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Electrolytes Flashcards

(38 cards)

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1
Q

Sodium

Lab Value

A

135-145 mEq/L

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2
Q

Potassium

Lab Value

A

3.5 - 5 mEq/L

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3
Q

Calcium

Lab Value

A

9 -10.5 mg/dL

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4
Q

Magnesium

Lab Value

A

1.5 - 2.5 mg/dL

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5
Q

Chloride

Lab Value

A

98 - 106 mEq/L

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6
Q

Phosphorus

Lab Value

A

3 - 4.5 mg/dL

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7
Q

Na+ and Cl+ are…

A

Directly related in levels

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8
Q

Cl+ is directly related to…

A

Na+ and K+

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9
Q

Cl+ is inversely related to…

A

Bicarb HCO3

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10
Q

Ca+ is inversely related to...

A

Phorsphorus (Ph)

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11
Q

Ca+ is acts as a…

S&S

A

Sedative

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12
Q

Renal Failure causes 3 Electrolytes to go UP

A
  • K+
  • Mg+
  • Ph
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13
Q

HypoCalcemia

2 Muscle Signs

A

Chvostek’s Sign
* Cheek
* Positive Chvostek’s sign, indicated by facial muscle twitching

Trousseau’s Sign
* Performed by inflating a blood pressure cuff on the arm, constricting blood flow and causing a carpopedal spasm (hand and wrist muscle spasms)

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14
Q

Hypocalcemia may cause what major cardiac issue?

A

VTach

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15
Q

What do you usually give with Calcium supplements to increase absorption?

HypoCa

A

VitaD

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16
Q

Ca+ is a Myocardial Protectant

Study These Flashcards
A

Ca+ is a Myocardial Protectant

17
Q

Stop taking Calcium Carbonate or…

Hypercalcemia

18
Q

What can be given to treat Hypercalcemia?

Rx

Study These Flashcards
A

Calcitonin
* Hormone produced in Thyroid
* It acts to lower blood Ca+ levels by inhibiting bone breakdown, reducing Ca+ absorption from the intestines, and increasing Ca+ excretion in the urine.

19
Q

Ca+ relation to Bleeding

Study These Flashcards
A
  • Ca Inc > Bloodclotting>DVT
  • Ca Dec > Bleeding
20
Q

Hyperphosphatemia

Causes

Study These Flashcards
A
  • Tumor Lysis Syndrome
    Tumor cell ruptures, releasing contents and Ph into blood.
    Ex: Rabdomyolysis > cell rupture > increased Ph
  • Rabdomyolysis > cell rupture > increased Ph
  • Hypoparathyroidism>HypoCa+
    >HyperPh
21
Q

HyperPh may cause what signs?

Study These Flashcards
A

HyperPh>HypoCa>Irritable
Chvostek/Trousseau Signs

22
Q

Hypophosphatemia

Causes

Study These Flashcards
A
  • TPN, vein doesn’t absorb Ph well
  • HypoPh > HyperCa > Sedation
  • Hyperparathyroidism>HyperCa+
    >HypoPh
23
Q

Mg+ is directly related to…

Study These Flashcards
A

Ca+
* Except in Renal Failure / Inversely related

24
Q

Mg+ acts like a…

Study These Flashcards
A

Sedative
* Same as Ca+

25
HyperMg+ may cause...
**Vasodilation** is specific to HyperMg
26
Treatment for HyperMg+
* **CaGluconate** protects heart (Ca) * CaGluconate directly antagonizes neuromuscular and cardiovascular effects of Mg+ * Loop Diuretics
27
HypoMg+ Causes
* Alcoholism * Diarrhea > Mg stored in lower GI tract * Malabsorption * HypoCa
28
HypoMg similar to HypoCa
**Agitated, not sedated** * Deep Tendon Reflexes
29
HypoMg+ EKG
**Torsades de Pointes** * Push IV Mg quickly instead
30
K+ Cellular Level
* K+ mostly found intracellular * K+ important for heart and skeletal muscles * Acidotic patient has more K+ stuck in bloodstream, can't get into cell
31
HyperK+ Causes
**Too much potassium moved from** **intracellular to extracellular** * Burns, Tissue Damage * DKA > K+ attach on glucose, can't get into cell **Renal Failure** **Meds** * Ace Inhibitors (E = Think Elevates K+) * K+ Sparing Diuretic (Spironolactone)
32
HyperK+ EKG Changes
* Wide, flat P waves * Prolonged PR interval * **Widened QRS interval** * Depressed ST segment * **Tall, peaked T waves** Can lead to **V-Fib or heart block** or eventually **cardiac arrest**!
33
HyperK+ Treatment
* **Monitor Cardiac Rhythm** * IV Calcium gluconate or chloride to protect heart * Drive potassium into cells **D5W + regular insulin K+ follows glucose into cell** * Reduce total body potassium **Kayexalate> K+ in Stool** **Diuretics** Hydrochlorothiazide Furosemide * Dialysis
34
HyperK+ **MURDER**
* **M**uscle Weakness, Cramps * **U**rine Abnormal * **R**esp. Distress * **D**ecreased Cardiac Contractability * **E**KG Changes * **R**eflexes (Depressed/Absent)
35
Causes of HypoK+ **DITCH**
**D**rugs Laxatives Diuretics Corticosteroids (**Na+ Up > K+ Down**) **I**nadequate K intake NPO Poor diet Anorexia nervosa Bulimia nervosa Alcoholism **T**oo much water Polydipsia (Excess thirst) Excessive IVF **C**ushing's syndrome **Too much cortisol Retention of Na/Water Secretion of K** **H**eavy fluid loss NGT suction Vomiting Diarrhea Wound drainage Sweating
36
HypoK+ EKG Dysrhythmias
* Slightly peaked P wave * Slightly prolonged PR interval * ST depression * Flat/shallow/inverted T waves * **Prominent U-Waves**
37
HypoK+ Treatment
Prevent arrhythmias * Place telemetry * **Hold Digoxin (Make sure no DigTox)** Prevent further K+ loss * Hold furosemide or other potassium wasting drugs Give more potassium **(POD)** * Potassium K+ IV Supplement * Oral K+ Supplement (with food to prevent GI upset) * Diet rich in K+
38
When giving K+ IV, **NEVER**...
Never push K+>**Cardiac Arrest** * Phlebitis * Extravasation

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