Electrolytes Flashcards by Rebekah Beyerlein

what 8 things/processes are electrolytes an essential component of?

volume and osmotic regulation
myocardial rhythm
cofactor in enzyme activation
Regulation of ATP ion pumps
acid-base balance
blood coagulation
neuromuscular excitability
production of ATP from glucose

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sodium is the major _______ _______. It determines the _______ of plasma, and it’s needed for ______ transport across the cell membrane.

sodium is the major extracellular cation. It determines the osmolality of plasma, and it’s needed for active transport across the cell membrane

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regulation of sodium depends on what? What percent of sodium is reabsorbed?

regulation of sodium depends on intake and excretion of water

60 -75% of sodium reabsorbed. (Maintained by Cl- reabsorption or H+ secretion)

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what are symptoms of hyponaturemia?

nausea, vomiting, muscle weakness, headache, lethargy, severe symptoms (seizures), coma, respiratory depression

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what are three reasons for hyponatremia, and reasons for each of those?

increased sodium loss
- decreased aldosterone
- diuretics
- ketonuria
increased water retention
- renal failure
- nephrotic syndrome
- hepatic syndrome
- CHF
water imbalance
- excess water intake
- pseudohyponaturemia

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what are symptoms of hypernatremia

CNS, altered mental state, lethargy, irritation, restlessness, muscle twitching, fever

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what are three causes of hypernatremia

excess water loss
- diabetes insipidus
- renal tubular disorder
- prolonged diarrhea
- severe burns
decreased water intake
- elderly and infants who cannot ask for water
increased intake or retention
- hyperaldosteronism
- sodium bicarb excess
- dialysis

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what is the analysis method for sodium?

ion specific electrodes

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what is the reference range for sodium?

136 - 145 mmol/L

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Potassium is the major _______ _______. Why is there only 2% of the body’s K+ circulating in the plasma?

it’s the major intracellular cation

there’s only 2% because cellular functions require the body to maintain a low ECF concentration

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what are four functions of potassium? How it is potassium regulated?

functions to regulate:
- neuromuscular excitability
- contraction of the heart
- intracellular volume
- H+ concentration

regulation:
- K+ absorbed, and then aldosterone causes K+ to be secreted into urine in exchange for Na+

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hypokalemia symptoms and four general reasons for hypokalemia

symptoms: weakness, fatigue, constipation, (and paralysis)

reasons for hypokalemia
1. gastrointestinal loss
2. renal loss
3. cellular shift
4. dehydration

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what are four reasons for gastrointestinal loss causing hypokalemia, and six reasons for renal loss causing hypokalemia?

GI loss:
1. vomiting/diarrhea
2. gastric suction
3. intestinal tumor
4. malabsorption’

Renal loss:
1. diuretics
2. nephritis
3. Cushing’s / hypoaldosteronism
4. hypomagnesemia
5. renal tubular acidosis
6. acute leukemia

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what are two reasons for cellular shift as they relate to hypokalemia?

cellular shift:
- alkalosis
- insulin overdose

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what are 4 symptoms of hyperkalemia? What are four general reasons for potassium decreases?

muscle weakness, tingling, numbness, and mental confusion

decreased renal excretion, cellular shift, increased intake, or artifact

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what are three reasons for decreased renal excretion, cellular shift, and artifact as they relate to hyperkalemia?

decreased renal excretion:
1. acute or chronic renal failure
2. hypoaldosteronism
3. Addison’s disease (hypoadrenalcorticalism)

cellular shift:
1. acidosis
2. chemo
3. hemolysis

artifact:
1. sample hemolysis
2. thrombocytosis
3. prolonged tourniquet use during blood draw

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what is the reference range for potassium?

3.5 - 5.1 mmol/L

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Chloride is the major _______ ______. It maintains what three things?

it is the major extracellular anion/ It maintains osmolality, blood volume. and electroneutrality

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After chloride is ingested and then absorbed in the intestine, anything left is reabsorbed where and with what? Excess chloride is excreted in what two places?

it’s reabsorbed in conjunction with sodium in the tubules

excess Cl- is excreted in the urine and sweat

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what are five ways to have hypochloremia?

excessive loss from:
1. vomiting
2. diarrhea
3. diabetic ketoacidosis
4. aldosterone deficiency
5. pyelonephritis

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what are two ways to have hyperchloremia?

excess loss of bicarbonate due to GI loss of metabolic acidosis

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what is the reference range for chloride?

98 - 107 mmol/L

bicarbonate is the _____ most common ____ in the ____ fluid

bicarbonate is the second most common anion in the extracellular fluid

how does bicarb function is the major buffering component system in the blood?

bicarb diffuses out of the cell in exchange for chloride to maintain ionic charge neutrality within the cell

how is bicarbonate regulated?

bicarbonate reabsorbed in tubules as CO2. In alkalosis (relative increase in bicarbonate), the kidneys increase excretion of HCO3- into urine carrying along a cation during compensation for acidosis, the body will reabsorb more than 90% of bicarbonate to make the blood more alkaline

what is the measurement system for measuring bicarbonate?

blood gas testing vie co-oximetry measurement of CO2

what is the reference range for bicarbonate

22 - 29 (22-33??) mmol/L

what two ways is calcium found in the blood?

it's in the blood either - free (active form) - bound to a protein (albumin) or anion (bicarbonate) (Ca2+ conc. more in blood than smooth muscle)

decreased ionized calcium impairs _____ function, so you have to maintain normal concentration during ____ and critically ill patients

impairs **myocardial** function maintain normal Ca2+ levels during **surgery**

what three things regulate serum calcium

parathyroid hormone (PTH), vitamin D, and calcitonin

what three body parts play a role in calcium homeostasis?

the intestines, bones, and kidneys

what are two symptoms of hypocalcemia?

neuromuscular irritability and cardiac irregularities

what are five ways to develop hypocalcemia

1. primary hypoparathyroidism 2. vit D deficiency 3. hypo/hypermagnesemia 4. acute pancreatitis 5. renal disease

what are 7 different symptoms of hypercalcemia?

1. drowsiness 2. weakness 3. depression 4. lethargy 5. coma 6. anorexia 7. ulcers

what are four ways to develop hypercalcemia?

1. primary hyperparathyroidism 2. increased vit D 3. malignancy 4. multiple myeloma

magnesium is mostly found in what four places? 1% of it is found where?

mostly found in 1. bone 2. muscle 3. organ tissue 4. soft tissue 1% found in **serum** where 1/3 of it is bound to albumin

magnesium is a cofactor for what 8 enzyme functions?

1. glycolysis 2. transcellular ion transport 3. neuromuscular transmission 4 - 7. carb, proteins, nucleic acids, lipid synthesis 8. release of/ response to certain hormones

Where and how is magnesium regulated?

Mg2+ controlled by the **kidneys**, which either reabsorb magnesium during deficiency (30% by proximal tubule) or excrete it in excess **Henle's loop** is major regulation site

What hormone is responsible for magnesium regulation, and how?

PTH increases in reabsorption of MG2+ and enhances absorption in the intestine

what four bodily states can be affected by hypomagnesemia?

cardiovascular, neuromuscular, psychiatric, and metabolic

what are 7 symptoms of hypomagnesemia?

1. arrhythmias 2. cramps 3. seizures 4. paralysis 5. coma 6. depression 7. psychosis

what are four general ways to be magnesium deficient?

1. increased excretion 2. decreased absorption 3. reduced intake (poor diet) 4. other (chronic alcoholism)

what are specific ways increased excretion can result in hypomagnesemia?

renal: tubular disorders endocrine: hyper- - (para)thyroidism - aldosteronism - calcemia and diabetic ketoacidosis drug-induced: diuretics, antibiotics, cyclosporine

what are decreased absorption causes of hypomagnesemia?

surgical resection of small intestine, pancreatitis, vomiting/diarrhea, and laxative abuse

what are eight symptoms of hypermagnesemia

bradycardia, heart block, skin flushing, increased skin temp, nausea, vomiting lethargy, coma

what are three general reasons for hypermagnesemia?

decreased excretion, increased intake, and miscellaneous

what are four specific reasons for decreased exertion leading to hypermagnesemia

1. acute/chronic renal failure 2. hypothyroidism 3. hypoaldosteronism 4. decreased growth hormone

what three things cannot be used for magnesium analysis?

oxalate, citrate, and EDTA

Phosphate is found everywhere in living cells. Phosphate participates in most important biochemical processes such as ______, _____, and _____

DNA/RNA, enzymes, ATP

what four things regulate phosphate in the body?

1. absorbed through diet, released from blood, or lost from bone 2. PTH lowers phosphate blood concentration (by increasing renal excretion) 3. via D increases phosphate in blood 4. growth hormone

what are seven reasons for hypophosphatemia?

1. diabetic ketoacidosis 2. chronic obstructive pulmonary disease 3. asthma 4. malignancy 5. inflammatory bowel disease 6. anorexia nervosa 7. alcoholism

six reasons for hyperphosphatemia

**renal disease**, increased intake, intense exercise, infections, neoplasm disorders, intravascular hemolysis

there is a ______ mortality rate associated with hypophosphatemia?

high