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APEX: Flashcards > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

normal serum K+

A

3.5 - 5.5 mEq/L

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2
Q

most abundant intracellular cation

A

K+

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3
Q

regulates RMP

A

K+

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4
Q

low K+ hyperpolarizes/depolarizes membrane

A

hyperpolarizes

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5
Q

high K+ hyperpolarizes/depolarizes membrane

A

depolarizes

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6
Q

Which organ is the most important regular of K+ homeostasis?

A

kidneys

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7
Q

Etiologies of hypokalemia ( < 3.5)

A
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8
Q

S/S hypokalemia

A
  • skeletal muscle cramps
  • weakness
  • paralysis
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9
Q

EKG findings hypokalemia

A
  • long PR & QT interval
  • flat T wave
  • U wave
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10
Q

Etiologies of hyperkalemia (> 5.5)

A
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11
Q

S/S hyperkalemia

A

cardiac rhythm disturbances

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12
Q

EKG findings hyperkalemia

A

5.5 - 6.5 = peaked T waves

6.5 - 7.5 = flat p wave, prolonged PR interval

7.0 - 8.0 = prolonged QRS

8.5 or greater = sine wave –> VFIB

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13
Q

Hyperkalemia Tx

A
  • Calcium
  • insulin + D50
  • bicarb
  • hyperventilate
  • B2 agonist (albuterol)
  • K+ wasting diuretics
  • Kayexalate
  • Dialysis
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14
Q

Max rate K+ should be administered through peripheral line

A

10 mEq/hour

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15
Q

Max rate K+ should be administered through central line

A

20 mEq/hour

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16
Q

normal serum Na+

A

135 - 145 mEq/L

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17
Q

Most abundant extracellular cation

A

Na+

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18
Q

Primary determinant of serum osmolarity

A

Na+

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19
Q

At what Na+ level should you consider delaying surgery?

A

less than 130

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20
Q

Hyponatremia

A

< 135

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21
Q

S/S hyponatremia

A

130 - 135 = no s/s to mild s/s

125 - 129 = N/V, malaise

115 - 124 = HA, lethargy, altered LOC

115 or less = SZ, coma, cerebral edema, resp arrest

22
Q

Hyponatremia Tx

A

Goals:

  • restore Na+ by manipulating serum osmolality & fluid balance w/ H2O restriction
  • IVF based on tonicity

-diuretics

23
Q

Hypernatremia

A

> 145

24
Q

S/S hypernatremia

A

Based on serum osmolality:

350 - 375 = HA, agitation, confusion

376 - 400 = weakness, tremors, ataxia

401 - 430 = hyperreflexia, muscle twitching

431 or more = SZ, coma, death

25
Q

Hypernatremia Tx

A

same goals as hyponatremia

26
Q

Na+ should be corrected no more than ____ mEq/L/hour

A

1-2

27
Q

Treating hyponatremia too quickly may cause:

A

central pontine myelinolysis

27
Q

Treating hypernatremia too quickly may cause:

A

cerebral edema

27
Q

normal serum Ca+ (total)

A

8.5 - 10.5 mg/dL

28
Q

normal ionized Ca+

A

4.65 - 5.28 mg/dL

or

2.2 - 2.6 mEq/L

29
Q

Parathyroid hormone & calcitonin feedback loop

A
30
Q

Etiologies of hypocalcemia

A
  • hypoparathyroidism
  • vit D deficiency
  • renal osteodystrophy
  • pancreatitis
  • sepsis
31
Q

S/S hypocalcemia

A
  • skeletal muscle cramps
  • nerve irritability –> paresthesia & tetany
  • laryngospasm
  • mental status changes –> SZ
  • Chvostek sign: tapping on angle of jaw –> facial contraction ipsilateral side
  • Trousseau sign: inflate BP cuff 3 min –> muscle spasm of hand & forearm
32
Q

EKG hypocalcemia

A

long QT interval

33
Q

Hypocalcemia Tx

A
  • Ca+
  • vit D
34
Q

Etiologies of hypercalcemia

A
  • hyperparathyroidism
  • CA
  • thyrotoxicosis
  • thiazide diuretics
  • immobilization
35
Q

S/S hypercalcemia

A
  • nausea
  • abdominal pain
  • HTN
  • psychosis
  • mental status changes –> SZ
36
Q

EKG hypercalcemia

A

short QT interval

37
Q

Hypercalcemia Tx

A
  • 0.9% NaCl
  • Loop diuretic (lasix)
38
Q

What hormone raises Ca+?

A

parathyroid hormone

39
Q

What hormone lowers Ca+?

A

calcitonin

40
Q

normal serum Mg+

A

1.7 - 2.4 mg/dL or 1.5 - 3 mEq/L

41
Q

Calcium antagonist

A

Mg+

42
Q

Clinical uses of Mg+

A
  • pre-eclampsia
  • opioid-sparing technique
  • acute bronchospasm
  • cardiac rhythm disturbance (torsades)
43
Q

Which is correct about magnesium sulfate?
A. produces vasoconstriction
B. decreases sensitivity to NDNMBs
C. NMDA receptor blockade
D. increases uterine tone

A

C

44
Q

Which is false about magnesium sulfate?
A. tocolytic
B. bronchodilator
C. antiepileptic
D. potentiates catecholamine release

A

D

45
Q

Etiology of hypomagesemia

A
  • poor intake
  • alcohol abuse
  • diuretics
  • critical illness
  • common w/ hypokalemia
46
Q

S/S hypomagnesemia

A

EKG findings not significant unless very low –> long QT

47
Q

Etiologies of hypermagnesemia

A
  • excessive administration
  • renal failure
  • adrenal insufficiency
48
Q

S/S hypermagnesemia

A

EKG changes not significant unless very high –> heart block

49
Q

Hypermagnesemia can ___________ neuromuscular blockade with sux & nondepolarizers.

A

potentiate

50
Q

How does Mg+ work as an opioid-sparing drug?

A

antagonizes NMDA receptor

APEX: Flashcards (13 decks)

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