Electrolytes Flashcards
(22 cards)
Types of hyponatremia?
1) Hypotonic
2) Isotonic
3) Hypertonic
Types of hypotonic hyponatremia?
1) Hypovolemic–either low urine Na or high urine Na causes
2) Euvolemic
3) Hypervolemic
Causes of low urine Na hypovolemic hyponatremia?
Diarrhea, vomiting, NG suction, diaphoresis, third-spacing, burns, pancreatitis
Causes of high urine Na hypovolemic hyponatremia?
Diuretic excess, decreased aldosterone (ACEIs), ATN
Causes of euvolemic hyponatremia?
SIADH, psychogenic polydipsia, postop, hypothyroidism, oxytocin use
Causes of hypervolemic hyponatremia?
CHF, nephrotic syndrome, liver dz
Causes of isotonic (pseudo)-hyponatremia?
Any condition that causes high protein or lipid levels
Causes of hypertonic hyponatremia?
Hyperglycemia
Tx for isotonic and hypertonic hyponatremia?
Tx the underlying cause
Tx for hypotonic hyponatremia?
1) Na 120-130 = water restriction
2) Na 110-120 = loop diuretics
3) Na <110 or if sxs = hypertonic saline
Types of hypernatremia?
1) Hypovolemic–diuretics, osmotic diuresis in DM, renal failure, diarrhea
2) Isovolemic–diabetes insipidus
3) Hypervolemic–large amounts of IV NaHCO3, TPN, exogenous glucocorticoids
Tx for hypovolemic hypernatremia?
0.9% Na (isotonic)
Tx for isovolemic hypernatremia?
Vasopressin for DI, also D5W 0.45% saline
Tx for hypervolemic hypernatremia?
Furosemide and D5W
Tx for sxs hypocalcemia?
IV Ca gluconate (oral for long term)
Tx for hypercalcemia?
IV NS and furosemide (bisphosphonates and calcitonin for long term)
Tx for hypokalemia?
Oral KCl (can be given IV if K t forget to add 1% lidocaine to bag cuz K burns!)
Tx for hyperkalemia?
1) If severe and ECG changes present = IV Ca
2) To shift K into the intracellular compartment = glucose and insulin, NaHCO3
3) Remove K from body = kayexalate, HD, furosemide
Tx for hypomagnesemia?
Mg
Tx for hypermagnesemia?
IV Ca gluconate (for cardioprotection), saline and furosemide
Tx for hypophosphatemia?
Phospate
Tx for hyperphosphatemia?
Antacids (aluminum hydroxide or carbonate)
