyte evaluation Normal = 23-30 mEq/L Critical values \< 6

Answer 15

Measures the H2CO3 (carbonic acid), dissolved CO2, and the bicarbonate ion (HCO3-) that exists in the serum. The amounts of the first two are small, so CO2 content is an indirect measure of the HCO3- anion, which is second in importance to the chloride ion in electrical neutrality of extracellular and intracellular fluid

Answer 16

Levels are regulated by the kidney. Levels are increased with alkalosis and decreased with acidosis

Answer 17

Plays a major role in acid base balance

Answer 18

**Underfilling the tube** allows carbon dioxide to escape and may reduce values **Drugs** may increase levels – aldosterone, barbiturates, bicarbonates, loop diuretics, steroids Drugs may decrease levels – some antibiotics, thiazide diuretics

Answer 19

**Severe vomiting, high volume gastric secretion, aldosteronism, use of mercurial diuretics** – hydrogen ions are lost **Chronic obstructive pulmonary disease** – ions are increased to compensate for chronic hypoventilation – compensation for respiratory alkalosis **Metabolic alkalosis** – defined by an increased number of anions in the blood

Answer 20

**Chronic diarrhea, chronic use of loop diuretics** – persistent loss of base ions **Renal failure, diabetic ketoacidosis, starvation** – ketoacids and other anions build up, neutralizing the acids and causing levels to drop **Metabolic acidosis** – defined by a decreased amount of anions in the blood **Shock** – lactic acid builds up and is buffered, causing levels to drop

Answer 21

Assists in the evaluation of patients with acid base disorders. It is used to attempt to identify the potential cause of the disorder and can be used to monitor therapy for acid base abnormalities Helpful in identifying the cause of metabolic acidosis

Answer 22

Anion gap is the difference between the cations and anions in the extracellular space. Normal = 12 +/- 4 mEq/L AG = Sodium – (Chloride + Bicarbonate)

Answer 23

Gap is created by small amounts of anions in the blood (lactate, phosphates, sulfates, organic anions, and proteins) that are not measured

Answer 24

As acids accumulate in the bloodstream (lactic acid or ketoacids), bicarbonate neutralizes them to maintain normal pH in the blood. When bicarbonate decreases, AG increases

Answer 25

As albumin (negatively charged) increases, the AG will increase. If albumin is normal, a high AG is usually due to an increase in non-chloride-containing acids or organic acids.

Answer 26

A decreased AG is rare and is due to an increase in unmeasured cations (calcium or magnesium). **A reduction in anionic proteins** (nephrotic syndrome) will also decrease AG. If proteins are lost, the bicarbonate increases to maintain electrical neutrality **Increases in cationic proteins** (some immunoglobulins) will also decrease AG. **Hyperaldosteronism** – lose large amounts of potassium and hydrogen ions causing a metabolic alkalosis with a decreased AG **Hypoproteinemia** – loss of anionic proteins directly causes decrease in AG **Lithium toxicity** – increase in inorganic cations decreases the measured cations to decrease the AG **Excess alkali ingestion (antacids)** – increases bicarbonate to decrease the AG **Multiple myeloma** – proteins produced by neoplastic cells are cationic, causing a compensatory decrease in measured cations and increase in measured anions to maintain electrical neutrality **Chronic vomiting or gastric suction** – loss of hydrochloric acid causes a decrease in chloride and an increase in bicarbonate to decrease the AG

Answer 27

An increased AG, despite a normal pH, will indicate an acidotic component to the metabolic picture **Lactic acidosis, diabetic ketoacidosis, alcoholic ketoacidosis, alcohol intoxication, starvation** – increased acid ions such as lactate, hydroxybutyrate, or acetoacetate are formed **Renal failure** – uremic organic acids (phosphate, sulfates) accumulate in the blood due to poor excretion. Hydrogen combines with the bicarbonate to maintain a normal pH, so bicarbonate levels decrease and AG rises. **Increased GI losses of bicarbonate (diarrhea or fistula)** – bicarbonate and other base losses can occur, increasing the AG **Hypoaldosteronism** – aldosterone stimulates acid secretion in the distal renal tubule in exchange for sodium. Acid can build up and combine with bicarbonate, which decreases to increase the AG

Answer 28

**Hyperlipidemia** – may cause under measurement of sodium to falsely decrease AG **Drugs** may increase AG – diuretics, ethanol, methanol, salicylate, some antibiotics Drugs may decrease AG – lithium, spironolactone

Answer 29

Blood Urea Nitrogen Rough measurement of renal function and glomerular filtration rate. Also a measurement of liver function. Measures the amount of urea nitrogen in the blood

Answer 30

Normal range : 10-20 mg/dL Critical value \> 100 mg/dL indicates serious impairment of renal function An elevated BUN alone does not indicate that renal function is inadequate.

Answer 31

Urea is formed in the liver as the end product of protein metabolism and digestion. Protein is broken down into amino acids which are catabolized in the liver to form free ammonia. Ammonia molecules are combined to form urea, which enters the blood and is transported to the kidneys for excretion

Answer 32

Patients with elevated BUN are said to have azotemia.

Answer 33

Renal diseases cause an inadequate excretion of urea, which causes blood concentration to rise. If only one kidney is diseased, the unaffected kidney can compensate for the diseased kidney, and the BUN may stay normal An elevated BUN alone does not indicate that renal function is inadequate.

Answer 34

**Elevation of BUN due to pathologic conditions that affect urea nitrogen accumulation before it gets to the kidney** Shock, dehydration, CHF, excessive protein catabolism GI bleeding causes blood in the intestinal tract – the proteins in the blood and blood cells are digested to urea and get absorbed, causing BUN to increase

Answer 35

**Elevation of BUN due to pathologic conditions that affect BUN after it gets to the kidney** What would cause this?????? Ureteral and urethral obstruction

Answer 36

Synthesis of urea also depends on the liver, so severe liver disease will have decreased BUN

Answer 37

**Combined liver and renal disease.** May have a normal BUN because of poor hepatic function resulting in decreased urea formation. A normal BUN is not an indicator that renal function is adequate

Answer 38

**BUN is interpreted with the creatinine**. These are referred to as renal functions. The BUN/creatinine ratio is a good measurement of kidney and liver function. Normal range is 6-25 with 15.5 being optimal

Answer 39

**Changes in protein intake** – low protein diets will decrease BUN if caloric intake is maintained with carbohydrates. High protein diets will elevate BUN. **Muscle mass** has an effect on BUN levels **Advanced pregnancy** may increase BUN due to high protein metabolism **GI bleeding** can increase BUN **Overhydration** dilutes BUN and causes lower levels. ** Dehydration** concentrates BUN and raises levels. **Many drugs** can increase BUN

Answer 40

**Hypovolemia, shock, burns, dehydration** – reduced blood volume decreases renal blood flow, so excretion of BUN is decreased and levels rise **CHF, MI** – decreased cardiac function decreases renal blood flow **GI bleeding, excessive protein ingestion ** – gut is overloaded with protein so urea is formed at a higher rate and BUN accumulates **Excessive protein catabolism, starvation** – increased rate of protein breakdown leads to increased urea formation **Sepsis** – renal blood flow and renal function are reduced, so BUN rises

Answer 41

**Renal disease (glomerulonephritis, pyelonephritis, acute tubular necrosis), renal failure, nephrotoxic drugs** – primary renal diseases all have reduced excretion of BUN

Answer 42

Ureteral obstruction from stones, tumor, congenital abnormalities, bladder outlet obstruction from prostatic hypertrophy or cancer or bladder/urethral congenital abnormalities – obstruction of urinary flow reduces excretion and BUN rises

Answer 43

**Liver failure** – BUN is made in the liver, so reduced liver function causes reduced BUN levels. **Overhydration** due to fluid overload from SIADH – BUN is diluted by fluid overload **Negative nitrogen balance (malnutrition, malabsorption)** – protein depletion causes reduced urea production to reduce BUN **Pregnancy** – early pregnancy has increased water retention and BUN dilution **Nephrotic syndrome** – protein loss in urine. With protein depletion, BUN is reduced.

Answer 44

Used to diagnose impaired renal function Normal ranges: Females: 0.5-1.1 mg/dL Males: 0.6-1.2 mg/dL Critical values \> 4 mg/dL indicates serious impairment in renal function

Answer 45

the kidneys

Answer 46

**Renal excretory function**. It is an approximation of glomerular filtration rate With normal renal function the creatinine level should remain normal and constant

Answer 47

Creatinine is a catabolic product of creatine phosphate, which is used in skeletal muscle contraction. Daily production depends on muscle mass

Answer 48

Tends to rise later than the BUN, so elevations in creatinine suggest the disease process is chronic. Doubling of the creatinine indicates a 50% reduction in GFR. In unstable critically ill patients, acute changes in renal function may not initially be reflected by serum creatinine.

Answer 49

Minimally affected by hepatic function

Answer 50

* *Diet high in meats** may cause transient elevation in creatinine * *Drugs** may increase creatinine – ACE inhibitors, nephrotoxic drugs

Answer 51

**Diseases affecting renal function** (glomerulonephritis, pyelonephritis, acute tubular necrosis, urinary tract obstruction, reduced renal blood flow due to shock, dehydration, CHF, atherosclerosis, diabetic neuropathy, nephritis) – renal function is impaired and creatinine rises **Rhabdomyolysis** – skeletal muscle injury causes myoglobin to be released into the bloodstream. Large amounts are nephrotoxic and creatinine levels rise. **Acromegaly, gigantism** – increased muscle mass causes “normal” creatinine level to be high **Dehydration**

Answer 52

**Debilitation, decreased muscle mass** (muscular dystrophy, myasthenia gravis) – decreased muscle mass causes “normal” creatinine to be low

Answer 53

A measure of the GFR (the number of milliliters of filtrate made by the kidneys per minute).

Answer 54

the **amount of blood** to be filtered and on the **ability of the glomeruli** to act as a filter

Answer 55

Bilateral obstruction to urinary outflow affects CrCl only after the obstruction is longstanding

Answer 56

Adult \< 40 years Male: 107-139 mL/min Female: 87-107 ml/min Values decrease 6.5 mL/min/ per decade of life after age 20.

Answer 57

incomplete collections will falsely decrease CrCl

Answer 58

Test requires a 24-hour urine collection and a serum creatinine level. CrCl = [(Cr excreted in urine over 24 hrs in mg/dl) X (vol of urine in mL/min)] / (serum creatinine in mg/dL)

Answer 59

Difficult to collect 24 hour urine collections, so a new measure is the estimated GFR, which uses the serum creatinine, age, and numbers that vary depending on gender and ethnicity to calculate the GFR.

Answer 60

**Exercise** may increase creatinine **Incomplete urine collection** may lower value **Pregnancy** increases CrCl – increased load on kidneys by the fetus **Diet high in meat** may transiently elevate creatinine and CrCl. When creatinine is high, its clearance is increased and GFR is overestimated Estimated GFR may be inaccurate in extremes of age and in patients with malnutrition or obesity, paraplegia or quadriplegia, and in pregnancy **Drugs** may increase levels – same as creatinine Drugs that may cause a decrease in estimated GFR interfere with creatinine secretion (cimetidine or trimethoprim) or creatinine assay (cephalosporins) – may need a 24 hour creatinine clearance.

Answer 61

**Exercise, pregnancy, high cardiac output syndromes** – blood flow increases to the kidney causing GFR and CrCl to increase

Answer 62

**Impaired kidney function** (renal artery atherosclerosis, glomerulonephritis, acute tubular necrosis), decreased GFR (CHF, cirrhosis with ascites, shock, dehydration) – decreased renal blood flow will decrease GFR **Decreased muscle mass**

Answer 63

Cockcroft and Gault equation: CrCl = (140 - age) x BM(kg) / (Plasma creatine x 72) (x 0.85 for females) Estimated Creatining Clearance

Answer 64

Most commonly used in the evaluation of diabetic patients Normal range: Fasting adult – 70-110 mg/dL Critical values: \< 40 and \> 400 mg/dL

Answer 65

Levels controlled by insulin and glucagon Levels must be evaluated according to the time of day they are obtained.

Answer 66

In the fasting state, glucose levels are low, so glucagon is secreted. Glucagon breaks down glycogen to glucose in the liver so glucose levels rise If fasting persists, protein and fatty acids are broken down due to glucagon stimulation so glucose levels continue to rise.

Answer 67

made in the alpha cells of the pancreatic islets of Langerhans.

Answer 68

made in the beta cells of the pancreatic islets of Langerhans

Answer 69

Glucose levels rise after eating. Insulin is secreted and attaches to insulin receptors in muscle, liver, and fatty cells. This drives glucose into these cells to be metabolized to glycogen, amino acids, and fatty acids and causes glucose levels to decrease.

Answer 70

Inadvertent insulin overdose

Answer 71

Glucose measurements must be performed frequently in new diabetic patients to monitor insulin dosage – finger stick measurements are often performed before meals and at bedtime.

Answer 72

**Stressors** (trauma, general anesthesia, infection, burns, MI) can increase glucose levels **Caffeine** may cause increased levels **Pregnancy** may cause glucose intolerance – gestational diabetes **IV fluids containing dextrose**, which gets converted to glucose to raise levels **Drugs may increase** (TCAs, corticosteroids, diuretics, epinephrine, glucagon, lithium, salicylates) or decrease (alcohol, anabolic steroids, insulin, propranolol, oral hypoglycemics) levels

Answer 73

* *Diabetes mellitus** – glucose intolerance and hyperglycemia * *Acute stress response** – infections, burns, and surgery stimulate catecholamine release to stimulate glucagon secretion to cause hyperglycemia **Cushing syndrome** – cortisol levels are high, leading to hyperglycemia **Pheochromocytoma** – catecholamine stimulates glucagon secretion **Chronic renal failure** – glucagon is metabolized by the kidney, so impaired renal function causes glucagon and glucose levels to rise. **Glucagonoma** – glucagon autonomously secreted to cause hyperglycemia **Acute pancreatitis** – glucagon spilled into the bloodstream as the cells of the pancreas are injured – glucagon causes hyperglycemia **Diuretic therapy** **Corticosteroid therapy** – cortisol causes hyperglycemia **Acromegaly** – growth hormone stimulates glucagon

Answer 74

**Insulinoma** – insulin autonomously produced **Hypothyroidism** – thyroid hormones affect glucose metabolism – decreased levels cause glucose levels to fall **Hypopituitarism** – ACTH and growth hormone, both secreted from the pituitary gland, affect glucose metabolism. Decreased hormone levels cause glucose levels to fall **Addison disease** – diminished cortisol levels cause glucose levels to fall **Extensive liver disease** – decreased liver function causes glucose levels to decrease **Insulin overdose** – most common cause of hypoglycemia **Starvation –** decreased carbohydrate ingestion causes glucose levels to fall.

Answer 75

Evaluates parathyroid function and calcium metabolism. Used to monitor patients with renal failure or transplant, hyperparathyroidism, and various malignancies as well as calcium levels during and after large volume blood transfusions.

Answer 76

Normal: Total calcium 9.0-10.5 mg/dL Ionized calcium 4.5-5.6 mg/dL or 1.05-1.30 mmol/L Critical values: Total calcium \< 6 or \> 13 mg/dL Ionized calcium \< 2.3 or \> 7 mg/dL or \< 0.78 or \> 1.58 mmol/L

Answer 77

About half of the total calcium exists in blood in its free ionized form and half exists in protein bound form (mostly to albumin)

Answer 78

**Serum calcium level is a measure of both free ionized and protein bound calcium**. So if albumin is low the calcium level will also be low. Total serum calcium decreases by 0.8 mg for every 1 gm decrease in albumin The ionized form is not affected by changes in albumin levels **A normal calcium with reduced albumin (calcium should be reduced)– patient may have hypercalcemia**

Answer 79

Parathyroid Hormone (PTH) is released from the parathyroid gland when calcium levels drop. This hormone stimulates realease of calcium from the bones. It also stimulates Ca2+ uptake in the kidneys and along with Vitamind D stimulates uptake in the intestines

Answer 80

hyperparathyroidism – causes increased GI absorption, decreased urinary excretion, and increased bone resorption.

Answer 81

Elevated levels cause anorexia, nausea, vomiting, somnolence, and coma.

Answer 82

Malignancy can elevate calcium due to metastasis (myeloma, lung, breast, renal cell) to the bone which then destroys the bone and pushes calcium into the blood. Some cancers (lung, breast, renal cell) can also produce a parathyroid hormone like substance that increases calcium.

Answer 83

Renal failure patients have high phosphate levels and other anions that chronically lower serum calcium, so parathyroid hormone is persistently stimulated to increase calcium levels. Calcium levels return to normal in time, but that level actually represents a “high” level as it should be low in these patients

Answer 84

**Vitamin D** intoxication can increase calcium **Excessive milk i**ngestion can increase calcium **Serum pH** – a decrease in pH causes increased calcium levels Prolonged tourniquet time lowers pH and factitiously increases calcium levels **Hypoalbuminemia** associated with decreased levels of total calcium **Drugs** may increase levels (alkaline antacids, calcium salts, lithium, thiazide diuretics, and vitamin D) or decrease levels (albuterol, anticonvulsants, aspirin, corticosteroids, estrogens, heparin, laxatives, loop diuretics, magnesium salts, and oral contraceptives.

Answer 85

**Hyperparathyroidism, nonparathyroid PTH producing tumor (lung or renal)** – PTH mobilizes calcium stores from bone to blood Metastatic tumor to bone, Paget disease of bone, prolonged immobilization – bone destruction or thinning pushes calcium from bone into blood **Milk-alkali syndrome** – increased ingestion of milk products or antacids (which contain calcium) causes elevation **Vitamin D intoxication** – vitamin D works with PTH to increase levels **Lymphoma, granulomatous infections (sarcoidosis and tuberculosis)** – have enhanced vitamin D levels **Addison disease** – glucocorticosteroids inhibit vitamin D activity – when steroid activity is decreased, vitamin D action is increased * *Acromegaly** * *Hyperthyroidism**

Answer 86

**Hypoparathyroidism** –Reduced PTH causes decreased calcium **Renal failure, hyperphosphatemia due to renal failur**e – excess anions present in renal failure patients bind calcium **Rickets, vitamin D deficiency Osteomalacia, hypoalbuminemia, malabsorption** – less calcium available to the blood **Pancreatitis, fat embolism** – saponification (binding of calcium to fats) of the peripancreatic tissue **Alkalosis** – high pH in blood drives calcium intracellularly.

Answer 87

Normal: 1.3-2.1 mEq/L Critical values \< 0.5 or \> 3 mEq/L

Answer 88

Most is found intracellularly with half in bone. Most is bound to ATP molecule and is important in phosphorylation of ATP , so it is critical in the metabolic process

Answer 89

Carbohydrate, protein, and nucleic acid synthesis and metabolism depends on magnesium. Also is a cofactor that modifies enzyme activity Most organ functions depend on magnesium Low magnesium levels may increase cardiac irritability and aggravate arrhythmias High magnesium levels retard neuromuscular conduction to slow cardiac conduction, diminish deep tendon reflexes, and cause respiratory depression.

Answer 90

hypocalcemia may respond to magnesium replacement

Answer 91

Magnesium deficiency occurs in **malnourished** patients due to malabsorption or maldigestion or lack of food intake. Important in postop patients who don’t eat for several days and whose metabolism is accelerated. **Alcoho**l abuse increases magnesium loss in the urine Low magnesium occurs in diabetes mellitus, hypoparathyroidism, hyperthyroidism, hyperaldosteronism, and toxemia of pregnancy. **Chronic renal tubular disease** – magnesium is reabsorbed in renal tubule. Diseases affecting this area of the kidney or drugs toxic to this area of the kidney allow increased losses of magnesium in the urine **Diabetic acidosis** – magnesium levels fall with treatment of diabetic ketoacidosis. Insulin drives glucose into the cells and magnesium follows.

Answer 92

Symptoms of decreased magnesium are mostly neuromuscular (weakness, irritability, tetany, EKG changes, delirium, and convulsions

Answer 93

Increased magnesium levels usually are associated with **ingestion of magnesium containing antacids** Most magnesium is excreted by the kidneys, so **chronic renal diseases** may elevate magnesium. **Hemolysis** of a blood sample will create a falsely elevated magnesium since it is an intracellular cation. **Hyperparathyroidism** – calcium levels are high so magnesium levels increase **Hypothyroidism** **Addison disease** – aldosterone enhances magnesium excretion. With reduced aldosterone, magnesium excretion is reduced

Answer 94

Symptoms of elevated magnesium are lethargy, nausea and vomiting, and slurred speech.

Answer 95

Hemolysis causes falsely elevated results Drugs may increase levels (antacids, calcium containing meds, laxatives, lithium, loop diuretics, thyroid meds) or decrease levels (some antibiotics, diuretics, and insulin)

Blood Chemistry and Renal function Flashcards

(125 cards)