Hyper and Hypo Conditions/"A Salty Tale" Flashcards

1
Q

Kidney disease, water loss from diarrhea/sweat, vomiting, or too little water intake may result in _____.

a. hyponatremia
b. hyperkalemia
c. hypophosphatemia
d. hypernatremia

A

d. hypernatremia

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2
Q

S/S of hypernatremia.

A
Tachycardia
Excessive thirst
Anxiety
Fatigue
AMS
Seizures
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3
Q

S/S of hyponatremia

A
MOA: Caused by the inability of neurons to depolarize.  
Fatigue
Nausea
Vomiting
Muscle spasms
Weakness
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4
Q

CHF, some kidney diseases, burns, and overhydration may result in _____.

a. hyponatremia
b. hyperkalemia
c. hypophosphatemia
d. hypernatremia

A

a. hyponatremia

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5
Q

Above 280 mEq/L, the body does what to produce a response to dilute increased osmolarity?

A
  • Increases thirst

- Releases arginine vasopressin (ADH) to reduce water loss

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6
Q

Osmoreceptors in the ____ release vasopressin/ADH to combat increased serum osmolarity.

a. Carotid body
b. Hypothalamus
c. Frontal cortex
d. Juxtaglomerular apparatus

A

b. Hypothalamus

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7
Q

The thirst mechanism is so effective in prevent hypernatremia, that hypernatremia is often only found in individuals with _____.

A

little access to water.

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8
Q

Why is hypernatremia damaging to the brain?

How does the body correct this?

A

Increased ECF osmolarity causes diffusion of water OUT of brain cells, causing shrinking of said cells.

The cells begin to produce amino acids/proteins, polyols, etc, to increase the osmotic pressure within the cells, “pulling” water back into them, thereby restoring normal cellular volume.

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9
Q

Explain the pathophysiology of seizure in hypernatremia.

A

Increased [Na] ECF will lead to depolarization of neurons, and any additional depolarization may cause seizures.

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10
Q

Explain the pathophysiology of tachycardia in hypernatremia.

A

Hypernatremia acts as to increase osmotic pressure. Therefore, increased [Na]ECF will “pull” water from cells/vasculature. This will cause tachycardia 2/2 to hypovolemia.

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11
Q

List common causes of hyponatremia:

A
  • liver disease
  • overhydration
  • CHF
  • burns
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12
Q

What neurologic/neuromuscular symptoms are associated with hyponatremia?

A
  • fatigue
  • spasms/weakness
  • seizures
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13
Q

In patient’s experiencing hypernatremia, when is the ONLY time that pre-hospital providers should provide normal saline (0.9%)?

A

When the patient is experiencing hemodynamic comprise 2/2 depletion of ECF volume.

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14
Q

Potassium is important in what stage of the action potential?

a. Phase 0
b. Phase 1
c. Phase 2
d. Phase 3

A

d. Phase 3

  • Depolarization of cells opens the voltage gated potassium channels.
  • This causes potassium to flow down its concentration gradient from inside to outside the cell, hyperpolarizing the cell.
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15
Q

Normal lab value for potassium.

A

3.5-5.0 mEq/L

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16
Q

Causes of hyperkalemia

A
  • renal failure
  • potassium sparing diuretics
  • NSAIDs
  • ACE inhibitors
  • Heparin
17
Q

S/S of hyperkalemia

A
  • weakness/fatigue/numbness/tingling (inability to reset neuronal RMP)
  • wide QRS complexes on EKG
  • unusually tall, peaked T waves on EKG
  • Both EKG changes are due to a higher ECF {K] than normal, preventing the repolarization of cells, so they remain in a depolarized state
18
Q

Causes of hypokalemia

A
  • kidney disease
  • vomiting/diarrhea
  • beta blocker overdose (moves K back into cells by unknown MOA)
  • non-potassium sparing diuretics
  • certain antibiotics
19
Q

S/S of hypokalemia

A
  • weakness
  • fatigue
  • cramping/constipation
20
Q

Importance of chloride in physiology.

A
  • maintain fluid balance

- prevent significant changes to pH

21
Q

Causes of hyperchlorinemia

A
  • massive diarrhea
  • kidney disease
  • PT glad disease
22
Q

S/s of hyperchlorinemia

A
  • headache
  • nausea
  • fatigue
  • tachypnea 2/2 metabolic acidosis
23
Q

S/S of hypochlorinemia

A
  • tetany
  • weakness
  • trouble breathing
  • fever
24
Q

Causes of hypochlorinemia

A
  • excessive sweating/urination
  • vomiting
  • adrenal gland disease
25
Q

Oversecretion of ____ may lead to hypercalcemia.

a. calcitriol
b. PTH
c. vitamin K
d. Glucagon

A

b. PTH - primary control of calcium - stimulates osteoclasts to secrete Ca2+ into bloodstream by bone breakdown

Calcitriol - reduces blood Ca2+ by binding Ca2+ with phosphate to strengthen bones
Vitamin K - more important in blood clotting than Ca2+
Glucagon - has no role in calcium control

26
Q

Signs of hypercalcemia.

A

Moans, groans, stones, bones

Moans: Abd. pain, nausea/constipation
Groans: Lethargy, weakness, confusion, coma
Stones: Polyuria, kidney stones, renal failure
Bones: body aches/pains, factures

27
Q

What EKG changes are associated with hypercalcemia?

A
  • Osborne waves
  • shortened ST segment
  • shortened QT segment
28
Q

Causes of hypocalcemia

A
  • Acute/chronic renal failure
  • Deficiencies and Vit D/Mg2+
  • hypoparathyroidism
  • acute pancreatitis
29
Q

S/S of hypocalcemia

A
  • confusion
  • lethargy
  • muscle cramping
  • weakness
  • parethesia
30
Q

What are the primary functions of phosphate (HPO4-) in the body?

A
  • Energy storage in ATP
  • Assists with storage of Ca2+ in bones
  • Cell reproduction/repair
31
Q

Normal HPO4- value

A

2.4-4.7 mg/dL

32
Q

Causes of hyperphosphatemia

A
  • kidney disease
  • excess intake of phosphate (uncommon)
  • hypoparathyrodisim
  • metabolic/respiratory acidosis
33
Q

S/S of hyperphosphatemia are similar to what other condition?

A

Hypercalcemia

34
Q

Causes of hypophosphatemia

A
  • Hyperparathyroidism (also leads to deceased Ca2+_
  • alcoholism
  • DKA/respiratory alkalosis
  • weakness
  • bone pain
  • AMS
35
Q

Ways to remember the electrolyte imbalances.

http://allnurses.com/nclex-discussion-forum/any-trick-to-541675.html

A

Okay. Will do!!!