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Electrolytes Flashcards

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1
Q

Why are electrolytes important in the body

A

Maintaining osmotic pressure/balance

Maintains pH in cells and tissues

Nerve and muscle function

Conduction of electrical impulses

Regulating enzymes

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2
Q

What regulates concentrations of elecrolytes in the body

A

The kidneys and adrenal glands

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3
Q

What are some key electrolytes in higher concentrations in intracellular fluid

A

Potassium (K+)

Magnesium (Mg+)

Phosphate (HPO4 2-)

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4
Q

What are some electrolytes in lower concentrations in the intracellular fluid

A

Sodium (Na+)

Chloride (Cl-)

Calcium (Ca+)

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5
Q

What are some major electrolytes in higher concentrations in extracellular fluid

A

Sodium (Na+)

Chloride (Cl-)

Calcium (Ca+)

Bicarbonate (HCO3-)

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6
Q

If an electrolyte is positively charged it is a

A

Cation

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7
Q

If an electrolyte is negatively charged it is an

A

Anion

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8
Q

What is potassium important for in intracellular fluid

A

Nerve signalling (heart, GI and kidney functions)

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9
Q

What is magnesium important for in intracellular fluid

A

Nerve and muscle function

Bone structure

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10
Q

What is phosphate important for in intracellular fluid

A

Required for ATP and DNA production

Helps control calcium levels

Found in bones and teeth

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11
Q

What is sodium important for in extracellular fluid

A

Major electrolyte for maintaining osmolarity

Effects amount of water in the body

Nerve signalling

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12
Q

What is calcium important for in extracellular fluid

A

Muscle contraction

Nerve activation

Cell signalling

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13
Q

What is chloride important for in extracellular fluid

A

Works with sodium to maintain osmotic balance

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14
Q

What is bicarbonate important for in extracellular fluid

A

Maintains acid-base balance

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15
Q

How are electrolytyes gained in the body

A

Diet

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16
Q

What are some ways electrolytes are lost

A 
Sweat
Urine
Feces 
Epithelial sloughing 
Vomit
Diarrhea 
Endocrine abnormalities
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17
Q

How are electrolyte levels in extracellular fluid measured

A

Serum chemistry panels and/or blood gas analysis

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18
Q

Changes in electrolyte levels will affect cell function and viability, this is especially important for concentrations of intra vs extracellular levels of

A

Sodium, potassium, calcium

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19
Q

What is hypokalemia

A

Low potassium levels in the blood

Potassium is normally higher inside the cells, but in hypokalemia intracellular levels drop

Affects the ability of muscle cells to depolarize

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20
Q

What are signs of hypokalemia (significant loss)

A 
Fatigue
Muscle weakness 
Muscle damage 
Vomit/diarrhea
Anorexia
Abnormal posture (dropped head due to muscle weakness)
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21
Q

What are some causes of hypokalemia

A

Anorexia
GI disease (vomiting/diarrhea)
Loss in urine
Iatrogenic due to use of furosemide

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22
Q

What is the treatment of hypokalemia

A

Oral supplementation

Supplement via IV fluids

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23
Q

What is hyperkalemia

A

High levels of potassium in the blood

Or increase in ratio of potassium to sodium

Normally: potassium flows out of the cell to reset muscles, excess potassium in extracellular fluid prevents the muscle from being reset (extends the time of contractions)

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24
Q

What is the most effected muscle with hyperkalemia

A

The heart (decreases heart rate)

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25
What are the causes of hyperkalemia
Renal disease (impaired excretion of K+) Urethral obstruction Addison’s disease (hypoadrenocortism) (adrenal glands can’t produce enough of the hormone that maintains Na and K levels) Equine hyperkalemia periodic paralysis disease (HYPP) in quarter horses Iatrogenic (we did it); adding too much K+ to fluids, or added K/KCl improperly to a bag
26
How can you add electrolytes to a fluid bag improperly?
ALWAYS disconnect the bag and mix the KCl well before attaching back to the patient Risk of giving it all to the patient at the same time if it all sinks
27
What are the symptoms of hyperkalemia
Decreased/irregular heart rate (bradycardia) Muscle weakness Tiredness, lethargy
28
How do you treat hyperkalemia
Fluid therapy to support blood pressure and restore balance There are emergency drugs to increase k+ uptake into the cell
29
What woukd you see on an ECG with hyperkalemia
Increased intervals Slowed heart rate
30
What is hyponatremia
Low sodium levels in extracellular fluid, water shifts into cells causing it to swell and possibly lyse
31
What are the causes of hyponatremia
Actue GI disease Renal disease Uroperitoneum (leakage of urine into the peritoneal space) Overhydration with water
32
What does hyponatremia do
Results in a relative increase of potassium levels so they may show muscle weakness Can also alter nerve conduction and muscle contraction
33
What is hypernatremia
High levels of sodium in the extracellular space
34
Explain the physiology of how cells swell in hypernatremia
Extracellular Sodium levels increase due to abnormally high sodium diet Sodium shifts into the cell This increases water intake (to the extracellular space) which then causes water to move into the cell (to the now high levels of sodium) Causes swelling of the cells
35
What can happen due to the swelling of cells with hypernatremia
Cerebral edema and compression
36
What is the main cause of hypernatremia
Ingestion of excessive amounst of salt or normal levels of salt and no water
37
What are the signs of hypernatremia
Neurological signs; central blindness, lack of proper responses, lethargy, circling, twitching and seizures
38
What is the treatment of hypernatremia
Very slow reintroduction of water (to allow sodium to balance itself between intra and extracellular fluid
39
How do you prevent hypernatremia
Appropriate mixing of diets for livestock Salt blocks Ensure access to water Avoid sudden water intake after dehydration
40
What is the most common situation of hypernatremia
Salt toxicosis in pigs Pigs often head press as a sign (to relieve pain?)
41
Salt is often given to dog as an at home remedy to make them throw up, what can this cause
Hypernatremia
42
What is hypophosphatemia
Low levels of phosphate
43
Why is hypophosphatemia a problem
Phosphate is required for production of ATP , when it is low there is lack of ATP and this results in weakness and over flexion of the neck
44
When is hypophosphatemia most commonly seen
In Refeeding Syndrome/injury In the event of starvation followed by too rapid of introduction of food
45
hypophosphatemia can also be seen with
Calcium dysregulation
46
How is hypophosphatemia treated
A slow controlled dietary increase (slowly to prevent refeeding syndrome)
47
If calcium levels increase
Phosphorus levels decrease
48
What is hypocalcemia
A decrease in levels of FREE calcium (NOT blood albumin calcium)
49
Calcium levels are regulated by
Calcitrol And parathyroid hormone
50
Calcium is released during muscle contraction (for strength of contraction), decreased calcium results in
Decreased muscle contraction
51
What causes hypocalcemia
Parathyroid disease (PTH and calcitrol increases Ca, so a decrease in Either decreases Ca) Vitamin D deficiency (which is required to absorb calcium in the intestines) Lack of sunlight ( for Vitamin D) Increased demand for Ca (pregnancy, lactation)
52
What is CHRONIC hypocalcemia
Due to lack of Ca and/or Vit D in diet Body does have time to adjust But will lead to osteoporosis It is not normally life threatening
53
What is osteoporosis
Loss of bone density due to decreased calcification (bones become soft/brittle and may bend) Increased risk of fractures
54
What is ACUTE hypocalcemia
Low Ca in ECF and ICF | Body does NOT have time to adjust fast enough to low levels
55
What happens due to acute hypocalcemia
The heart cannot contract efficiently Clinical signs: CAT Convulsions, Arrythmias, muscle Tetany (uncontrolled, often constant contractions) Muscles in limbs contract and extend outwards After cardiac failure, death is rapid
56
Who is most prone to acute hypocalcemia
Eclampsia in small breed dogs after parturition Milkfever in cows (lactating after parturition) Or during pregnancy
57
What is hypercalcemia
High extracellular FREE calcium Results in: Prolongs rest periods in neurons, and cannot be reactivated, causes sudden muscle contractions (tetany, tachycardia, arrhythmias) followed by sudden weakness Most common in dogs and cats
58
If there is a slow increase of calcium resulting in hypercalcemia we would see
calcification of kidneys and other tissues
59
What are causes of hypercalcemia
Idiopathic (dont know) Hyperparathyroidism (increases calcium levels by increasing absorption frim diet, bone and kidneys) (could be from tumors) Due to cancers vitamin D toxicity (increases Ca absorption) due to over supplementation, diet or accidental ingestion Chronic kidney disease Hyperadrenocorticism (cushing’s disease) Iatrogenic
60
What is cushing’s disease
Benign tumor on the pituitary gland
61
What is Iatrogenic hypercalcemia
Occurs with improper administration of calcium-gluconate by IV injection (too fast) Too fast can cause sudden cardiac failure and instant death
62
How can you prevent iatrogenic hypercalcemia
IV injection of calcium Should always be given slowly, monitor heart rate/rhythm during and after administration
63
What is eclampsia
condition in lactating dogs that leads to weakness, muscle stiffness, seizures, and even death. It is caused by low levels of calcium in the blood.

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