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Electrolytes Flashcards

(54 cards)

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1
Q

Hypovolemic Hyponatremia

A

low extracellular fluid volume

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2
Q

Cause of Hypovolemic Hyponatremia

A

Increase ADH leading to hyponatremia in free H20 intake

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3
Q

Hypervolemic Hyponatremia

A

Increased extracellular fluid volume

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4
Q

List causes of Hypervolemic Hyponatremia

A

CHF

Nephrotic syndrome

Cirrhosis

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5
Q

Isovolumic (Euvolemic) Hyponatremia

A

equal extracellular and intracellular fluid volume

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6
Q

List causes of Isovolumic (Euvolemic) Hyponatremia

A

Glucocorticoid deficiency 2nd to adrenal failure

Hypothyroidism

Syndrome of inappropriate antidiuretic hormone secretion

Renal dysfunction

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7
Q

Hyponatremia: clinical manifestations

A

Nausea/vomiting

Anorexia

Headache

Muscle twitching

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8
Q

Hyponatremia: Diagnostic studies

A

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

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9
Q

Hyponatremia: Treatment plan

A

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

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10
Q

Hypernatremia: Excessive sodium intake

A

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

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11
Q

Hypernatremia: water deficiency

A

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

Pulmonary infections - from hyperventilation

Extensive burns

Severe watery diarrhea - especially dangerous in children

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12
Q

Hypernatremia: Clinical Manifestations

A

Skin Flushed

Agitation/Restlessness

Low-grade Fever

Thirst

[SALT]

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13
Q

Hypernatremia: Diagnostic Tests

A

Serum sodium

Urine sodium

Urine concentration

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14
Q

Why do you use caution when treating Hypernatremia?

A

Rapid correction can cause pulmonary or cerebral edema

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15
Q

Mechanisms used to regulate potassium levels

A

Must be daily ingested - body cannot conserve it

Excreted through renal tubules

Kidneys do not have a mechanism to prevent K+ loss

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16
Q

Causes of hypokalemia

A

Renal tubular Acidosis

Elevated glucose

Cushing’s Syndrome

Hyperaldosteronism

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17
Q

Hypokalemia: clinical manifestations

A

Skeletal Muscle Weakness - can lead to paralysis

U Wave - changes on ECG

Constipation, Ileus

Toxicity - Digitalis

Irregular Weak Pulse

Orthostatic Hypotension

Numbness - Paresthesia

[SUCTION]

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18
Q

What cardiac manifestation can hypokalemia cause?

A

Cardiac Arrest

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19
Q

Hypokalemia: Diagnostics

A

ECG: U Wave

Bicarb and pH: elevated

Serum Glucose: slightly elevated

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20
Q

Hypokalemia: Treatment for outpatient

A

Oral potassium therapy - preferably potassium chloride

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21
Q

Hypokalemia: Treatment for emergent inpatient

A

IV potassium replacement

Close monitoring - to avoid serious complications

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22
Q

Causes of Hyperkalemia

Study These Flashcards
A

Metabolic acidosis

Cell injury

NSAIDS and ACE

Acute/Chronic RF

23
Q

Clinical cardiac causes of Hyperkalemia

Study These Flashcards
A

Dysrhythmias

Irregular pulse

Cardiac arrest

Hypotension

[DICH]

24
Q

Clinical Neuromuscular causes of Hyperkalemia

Study These Flashcards
A

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
31
Increase of Calcitonin hormone caused by hypocalcemia results in inhibition of what?
Inhibition of bone reabsorption Inhibition of calcium absorption Inhibition of enhanced renal excretion
32
The active form of Vitamin D promotes what when hypocalcemic?
Intestinal absorption Bone reabsorption Renal reabsorption
33
Causes of hypocalcemia?
Dietary insufficiency - alcoholic Malabsorption - from laxative abuse, severe diarrhea Chronic kidney disease - inability to activate vitamin D Complete cardiovascular collapse
34
Hypocalcemia: Clinical Manifestations
Bradycardia/syncope/angina Trousseau's and Chvostek's sign
35
Hypocalcemia: Diagnostic
ECG: Prolonged ST segment, torsades de pointes
36
Hypocalcemia: Treatment for mild outpatient
Oral Calcium and Vitamin D Supplements Dietary Education: Calcium/Protein Dietary Needs
37
Hypocalcemia: Treatment for severe: Inpatient
IV Calcium Gluconate or Calcium Chloride
38
Hypocalcemia: Treatment for emergent: Inpatient
Emergent: Inpatient | Treat Any Emergent Cardiovascular States
39
Hyperparathyroidism cause by Hypercalcemia results in an increase of PTH excretion causing?
Increased bone reabsorption Increased renal reabsorption Increased intestinal absorption
40
Cancer cause by Hypercalcemia results in bone destruction-release substance similar to PTH causing?
Kidneys to become overwhelmed - unable to keep up with excess calcium Cancers: lung, squamous cell
41
Hypercalcemia: Clinical Manifestations
Polyuria Orthostatic hypotension Dehydration Stupor
42
Hypercalcemia: Diagnostic Studies
CXR: possible mass ECG: short QT interval
43
Hypercalcemia: Treatment plan
Increase secretion of Calcium with IV fluids Bisphosphonates for severe hypercalcemia Treat the underlying cause
44
Mechanisms used to regulate magnesium levels
Assists enzyme reactions within cells during carbohydrate metabolism
45
Hypomagnesemia: Causes
Chronic alcoholism Decreased GI absorption Increased GI loss Increased urinary loss Loops/Thiazides
46
Hypomagnesemia: Clinical Manifestations
Seizures Tetany, Tremors, Twitching Anorexia and arrhythmias Rapid heart rate Vomiting Emotional lability, confusion, depression Deep tendon reflex increased [STARVED]
47
Hypomagnesemia: diagnosis studies-Labs
Hypomagnesemia, hypokalemia
48
Hypomagnesemia: diagnosis studies-ECG
Prolonged PR and QT intervals or widening QRS, Flattened T-wave, prominent U-wave
49
Mild Hypomagnesemia: Treatment
Dietary education on replacement Oral magnesium oxide supplement
50
Severe Hypomagnesemia: Treatment
IV or IM Magnesium sulfate Treat underlying conditions
51
A key point of Hypovolemic Hyponatremia
Always monitor fluid status!!
52
A key point of hypernatremia
elevated Na --> hypothalamus initiates thirst --> ADH increases water retention --> lowers Na level
53
In hypernatremia, urine will be concentrated d/t
extrarenal causes
54
In hypernatremia, urine will be diluted d/t
diabetes insipidus

Renal (4 decks)

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