Electrolyte Abnormalities Flashcards
What defines Hypokalaemia?
- <3.5mmol/L
- If <2.5 = URGENT TREATMENT
What ECG changes would you expect to see in hypokalaemia?
Small or inverted T waves, Prominent U waves, long PR interval + depressed ST segments
What are the signs of hypokalaemia?
- Muscle weakness
- Hypotonia
- Cramps
- Tetany
- Palpitations
- Light-headedness - arrhythmias
How would you treat hypokalaemia?
> 2.5 = oral K+ supplement + review in 3 days
<2.5 = IV K+ but cautiously - no more than 20mmol/hr and not more concentration that 40mmol
How do you treat hyperkalaemia?
- 30ml 10% calcium gluconate over 5-10mins or 10ml 10% CaCl2, repeat if necessary
- 10U IV ACTRAPID + 50ml 50% Dex over 30mins
- 10-20mg Salbutamol NEB
What are the signs of hypernatramea?
- Plasma Na >145
- Lethargy, thirst, weakness, irritability, confusion, coma, fits and signs of dehydration
What are the sing/symptoms of hyponatraemia?
- Anoerxia
- Malaise
- Headache, irritability, confusion, weakness, reduced GCS, seizures
What are causes of hyponatraemia in a dehydrated patient?
- Addison’s
- Renal failure
- Diuretic excess
- D+V, burns, small bowel obstruction, CF
What are causes of hyponatraemia in a non-dehydrated patient?
- Nephrotic syndrome
- Cardiac failure
- Water overload
- Severe hypothyroidism
How do you treat hyponatraemia?
- Correct underlying cause
- SLOW IV infusion of 0.9% saline
What ECG changes can hypercalcaemia cause?
- Shortened QT
- Heart block
- VF
How do you differentiate between DKA and hyperglycaemic Hyperosmolar state?
- Ketones in DKA not in HHS
What can cause HHS?
- Infection
- Infarction
- Insufficient insulin
- Intercurrent illness
How would you treat HHS?
- ABCDE
- IV 0.9% NaCl + K+
- Insulin 0.05U/kg - half amount for DKA
- When glucose returns to normal, add dextrose
What defines hypoglycaemia?
glucose <4.0mmol/L
