Electrolyte Imbalances

Question 1

normal K

Answer 1

3.5 - 5

Question 2

normal Na

Answer 2

135 - 145

Question 3

normal Cl

Answer 3

95 - 105 ish

Question 4

normal Mg

Answer 4

1.3 - 2.1

Question 5

normal Ca

Answer 5

9 - 11

Question 6

how does hyperkalemia affect the heart

Answer 6

HIGH pumps
- peaked T waves & ST elevation
- V fib. if severe
- hypotension
- bradycardia

Question 7

how does hyperkalemia affect the neuromuscular system

Answer 7

HIGH
- increased DTR
- paralysis & paresthesia
- muscle weakness

Question 8

how does hyperkalemia affect the GI system

Answer 8

HIGH pumps
- diarrhea
- hyperactive bowel sounds

Question 9

treatment for hyperkalemia

Answer 9

potassium binders: calcium sulfonate, sodium sulfonate

Question 10

what are the causes of hyperkalemia

Answer 10

• renal failure
• cellular injuries (burns, trauma)
• metabolic acidosis (shift from ICF to ECF)
• low aldosterone (ACE inhibitors)
• not enough insulin & DKA
• rhabdomyolysis (think cell damage release K)
• multiple blood transfusions (mechanical hemolysis)

Question 11

what lab to monitor for mechanical hemolysis via multiple blood transfusions

Answer 11

lactate dehydrogenase

Question 12

what lab to monitor for rhabdomyolysis

Answer 12

creatinine phosphokinase
urine myoglobin

Question 13

what foods contain high potassium

Answer 13

potatoes, prunes, oj, yogurt

Question 14

how does hypokalemia affect the heart

Answer 14

LOW & SLOW
- flat T waves, ST depression & U wave

Question 15

how does hypokalemia affect the neuromuscular system

Answer 15

LOW & SLOW
- shallow respirations
- decreased DTR
- muscle cramping & flaccid paralysis

Question 16

what are the causes of hypokalemia

Answer 16

• diarrhea, suctioning
• diuretics
• high aldosterone

Question 17

how to treat hypokalemia

Answer 17

check urine output prior to IV K
give IV K without glucose, or else increases insulin for cell K uptake

Question 18

how does potassium affect digitalis toxicity

Answer 18

hypokalemia can lead to digoxin toxicity

Question 19

what are the signs of hypernatremia

Answer 19

• cerebral edema
• flushed red skin
• increased muscle tone
• swollen dry tongue
• N&V

Question 20

what are the causes of hypernatremia

Answer 20

• diabetes insipidus
• rapid respirations
• diarrhea
• loss of thirst
• hypertonic fluids

Question 21

what are the signs of hyponatremia

Answer 21

Brain - low n slow
- headache
- ALOC
- seizures & coma
- extreme thirst

Muscular
- fatigue & muscle cramps

Respiratory arrest

Question 22

what are the 3 main categories for causes of hyponatremia

Answer 22

• hypovolemia: Na loss via renal or extra-renal (third spacing)
• euvolemia: fluid loss without Na replacement (SIADH)
• hypervolemic: too much fluids relative to Na (cirrhosis, HF)

Question 23

what are the causes of hyponatremia

Answer 23

• cirrhosis, HF
• excessive water intake
• SIADH
• V & D
• diuretics
• low aldosterone

Question 24

what inhibits the absorption of Mg

Answer 24

• phytic acid
• proton pump inhibitors (PPIs)
• Ca
• P
• fats

Question 25

what foods contain Mg

Answer 25

green veggies nuts refined grains

Question 26

how does hypermagnesemia affect the heart

Answer 26

HIGH MELLOW - heart block, dysrhythmias - hypotension, bradycardia

Question 27

how does hypermagnesemia affect the muscles

Answer 27

hyporeflexia - decreased DTR

Question 28

how does hypermagnesemia affect the lungs & GI

Answer 28

depressed respirations hypoactive bowel sounds

Question 29

causes of hypermagnesemia

Answer 29

- excessive laxatives, antacids - hyperparathyroidism, hypothyroidism (Ca related) - hemodialysis - meds that decrease gastric motility (opioids) - renal disorders

Question 30

how does hypomagnesemia affect the heart

Answer 30

- torsades de pointes - prolonged PR interval - v fib

Question 31

how does hypomagnesemia affect the muscles

Answer 31

- hyperreflexia: increased DTR - trousseau/chvostek signs

Question 32

how does hypomagnesemia affect the GI system

Answer 32

- diarrhea - hyperactive bowel sounds

Question 33

what are causes of hypomagnesemia

Answer 33

- Crohn's dx, Celiac dx - phytic acid, PPIs, Ca, phosphates, fat - kidney dx w/ creatinine clearance less than 20mL/min - alcohol use disorder - excessive sweating - diarrhea/ gastric bypass sx

Question 34

what relationship does Ca have with another electrolyte

Answer 34

Inverse relationship with phosphate Ca high = PO4 low friends with Mg Mg high = Ca high

Question 35

what are the signs of hypercalcemia

Answer 35

- kidney stones (renal calculi) - constipation - bone pain - severe muscle weakness & lethargy - encephalitis > 14, life threatening >15

Question 36

what are the causes of hypercalcemia

Answer 36

- hyperparathyroidism - high PTH - cancer - immobility - acidosis

Question 37

what are the signs of hypocalcemia

Answer 37

- Trousseau's & Chvostek's sign: tetany - diarrhea - weak bones, weak blood clotting - depression/anxiety - cardiac dysrhythmias: prolonged QT interval - seizures

Question 38

what are the causes of hypocalcemia

Answer 38

- hypoparathyroidism, thyroidectomy - low PTH -> high calcitonin - renal failure (CKD) - alkalosis - low Mg, vit D - meds: bisphosphonates, denosumab (osteoporosis meds)

Question 39

normal GFR

Answer 39

90-120