Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
56 Cards in this Set
- Front
- Back
|
Hyperkalemia |
Excess serum potassium K > 5.0 |
|
|
Causes of Hyperkalemia |
Massive intake of K Impaired renal function Addison’s (low aldosterone) Massive cellular destruction (trauma)—cells leak K into plasma Acidosis (draws K out of cells to raise pH) Medications: ACE Inhibitors (prils), Aldactone
|
|
|
Signs of Hyperkalemia |
Heart (Tight and Contracted): Ventricular fibrillation/cardiac standstill, hypotension, bradycardia GI Tract (Tight and Contracted): Abdominal cramping/diarrhea Neuromuscular (Tight and Contracted): paralysis and muscle weakness, muscle cramps, increased DTRs Oliguria |
|
|
Management of Hyperkalemia |
Eliminate oral/parenteral intake Increase elimination with loop and thiazide diuretics, dialysis, Kayexalate |
|
|
Hypokalemia |
Low serum potassium K < 3.5 |
|
|
Causes of Hypokalemia |
Most common: diuretics Abnormal losses of K through kidneys, GI tract, and enteral feedings Magnesium deficiency Hyperaldosteronism Metabolic alkalosis Low intake |
|
|
Signs of Hypokalemia |
Heart (low and slow): flat T waves, ST depression, cardiac arrhythmias Muscular (low and slow): Decreased DTRs, muscle weakness GI (low and slow): Decreased GI motility—constipation, paralytic ileus Impaired regulation of arterial blood flow
|
|
|
Management of Hypokalemia |
KCl supplements PO or IV IV should not exceed 10-20 mEq/hr Monitor UOP for renal function |
|
|
Sodium |
Imbalances associated with parallel changes In osmolality Plays role in ECF volume and concentration, transmission of nerve impulses, acid-base balance Reabsorbed/excreted by kidneys |
|
|
Hypernatremia |
Elevated serum sodium occurring with water loss or sodium gain Causes hyper osmolality leading to cell dehydration Primary protection is thirst Fluid goes from ICF to ECF (cells shrink) Na > 145 |
|
|
Signs of Hypernatremia |
Skin (Big and Bloated): flush skin, edema, fever Thirst High USG Serious signs: swollen and dry tongue, N/V, increased muscle tone Neurological deficits (confusion) |
|
|
Management of Hypernatremia |
Treat underlying cause Restrict Na Push fluids I and O, daily weights, serum tests IV solution of D5W or 0.45% NS
|
|
|
Management of Hypercalcemia |
Excretion of Ca with loop diuretics Isotonic saline Calcitonin Mobilization Mithracin and Aredia |
|
|
Hypocalcemia |
Low serum calcium Ca < 8.5 |
|
|
Causes of Hypocalcemia |
Thyroidectomy: decreased PTH Pancreatitis Blood transfusions Alkalosis Decreased intake Renal failure: make less vitamin D |
|
|
Signs of Hypocalcemia |
Tingling around mouth and extremities Increased muscle tone Seizures Positive Trousseau (finger flex after BP) and Chvostek sign (cheek spasm) Dysphagia, laryngeal stridor Risk for: bone fractures, bleeding, arrhythmias |
|
|
Management of Hypocalcemia |
Treat cause Calcium supplements (not IM, if IV give slowly) Vitamin D Place on heart monitor Prevent hyperventilation |
|
|
Magnesium |
50-60% in bone Coenzyme in metabolism of protein and carbs Acts on myoneural junction to calm down muscles Important for cardiac function Important for calcium and vitamin D absorption Reabsorbed/excreted by kidneys; excreted by feces |
|
|
Hypermagnesemia |
High serum magnesium Mg > 2.1 |
|
|
Causes of Hypermagnesemia |
Increased intake with renal problems
|
|
|
Organs affected by Magnesium |
Heart Kidneys Muscles |
|
|
Signs of Hypermagnesemia |
Heart (Calm and Quiet): heart block, cardiac arrest, bradycardia, hypotension Tendons (Calm and Quiet): Loss of DTRs Lungs (Calm and Quiet): slow, shallow respirations GI (Calm and Quiet): hypoactive bowel sounds |
|
|
Hyponatremia |
Low serum sodium Results from loss of sodium-containing fluids or water excess Fluid goes from ECF to ICF (cells swell) Na < 135 |
|
|
Management of Hypermagnesemia |
Restrict intake Emergency tx is IV CaCl Fluids to promote excretion Dialysis with renal failure |
|
|
Hypomagnesemia |
Low serum magnesium Mg < 1.6 |
|
|
Causes of Hypomagnesemia |
Prolonged starving Chronic alcoholism Fluid loss from GI tract Parental nutrition Diuretics Hyperglycemia |
|
|
Signs of Hypomagnesemia |
Cardiac (Wild): V fib, tachycardia Tendons (Wild): increased DTRs Eyes (Wild): nystagmus GI (Wild): diarrhea |
|
|
Management of Hypomagnesemia |
Supplements Increased intake IV or IM Mg |
|
|
Phosphate |
Involved in acid-base buffering, ATP, uptake of glucose, and bone formation Decreased by PTH and reabsorbed/excreted by kidneys |
|
|
Hyperphosphatemia |
High serum phosphate P > 4.5 |
|
|
Causes of Hyperphosphatemia |
Renal failure Chemotherapy Excessive intake |
|
|
Signs of Hyperphosphatemia |
Calcified deposits on soft tissues NM irritability Signs of Hypocalcemia: weak Bs |
|
|
Management of Hyperphosphatemia |
Treat cause Restrict intake Avoid foods high in protein Hydration |
|
|
Causes of Hyponatremia |
Excess hypotonic fluids FVE (renal failure, HF) Psychogenic polydipsia SIADH—excess ADH Addison’s disease—low aldosterone Diuretics—waste Na Drinking only water for fluid replacement (common in athletes) Low intake of Na (not eating) |
|
|
Hypophosphatemia |
Low serum phosphate P < 2.5 |
|
|
Causes of Hypophosphatemia |
Malnutrition/malabsorption Alcohol withdrawal Phosphate-binding antacids Parenteral feeding |
|
|
Signs of Hypophosphatemia |
Signs of hypercalcemia (Swollen and Slow): CNS depression, muscle weakness, decreased HR/RR, decreased DTRs Confusion
|
|
|
Management of Hypophosphatemia |
Oral supplements Food high in protein IV of Na or K Phosphate |
|
|
Sodium Correlations |
Water follows Na When Na increases, K decreases |
|
|
Calcium Correlations |
When calcium increases, phosphate decreases When vitamin D increases, calcium increases Calcium and magnesium increase together |
|
|
Magnesium Correlations |
Close relationship with calcium Magnesium depletion accompanies potassium depletion and vice versa (Mg often needs to be replaced first) When magnesium decreases, phosphate increases |
|
|
Signs of Hyponatremia |
Neurological (Depressed and Deflated): seizures, coma Heart (Depressed and Deflated): Tachycardia, weak pulses Respiratory Arrest (Depressed and Deflated) Neurological deficits |
|
|
Management of Hyponatremia |
I and O, daily weights, serum levels Due to water excess: Fluid restriction Loop diuretics 3% NaCl IV solution given slowly to not cause damage Due to fluid loss: ADH blockers (vaptans) Fluid replacement with sodium (saline, salt tablets) Hold diuretics |
|
|
Calcium |
Obtained from ingested foods Most combined with P and concentrated in bones Bones are readily available storage Roles are transmission of nerve impulses, heart contractions, blood clotting, formation of teeth and bone, muscle contractions Three Bs: bones, beats, blood Balance controlled by PTH (increases serum levels), calcitonin (decreases serum levels), vitamin D (helps absorption) |
|
|
Organs Affected by Calcium |
Teeth/bones Heart Muscles Nerves/CNS |
|
|
Hypercalcemia |
High serum calcium levels Ca > 10.5 |
|
|
Causes of Hypercalcemia |
Most—Hyperparathyroidism (excessive PTH) Cancer Vitamin D overdose Prolonged immobility Addison’s disease: decreased cortisol—high vitamin D |
|
|
Signs of Hypercalcemia |
Swollen and Slow: Muscle weakness, constipation, bone pain, kidney stones, decreased DTRs and muscle tone, lethargy May lead to electrolyte imbalances, risk for injuries |
|
|
Hypochloremia |
Low serum chloride Can occur secondary to hyponatremia or elevated bicarbs Can occur with metabolic alkalosis Signs are similar to Hyponatremia but with fever Cl < 96 |
|
|
Potassium |
Major ICF cation Roles in transmission of nerve and muscle impulses Cell growth Cardiac rhythms Acid-base balance (can increase pH by exchanging for H ions) Sources: fruits and leafy greens, salt substitutes, potassium meds, stored blood Reabsorbed/excreted by kidneys |
|
|
Major Organs Affected by Sodium |
Kidneys Brain |
|
|
Major Organs Affected by Potassium |
Heart Muscles Nerves Brain |
|
|
Major Organs Affected by Phosphate |
Bones/teeth Kidneys |
|
|
Causes of Hypernatremia |
Diabetes insipidus—low ADH (increased UOP) Water deficiency from burns, D/V, fever Enteral feedings Hypertonic saline IV Excessive intake without water Hyperaldosteronism |
|
|
Signs of Hyperchloremia |
Similar to hypernatremia N/V, swollen tongue, confusion |
|
|
Hyperchloremia |
High serum chloride Cl > 106 |
