Electrolyte Disorders

Question 1

What value is considered hyponatremia?

Answer 1

> 135mEq/L

Question 2

What is the most common electrolyte abnormality in hospitalized patients?

Answer 2

Hyponatremia

Question 3

What is hyponatremia?

Answer 3

Reflects excess water retention relative to sodium

Question 4

Mismanagement of hyponatremia can lead to what catastrophe?

Answer 4

Neurological catastrophe

Question 5

What is the value for mild hyponatremia?

Answer 5

130-135mEq/l

Question 6

What are mild sx of hyponatremia?

Answer 6

Usually asymptomatic but can have nausea and malaise

Question 7

What are moderate sx of hyponatremia?

Answer 7

Headache, lethargy and disorientation

Question 8

What are severe sx of hyponatremia?

Answer 8

Respiratory arrest, seizure, coma, permanent brain damage, DEATH

Question 9

What labs should be done for patients with hyponatremia?

Answer 9

Serum electrolytes: <135mEq/l
Creatinine
Urine sodium

Question 10

What is the treatment for hyponatremia?

Answer 10

Restriction of free water and hypotonic fluid
Free water intake should be <1-1.5l/day
Hypertonic saline may be necessary

Question 11

What is hypernatremia?

Answer 11

Sodium concentration greater than 145mEq/l

Question 12

What is the primary defense against hypernatremia?

Answer 12

Intact thirst mechanism and access to water

Question 13

Patient presents with orthostatic hypotension and oliguria, what electrolyte disorder condition might they have?

Answer 13

Hypernatremia

Question 14

What are early signs of hypernatremia?

Answer 14

Lethargy, irritability and weakness

Question 15

What are severe signs of hypernatremia?

Answer 15

Hyperthermia, delirium, seizures, coma

Question 16

What labs and findings do you expect in patients with hypernatremia?

Answer 16

Serum electrolyte >145mEq/l

Question 17

How long should fluids be administered for a patient with hypernatremia and what should the sodium correction approximately be?

Answer 17

Fluids should be administered over a 48hr period
Correction should be approximately 1mEq/L/H

Question 18

What could rapid correction of hypernatremia cause?

Answer 18

Cerebral edema and severe neurologic impairment

Question 19

What serum potassium level is hypokalemia?

Answer 19

3.5

Question 20

Severe hypokalemia may induce what?

Answer 20

Arrhythmias and rhabdomyolysis

Question 21

Insufficient dietary potassium intake, intracellular shifting of potassium to extracellular space may cause what condition?

Answer 21

Hypokalemia

Question 22

What is the most common cause of hypokalemia?

Answer 22

Infectious diarrhea

Question 23

Muscular weakness, fatigue and muscle cramps are mild to moderate sx of what electrolyte disorder?

Answer 23

Hypokalemia

Question 24

Rhabdomyolysis, flaccid paralysis, hyporeflexia, hypercapnia, tetany are severe sx of what electrolyte disorder?

Answer 24

Hypokalemia (<2.5)

Question 25

What labs and results do you expect in patient with hypokalemia?

Answer 25

<3.5mEq/l

Question 26

An EKG with decreased amplitude and broadening T waves, premature ventricular contractions and depressed ST segments is indicative of what electrolyte disorder?

Answer 26

Hypokalemia

Question 27

How do you treat hypokalemia?

Answer 27

Oral potassium for mild to moderate deficiency
40-100

Question 28

What is hyperkalemia?

Answer 28

> 5.0

Question 29

Patients taking ACEi, angiotensin blockers and potassium sparing diuretics may develop what electrolyte disorder?

Answer 29

Hyperkalemia

Question 30

Patient presents with muscle weakness, flaccid paralysis and ileus might have what electrolyte disorder?

Answer 30

Hyperkalemia

Question 31

What labs and findings are expected in a patient with hyperkalemia?

Answer 31

> 5.0
Fist clenching may raise potassium

Question 32

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?

Answer 32

Hyperkalemia

Question 33

What is the treatment for hyperkalemia?

Answer 33

Withhold potassium
Identify cause

Question 34

What loop diuretics can be given to patients with hyperkalemia?

Answer 34

Furosemide
Bumex