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Flashcards in Electrolytes Deck (54)
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1

Hypovolemic Hyponatremia

low extracellular fluid volume

2

Cause of Hypovolemic Hyponatremia

Increase ADH leading to hyponatremia in free H20 intake

3

Hypervolemic Hyponatremia

Increased extracellular fluid volume

4

List causes of Hypervolemic Hyponatremia

CHF

Nephrotic syndrome

Cirrhosis

5

Isovolumic (Euvolemic) Hyponatremia

equal extracellular and intracellular fluid volume

6

List causes of Isovolumic (Euvolemic) Hyponatremia

Glucocorticoid deficiency 2nd to adrenal failure

Hypothyroidism

Syndrome of inappropriate antidiuretic hormone secretion

Renal dysfunction

7

Hyponatremia: clinical manifestations

Nausea/vomiting

Anorexia

Headache

Muscle twitching

8

Hyponatremia: Diagnostic studies

Serum sodium will increase or decrease d/t cause of the increase of BUN/Creatine

Chest CT to r/o lung SCC

Admit if symptomatic or if Na <125

9

Hyponatremia: Treatment plan

Admit - if symptomatic or Na+ <125 mEq/L

Treat Underlying condition - usually fluid restriction

Except: Hypovolemic hyponatremia treat with isotonic saline
---> always monitor volume status

10

Hypernatremia: Excessive sodium intake

Salt tablets

Food

Medications - containing high sodium content

Excessive parental administration of Na+ solution - hypertonic Na+ solutions or sodium bicarbonate

Near salt-water drowning

Crushing's - excess adrenocortical hormones

Hyperaldosteronism

11

Hypernatremia: water deficiency

Fever and heat stroke - especially older adults, peds, and athletes

Pulmonary infections - from hyperventilation

Extensive burns

Severe watery diarrhea - especially dangerous in children

12

Hypernatremia: Clinical Manifestations

Skin Flushed

Agitation/Restlessness

Low-grade Fever

Thirst

[SALT]

13

Hypernatremia: Diagnostic Tests

Serum sodium

Urine sodium

Urine concentration

14

Why do you use caution when treating Hypernatremia?

Rapid correction can cause pulmonary or cerebral edema

15

Mechanisms used to regulate potassium levels

Must be daily ingested - body cannot conserve it

Excreted through renal tubules

Kidneys do not have a mechanism to prevent K+ loss

16

Causes of hypokalemia

Renal tubular Acidosis

Elevated glucose

Cushing's Syndrome

Hyperaldosteronism

17

Hypokalemia: clinical manifestations

Skeletal Muscle Weakness - can lead to paralysis

U Wave - changes on ECG

Constipation, Ileus

Toxicity - Digitalis

Irregular Weak Pulse

Orthostatic Hypotension

Numbness - Paresthesia

[SUCTION]

18

What cardiac manifestation can hypokalemia cause?

Cardiac Arrest

19

Hypokalemia: Diagnostics

ECG: U Wave

Bicarb and pH: elevated

Serum Glucose: slightly elevated

20

Hypokalemia: Treatment for outpatient

Oral potassium therapy - preferably potassium chloride

21

Hypokalemia: Treatment for emergent inpatient

IV potassium replacement

Close monitoring - to avoid serious complications

22

Causes of Hyperkalemia

Metabolic acidosis

Cell injury

NSAIDS and ACE

Acute/Chronic RF

23

Clinical cardiac causes of Hyperkalemia

Dysrhythmias

Irregular pulse

Cardiac arrest

Hypotension

[DICH]

24

Clinical Neuromuscular causes of Hyperkalemia

Numbness

Paresthesia

Skeletal muscle

Weakness

Flaccid paralysis

25

Clinical GI causes of Hyperkalemia

Diarrhea

Abdominal cramping

Nausea

26

Hyperkalemia: Diagnostic Studies

ECG - tall tented T wave, flattened P wave, prolonged PR interval, widened QRS, depressed ST Segment

27

Treatment for mild Hyperkalemia

Restrict dietary and supplemental K+

Initiate loop and thiazide diuretics

Discontinue K+ sparing meds

28

Treatment for moderate Hyperkalemia

Sodium polystyrene

29

Treatment for severe Hyperkalemia

With ECG changes: calcium gluconate

With Acidosis: sodium bicarbonate

Insulin with glucose

30

Hyperparathyroidism cause by Hypocalcemia results in?

Increased bone reabsorption

Increased renal reabsorption

Increased intestinal absorption