P3 Therapeutics Test 1 Mg/k

Front 1

what are the normal Mg levels

Back 1

1.7-2.3 mg/dL
1.4-1.8 mEq/L

Front 2

what is Mg natural function

Back 2

natures Ca blocker

Front 3

why would we replace Mg in pt w/ arrythmia

Back 3

Mg also involved in CV tone

Front 4

what is the etiology of Hypomagnesemia

Back 4

decrease intake
redistribution by dextrose/insulin
drug induced
alcoholism

Front 5

what drugs induce hypomagnesemia

Back 5

amphotericin B
aminoglycosides
cyclosporin
diuretics
cisplatin

Front 6

what arrythmia is commonly seen in alcoholics

Back 6

torsades

Front 7

what are some signs and symptoms of hypomagnesemia

Back 7

torsades
ventricular fibrillation
digitalis mediated arrhythmias
tachycardia
refractory hypokalemia and hypocalcemia

Front 8

how do you treat hypomagnesemia

Back 8

if aymptomatic
-oral mag supps (Mag Ox, magnesium hydroxide, magnesium containing antacids)

if critically ill or have malabsorption
-paranteral magnesium sulfate

Front 9

what is the infusion rate for Mg sulfate and what is it used to treat

Back 9

treats hypomagnesemia
infuse at rate > 8mEq/hr

Front 10

what is the monitoring for hypomagnesemia if not symptomatic

Back 10

takes 3-5 days to replenish total body Mg

Front 11

what is the monitoring for hypomagnesemia if symptomatic

Back 11

monitor hourly until Mg reaches 1.5 mEq/L and symptom free
every 6-12 hrs while on Mg supplementation
daily once Mg is normal

Front 12

what are teh causes of hypermagnesemia

Back 12

decreased excretion
excessive intake/admin
drug induced

Front 13

what drugs cause hypermagnesemia

Back 13

lithium

Front 14

how do you treat hypermagnesemia

Back 14

calcium chloride or gluconate
IV furosemide
hemodialysis

Front 15

what is the monitoring for asymptomatic pt w/ hypermagnesemia

Back 15

monitor every 24hrs

Front 17

what is the normal serum levels of K

Back 17

3.5-5.5 mEq/L

Front 18

at what K level can paralysis occur

Back 18

K <2.5

Front 19

what is the etiology of hypokalemia

Back 19

poor intake
GI losses
ECF to ICF K shift
Renal losses

Front 20

what can cause an ECF to ICF shift in potassium

Back 20

dextrose (b/c it causes insulin release)
metabolic alkalosis
NaHCO3
Na/K ATPase stimulation
-beta 2 Rc stimulation by albuterol, catecholamines
-insulin also stimulates Na/K ATPase

Front 21

what causes renal losses of K

Back 21

hypomagnesemia (impairs fxn of Na/K ATPase promoting K wasting)
Mineral corticoid excess (retain Na but excrete K)
Medications

Front 22

what medications cause hypokalemia

Back 22

diuretics
amphotericin B
aminoglycosides
cisplatin
aldosterone

Front 23

what clinical manifestations are seen in Hypokalemia

Back 23

T wave INVERSION
U wave appearance
ST depression or flattening
arrhythmias
increase risk of digitalis toxicity
rhabdomyolysis
cramps, weakness, paralysis

Front 24

every 1 mEq decrease in K (below 3.5) causes a 100-400 mEq total body K deficit what does this show

Back 24

that the smallest decrease in serum K can cause a very large decrease in total body K

Front 25

in pts with normal renal function and suffering from hypokalemia every 10 mEq given will raise serum K by what

Back 25

0.1 mEq/L

Front 26

what are the treatment options for hypokalemia

Back 26

diet modification
oral K
IV K - prepared in saline solution
K sparring diuretics

Front 27

why is IV K administered in a saline solution and not the conventional dextrose

Back 27

dextrose > insulin release > ECf to ICF shift of K which will make Hypokalemia worse

Front 28

how should IV K be diluted when given via a central line and peripheral line

Back 28

central line 20mEq/100ml
peripheral line 10 mEq/100ml

this is done to prevent phlebitis and thrombosis from occuring

Front 29

what are the causes of hyperkalemia

Back 29

excessive intake
decrease renal excretion
cellular disruption
innappropriate blood draw
ICF to ECF shift

Front 30

how can cellular disruption cause hyperkalemia

Back 30

disruption or lysing of cell makes it spill its intracellular contents into blood, one of which being K+

Front 31

how can innappropriate blood draw cause hyperkalemia

Back 31

drawing blood at site distal to K infusion

Front 32

what causes ICF to ECF shift in K

Back 32

insulin deficiency
metabolic acidosis
Beta blockers
digoxin OD
succinylcholine

Front 33

what is the clinical manifestation of Hyperkalemia

Back 33

PEAKED T waves
widening QRS complex
loss of P waves
ventricular fibrillation

Front 34

how do you treat hyperkalemia

Back 34

determine if lab values are real
if symptomatic:
IV calcium (THIS ONLY STABILIZES THE HEART AND DOESN'T DECREASE K)

ECF to ICF K shift

Front 35

what drugs shift K from ECF to ICF

Back 35

insulin
dextrose
sodium bicarbonate
albuterol

Front 36

what can be done to increase K elimination

Back 36

furosemide
sodium polystyrene sulfonate
hemodialysis

Front 37

what is 1st line for hyperkalemic emergencies

Back 37

dextrose and insulin

Front 38

what is the monitoring when administering Nabicarbonate

Back 38

monitor acid base and fluid status
caution in CHF and fluid retention states

Front 39

what is the monitoring for Albuterol admin

Back 39

can precipitate or worsen tachycardia

Front 40

what is the monitoring for hyperkalemia if acute symptomatic

Back 40

monitor ECG until k <5
frequent serum K levels every 1-6 hrs
review for drugs that cause hyperkalemia

Front 41

what drugs can cause decreased renal excretion of K therefore lead to hyperkalemia

Back 41

ACE-I
ARBs
K sparring diuretics
heparin
trimethoprim
NSAIDs

Front 42

what is the max you can replace K in a day

Back 42

10-20 mEq/hr

Front 43

what is the max infusion rate for Mg Sulfate

Back 43

8 mEq/L/hr

Front 44

what electrolyte disorder does bactrim cause and due to what component

Back 44

hyperkalemia

due to trimethoprim