Electrolytes Flashcards
lasix side effects
loss of water and electrolytes = dehydration and electrolyte depletion, ototoxicity (kidney problems)
Dizziness, lightheadedness, headache, and blurred vision
Muscle cramps, weakness, unusual tiredness, confusion, severe dizziness, fainting, drowsiness, dry mouth/thirst, nausea, vomiting, and increase HR
Lasix use and mechanism of action
makes pee a lot and cause more fluid to move into the urine
loop diuretic that can be given orally or IV acts on a loop of Henle in the kidney to increase water excretion (inhibits NaCl cotransport system) and inhibit the reabsorption of NaCl in proximal and distal tubules
ADH stimulates reabsorption from collecting ducts
remove Na, K, Mg and Cl (watch these levels when using diuretic), blood pressure will decrease (less fluid), monitor K+ levels!
Hypermagnesemia treatment
diuretics to increase excretion, increase fluids dialysis calcium gluconate IV (for emergency situations) mechanical ventilation for resp distress avoid food with Mg2+
Hypermagnesemia causes and manifestations
rarer and less treated
with 5.0 vasodilation and hypotension due to vascular smooth muscle relaxation (collapsed/relaxed),
> 15 respiratory failure, and coma
ECG change: complete heart block, asystole
hypomagnesemia treatment
oral or IV replacement (run slowly over a couple of hours)
ECG monitoring
Widened QRS = possible lethal rhythm, possible code!
hypomagnesemia causes and manifestations
magnesium is a cofactor in numerous enzymatic reactions
heart loves magnesium and low = cardiac irritability
causes include alcohol use, pancreatitis, vomiting, diarrhea, diuretics
tetany, weakness, confusion, hyperactive deep tendon reflexes, Chvostek’s and trousseau’s sign
ECG changes: widened QRS, prolonged PR, and QT interval
hyperkalemia treatment
IV insulin (shifts potassium into cells) Insulin pushes K+ into cells
dialysis, calcium chloride/gluconate (heart tissue-protective)
Insulin pushes K+ into cells
kayexalate (stool excretion
Stool method last option (oral supplement) to have K+ come into a stool and poop it out
hyperkalemia causes and manifestation
renal dysfunction causing reduced urinary excretion
tissue shift of K from tissues
the shift of K from cells to extracellular fluid
muscle weakness (cramping),
ECG: tall tented T wave
AV blocks
treatment hypokalemia
orally/IV intake of Kᐩ (KCl)
continuous ECG monitoring (potassium very important for heart functioning)
oral potassium
IV (central line pressured due to extravasation risk and complain arm is burning)
hypokalemia manifestations and causes
Can occur with GI loss, diuretic, urinary loss, and diet with low K+ Urinary loss (diuretics) and GI loss are most common, decrease K intake, laxative abuse
ECG changes: flattened T wave (first sign) can turn to U wave
U wave is late-stage
Muscle weakness
hypernatremia treatment
Give H2O to decrease Na levels (ADH mechanisms)
replace fluids
start with free water orally or through an NG tube if possible
if neurological symptoms are present, consider hypotonic saline (½ NS) replace slowly
do not over-hydrate cells too quickly
Hypernatremia: what causes it and manifestations
water deficit or excess gain of sodium thirst dry mucus membrane restlessness weakness lethargy disorientation muscle irritability convulsions
treatment for hyponatermia (hypovolemic hyponatremia and hypervolemix hyponatremia)
Hypovolemic hyponatremia: less volume, treated with IV fluids (normal saline and L.R.)
Euvolemic hyponatremia: treat with fluid restrictions, with normal fluid volume just low Na, track fluid limit
Hypervolemic hyponatremia: react with diuretics dilutes Na, lasix
Severe: give hypertonic saline if patient is symptoms (3% slaine), ICU slowly in small amounts to prevent seizure, neurological symptoms occur with severe, and correct Na+ slowly
Hyponatremia manifestations
Nausea, vomiting, abdominal cramping, muscle cramping, lethargy, weakness, headache, seizures, confusion, respiratory arrest, and coma
Exercise cramp = low fluid = low Na
Hyponatremia
what electrolyte affected and the two types
Low Na+
dilutional: can have neurological symptoms if excess in brain and swell, swollen and fluid vol overload symptoms,
depletional: loss Na dry symptoms , excessive sodium loss (sweating)
CHF (hypervolemia) treatment
remove excess vol, possible respiratory support, sodium restriction, daily weights, Lasix, bumex
CHF manifestations
SOB
swelling in legs and feet
high fluid vole leak out capillaries membranes into lung tissue pulmonary edema,
inefficient pump congestion of blood don’t flow
Dyspnea (SOB), adventitious lungs sounds (crackles), edema, ascites, third heart sounds
jugular venous distention
Congestive heart failure (cause and characteristics)
volume overload
high vol that cannot get out
excess fluid around lung
Treatment for hypervolemia
administer hypertonic solution (3% NaCl)
volume overload (hypervolemia) causes and characteristic
need to pull fluid from interstitial space
Excessive oral intake of salty foods and water (Na+ excess in the bloodstream and high spots = drink h2o
excessive administration of sodium-containing isotonic IV fluids (0.9% NaCl)
renal retention of sodium and water (HF, Renal failure = cannot get rid of fluid as easily)
fluid shift into intravascular space
Treatments of hypovolemia
isotonic blouse L.R. and 0.9% normal saline
restore circulating fluids
replace fluid volume depletion to restore intravascular pressure
measure vol lost and ‘give back what they’ve lost
volume loss is hemorrhagic administer blood products
after replacing fluid loss focus on maintaining fluid vol status and electrolyte corrections
Clinical manifestation of hypovolemia
thirst
decrease urine output
concentrated urine (yellow 30mL/hr or more)
dry mucous membranes
dry lips
decrease skin and tissue turgor skin tenting
weakness, dizziness, orthostatic hypotension
weight loss
hypotension
tachycardia
tachypnea
mental status change (restlessness, drowsiness, lethargy, confusion, coma)
Volume Deficit (causes and the 2 types)
hemorrhagic hypovolemia: blood loss
GI bleed, trauma, pregnancy
Non-hemorrhagic hypovolemic dehydration, non-blood causes
vomit, diarrhea, burns, sun exposure, renal salt wasting, diuretics, third spacing
Normal range of Kᐩ and where it is located
3.4-5.0 mmol/L
Inside cell
