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CLASS 22010 GU > ELECTROLYTE DISORDERS > Flashcards

ELECTROLYTE DISORDERS Flashcards

1
Q

What is caused by a serum sodium concentration less than 135mEq/L (135mmol/L)?

A

Hyponatremia

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2
Q

What is the most common electrolyte abnormality in hospitalized patients, often caused by hypotonic solutions, and usually reflects excess water – retention relative to sodium rather than sodium – deficiency?

A

Hyponatremia

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3
Q

True or False

Mismanagement of hyponatremia can result in neurologic catastrophes from cerebral osmotic demyelination

A

True

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4
Q

Evaluation for hyponatremia starts with a careful history for what?

A
  1. new meds
  2. changes in fluid intake
  3. changes fluid output
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5
Q

True or False

Symptoms of hyponatremia depend on the severity and acuity

A

True

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6
Q

Is mild hyponatremia (sodium concentration 130-135mEq/L) usually asymptomatic?

A

Yes

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7
Q

What are mild symptoms of hyponatremia?

A
  1. nausea

2. malaise

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8
Q

What are moderate symptoms of hyponatremia?

A
  1. headache
  2. lethargy
  3. disorientation
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9
Q

What are severe symptoms of hyponatremia?

A
  1. Respiratory arrest
  2. seizure
  3. coma
  4. brain damage
  5. brainstem herniation
  6. death
  7. Bad shit
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10
Q

What is the initial step in the management of hyponatremia?

A

restriction of free water and hypotonic fluid intake

free water intake should be less than 1-1.5 L/day

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11
Q

What may be necessary in patients with negative free water clearance?

A

hypertonic solutions

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12
Q

What is the most serious complication of hyponatremia caused from overly rapid sodium correction?

A

iatrogenic cerebral osmotic demyelination

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13
Q

What is a sodium concentration greater than 145mEq/L and is typically due to free water losses?

A

Hypernatremia

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14
Q

What are the primary defense mechanisms against hypernatremia?

A
  1. intact thirst mechanism

2. access to water

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15
Q

What are these signs and symptoms of?

  1. orthostatic hypotension
  2. oliguria
  3. Lethargy
  4. irritability
  5. weakness
A

Dehydration and early signs of hypernatremia

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16
Q

What are these signs and symptoms of?

  1. hyperthermia
  2. delirium
  3. seizures
  4. coma
A

Sever signs of hypernatremia

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17
Q

What is the treatment for hypernatremia?

A
  1. correcting cause of fluid loss
  2. replacing electrolytes
  3. replacing water
17
Q

What is the treatment for hypernatremia?

A
  1. correcting cause of fluid loss
  2. replacing electrolytes
  3. replacing water
18
Q

Hypernatremia

Fluids should be administered over a ____ hour period

A

48 hour

Aiming for serum sodium correction of 1 mEq/L/hr

19
Q

Rapid correction of hypernatremia may cause what?

A
  1. cerebral edema

2. potentially severe neurologic impairment

20
Q

What is a serum potassium level less then 3.5 mEq/L?

A

Hypokalemia

21
Q

Severe hypokalemia may induce what?

A
  1. arrhythmias

2. rhabdomyolysis

22
Q

True or False
Hypokalemia can result from insufficient dietary potassium intake and intracellular shifting of potassium from the extracellular space

A

True

23
Q

What is the most common cause of hypokalemia?

A

GI loss from infectious diarrhea

24
Q

Potassium concentration in intestinal secretion is ___ times higher than in gastric secretions

A

10 times

25
Q

What are these symptoms of?

  1. muscle weakness
  2. fatigue
  3. muscle cramps
A

Mild to moderate hypokalemia

26
Q

What are these symptoms of?

  1. flaccid paralysis
  2. hyporeflexia
  3. hypercrampia
  4. tetany
  5. rhabdomyolysis
A

Severe hypokalemia (less than 2.5 mEq/L)

27
Q

What may an electrocardiogram show for a patient with hypokelmia?

A
  1. decreased amplitude and broadening T waves
  2. PVC
  3. depressed ST segments
28
Q

What is the safest and easiest treatment for mild to moderate hypokalemia?

A

Oral potassium 40-100mEq/day over a period of days to weeks

29
Q

What is a serum potassium level greater than 5.0mEq/L?

A

Hyperkalemia

30
Q

Patients taking ACE inhibitors, ARB’s, or Potassium-Sparing diuretics may develop what?

A

Hyperkalemia

31
Q

Hyperkalemia usually occurs in patients with what?

A

advanced kidney disease

32
Q

Hyperkalemia

___ causes intracellular potassium to shift extracellularly

A

Acidosis

33
Q

Hypernatremia impairs neuromuscular transmission, causing what?

A
  1. muscle weakness
  2. flaccid paralysis
  3. ileus
34
Q

These are all changes in ECG’s associated with what?

  1. bradycardia
  2. PR interval prolongation
  3. peaked T waves
  4. QRS widening
  5. Conduction disturbances
    a. bundle branch block
    b. atrioventricular block
  6. V-fib and cardiac arrest are terminal events
A

Hyperkalemia

35
Q

Emergent treatment for hyperkalemia is indicated when?

A
  1. Cardiac toxicity
  2. muscle paralysis
  3. Severe hyperkalemia (greater than 6.5 mEq/L)
36
Q

True or False
Insulin, bicarbonate, and beta-agonists all shift potassium intracellularly within minutes of administration for a patient with hyperkalemia

A

True

37
Q

When giving insulin for treatment of hyperkalemia, should you give insulin to the patient as well?

A

YES

38
Q

What may be given to a patient with hyperkalemia to antagonize the cell membrane effects of potassium?

A

IV calcium

39
Q

What are some loop diuretics that can be used to treat hyperkalemia?

A
  1. Furosemide 40-80mg IV

2. Bumetanide 1mg IV

40
Q

True or False

An IDC can manage severe hyperkalemia on their own.

A

FALSE

Severe hyperkalemia should be sent to the emergency department for immediate treatment (MEDEVAC DAT HOE)

CLASS 22010 GU (41 decks)

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