Electrolyte Disorders Flashcards
What value is considered hyponatremia?
> 135mEq/L
What is the most common electrolyte abnormality in hospitalized patients?
Hyponatremia
What is hyponatremia?
Reflects excess water retention relative to sodium
Mismanagement of hyponatremia can lead to what catastrophe?
Neurological catastrophe
What is the value for mild hyponatremia?
130-135mEq/l
What are mild sx of hyponatremia?
Usually asymptomatic but can have nausea and malaise
What are moderate sx of hyponatremia?
Headache, lethargy and disorientation
What are severe sx of hyponatremia?
Respiratory arrest, seizure, coma, permanent brain damage, DEATH
What labs should be done for patients with hyponatremia?
Serum electrolytes: <135mEq/l
Creatinine
Urine sodium
What is the treatment for hyponatremia?
Restriction of free water and hypotonic fluid
Free water intake should be <1-1.5l/day
Hypertonic saline may be necessary
What is hypernatremia?
Sodium concentration greater than 145mEq/l
What is the primary defense against hypernatremia?
Intact thirst mechanism and access to water
Patient presents with orthostatic hypotension and oliguria, what electrolyte disorder condition might they have?
Hypernatremia
What are early signs of hypernatremia?
Lethargy, irritability and weakness
What are severe signs of hypernatremia?
Hyperthermia, delirium, seizures, coma
What labs and findings do you expect in patients with hypernatremia?
Serum electrolyte >145mEq/l
How long should fluids be administered for a patient with hypernatremia and what should the sodium correction approximately be?
Fluids should be administered over a 48hr period
Correction should be approximately 1mEq/L/H
What could rapid correction of hypernatremia cause?
Cerebral edema and severe neurologic impairment
What serum potassium level is hypokalemia?
3.5
Severe hypokalemia may induce what?
Arrhythmias and rhabdomyolysis
Insufficient dietary potassium intake, intracellular shifting of potassium to extracellular space may cause what condition?
Hypokalemia
What is the most common cause of hypokalemia?
Infectious diarrhea
Muscular weakness, fatigue and muscle cramps are mild to moderate sx of what electrolyte disorder?
Hypokalemia
Rhabdomyolysis, flaccid paralysis, hyporeflexia, hypercapnia, tetany are severe sx of what electrolyte disorder?
Hypokalemia (<2.5)
What labs and results do you expect in patient with hypokalemia?
<3.5mEq/l
An EKG with decreased amplitude and broadening T waves, premature ventricular contractions and depressed ST segments is indicative of what electrolyte disorder?
Hypokalemia
How do you treat hypokalemia?
Oral potassium for mild to moderate deficiency
40-100
What is hyperkalemia?
> 5.0
Patients taking ACEi, angiotensin blockers and potassium sparing diuretics may develop what electrolyte disorder?
Hyperkalemia
Patient presents with muscle weakness, flaccid paralysis and ileus might have what electrolyte disorder?
Hyperkalemia
What labs and findings are expected in a patient with hyperkalemia?
> 5.0
Fist clenching may raise potassium
An EKG with bradycardia, PR interval prolongation, peaked T waves, widening QRS, conduction disturbances and possibly Vfib and cardiac arrest is indicative of what electrolyte disorder?
Hyperkalemia
What is the treatment for hyperkalemia?
Withhold potassium
Identify cause
What loop diuretics can be given to patients with hyperkalemia?
Furosemide
Bumex
