Electrolyte Abnormalities

Question 1

Hypernatremia

Answer 1

FRIED: fever, flushed, restless, inc BP, inc fluid retention, edema, decreased urinary output, dry mouth

Question 2

Hyponatremia

Answer 2

anorexia, N/V, HA, lethargy, dizzy, confusion, muscle cramp/weak/twitch, seizures, papilledema, dry skin, inc pulse, dec BP, wt gain, edema

Question 3

Hyperkalemia

Answer 3

MURDER: muscle weakness, urine (oliguria, anuria), resp distress, decreased cardiac contractility, ECG changes (peaked T waves, prolonged PR and QRS, absent P, ST depression), reflexes (hyperreflexia, areflexia)

Question 4

Hypokalemia

Answer 4

fatigue, anorexia, N/V, polyuria, dec bowel motility, ventricular asystole or fibrillation, paresthesias, leg cramps, dec BP, ileus, abd distension, dec reflexes, ECG changes (flat T waves, prominent U waves, ST dep, prolonged PR)

Question 5

Hypercalcemia

Answer 5

constipation, anorexia, N/V, polyuria, polydypsia, dehydration, dec reflexes, lethargy, bone pain, HTN, fractures, flank pain, Ca stones, ECG changes (shortened ST and QT, bradycardia, heart blocks)

Question 6

Hypocalcemia

Answer 6

CATS: convulsions, arrhythmias, tetany, spasms and stridor; numb, tingling, dec BP, anxiety, seizures, inc reflexes, irritability, bronchospasm, dec clotting time, diarrhea, ECG changes (prolonged QT and ST)

Question 7

Hypermagnesemia

Answer 7

Normal - 2
Therapeutic - 5
Dec reflexes, CNS depression - 10
Resp paralysis - 15
ECG changes (prolonged PR and QT, widened QRS) - 20
Cardiac arrest - 25

Risk of cardiotoxicity increased with hypocalcemia, hyperkalemia, renal insufficiency, digitalis.