Flashcards in Electrolytes Deck (20)
Loading flashcards...
1
Hypercalcemia EKG changes
short QT
2
Hypercalcemia treatment
First: IVF!
-Bisphosphonates, calcitonin
-give steroids if vit D or MM related cause
-dialysis for ESRD pts
-NB: phosphate effective but avoided bc of risk of metastatic calcification
3
Hypocalcemia symptoms
-Numbness/tingling
-Tetany (Chvostek'-facial nerve, Trosseu's-BP cuff)
-Long QT
-seizures
4
Causes of hypocalcemia
-HyperPTH most common
-Acute pancreatitis
-Renal insufficiency
-Vit D deficiency
-Hyperphosphatemia
-Blood transfusion w/ citrated products
-Hypomagnesemia (dec PTH secretion)
5
What causes a low calcium level with normal free (ionized) calcium?
Low albumin
correction: 0.8 (4-albumin) + serum calcium
6
Treatment of hypocalcemia
Emergent: IV calcium gluconate
Long-term: oral calcium supplements and vitamin D
CORRECT HYPOMAG
7
Alkalosis leads to hypo or hyperkalemia?
Alkalosis --> hypokalemia
8
Acidosis leads to hypo or hyperkalemia?
Acidosis --> hyperkalemia
9
Symptoms of hypokalemia
Weakness, paralysis, ileus, ST depression, flattening of T waves and long QT w/ prominent U waves
10
What are some causes of redistribution hypokalemia?
Alkalosis, beta-agonists (e.g. epi in trauma), insulin excess
11
Treatment of hypokalemia
Treat underlying cause. Usually just use oral KCl. IV KCl can be given if
12
Hyperkalemia EKG
EKG: peaked T waves, widened QRS, PR prolongation, loss of P waves, lastly sine wave pattern
13
Hyperkalemia symptoms
Like hypo- weakness, decreased DTRs, N/V
also diarrhea, respiratory failure
14
Treatment of hyperkalemia
If severe or ECG changess, first give calcium gluconate. Next glucose and insulin, beta agonists, Kayexalate. If desperate, sodium bicarb raises pH which sends K into cells. Dialysis for renal failure. Diuretics (e.g. furosemide).
15
Hypomagnesemia can cause what two other electrolye imbalances?
Hypomagnesemia is assoc with hypocalcemia and hypokalemia
16
Most common cause of hypomag?
Malabsorption, steatorrheic states
17
Most common cause of hypermag?
Renal failure
18
Signs of hypermag?
(remember labor floor..)
Nausea, weakness, loss of DTRs (first sign) --> somnolence, coma, muscular paralysis --> resp failure or cardiac arrest
19
Treatment of hypermag?
Calcium gluconate to stabilize herat. Saline + furosemide. Intubate as needed.
20
