Electrolits

Question 1

Time definition for acute vs chronic hyponatremia

Answer 1

48 hour cutoff

Question 2

Severe hyponatremia symptoms

Answer 2

seizures, obtundation, coma, and respiratory arrest

Question 3

What are the symptoms of Mild to moderate hyponatremia

Answer 3

relatively nonspecific and include headache, fatigue, lethargy, nausea, vomiting, dizziness, gait disturbances, forgetfulness, confusion, and muscle cramps.

Question 4

Hypomagnesemia, asymptomatic treatment:

Answer 4

Oral replacement therapy is a better replacement method than IV administration.
Mild deficiency: IM: 1 g every 6 hours for 4 doses, or as indicated by serum magnesium concentrations
Mild to moderate (serum concentration 1 to 1.5 mg/dL): IV: 1 to 4 g (up to 0.125 g/kg), administer at ≤1 g/hour if asymptomatic; do not exceed 12 g over 12 hours (Kraft 2005). Note: Additional supplementation may be required after the initial dose with replenishment occurring over several days.

Question 5

Which way cause more commonly hypomagnesemia?

Diarrhea or vomiting? Why?

Answer 5

More commonly due to diarrhea. This is because the magnesium content of lower tract secretions is significantly higher (up to 15 mEq/L versus approximately 1 mEq/L for upper tract). Common settings in which hypomagnesemia may be seen include acute or chronic diarrhea, malabsorption and steatorrhea, and small bowel bypass surgery.

Question 6

What are the manifestations of hypomagnesemia?

Answer 6

●The major clinical manifestations of hypomagnesemia include (see ‘Overview of clinical manifestations’ above):

• Neuromuscular manifestations, including neuromuscular hyperexcitability (eg, tremor, tetany, convulsions), weakness, apathy, delirium, and coma. (See ‘Neuromuscular’ above.)
• Cardiovascular manifestations, including widening of the QRS and peaking of T waves with moderate magnesium depletion, and widening of the PR interval, diminution of T waves, and atrial and ventricular arrhythmias with severe depletion. (See ‘Cardiovascular’ above.)
• Abnormalities of calcium metabolism, including hypocalcemia, hypoparathyroidism, parathyroid hormone (PTH) resistance, and decreased synthesis of calcitriol. (See ‘Calcium metabolism’ above.)
• Hypokalemia. (See ‘Hypokalemia’ above.)