Electrolyte Disorders Flashcards
Lab value defining hypercalcemia
> 10.5
Causes of hypercalcemia (2)
Hyperparathyroidism
Malignancy
Sxs of hypercalcemia (6)
"Stones, bones, groans, psych overtones" HTN Constipation Decreased DTRs/ hyporeflexia Polyuria/ polydipsia Lethary
EKG findings of hypercalcemia
Shortened QT
Associated electrolyte disorders with hypercalcemia
Hyperparathyroidism
Hypophosphatemia
Treatment for hypercalcemia
Mild: none
Severe/ sxs: IV saline, furosemide
What should you NOT use in the treatment of hypercalcemia
HCTZ
Lab value defining hypermagnesemia
> 2.6
Causes of hypermagnesemia
RARE
Renal insufficiency
Rhabdo
Increased Mg intake
Sxs of hypermagnesemia
Muscle weakness
EKG findings of hypermagnesemia
Prolonged QT, PR, wide QRS
Associated electrolyte imbalances with hypermagnesemia
Hypocalcemia
adverse effect of increased Mg due to temporary suppression of PTH secretion
Treatment for hypermagnesemia
IV NS
Loop diuretics
IV calcium gluconate to reverse Mg toxicity
Lab value defining hyperkalemia
> 5.5
Sxs of hyperkalemia
Muscle fatigue
EKG findings of hyperkalemia
Peaked T waves
Prolonged QRS
Treatment for hyperkalemia
Insulin
Sodium bicarb + glucose
Calcium gluconate (typically only used if > 6.5)
Lab value defining hypernatremia
> 145
Causes of hypernatremia
Body loss (diarrhea, sweat, diuretics)
Hyperglycemia
Burns
DI
Sxs of hypernatremia
Poor skin turgor Dry mucous membranes Flat neck veins Hypotension CNS dysfunction (confusion, lethargy, coma, muscle weakness)
Associated electrolyte imbalances with hypernatremia
Hyperglycemia
High BUN/ creatinine
Treatment for hypernatremia
Hypotonic fluids
Lab value defining hyperphosphatemia
> 4.5
Causes of hyperphosphatemia
Renal failure >
Hypoparathyroidism
Vit D intoxication
Sxs of hyperphosphatemia
(due to hypocalcemia)
Muscle cramps, tetany, perioral numbness/ tingling
Associated electrolyte imbalances with hyperphosphatemia
Hypocalcemia
Hypoparathyroidism
Treatment for hyperphosphatemia
Acute: NS +/- hemodialysis
Chronic: low phosphate diet + aluminum based phosphate binders
Lab value defining hypocalcemia
< 8.4
Causes of hypocalcemia
Hypoparathyroidism
Hypomagnesemia
Renal disease (if high PTH)
Sxs of hypocalcemia
Chovstek (touching cheek)
Trousseu (BP cuff)
Cramps, spasms, tetany
Increased DTRs
EKG findings of hypocalcemia
Prolonged QT
Associated electrolyte imbalances with hypocalcemia
Hypoparathyroidism
Hyperphosphatemia
Treatment for hypocalcemia
Mild: PO Ca + vit D
Severe/ sxs: IV calcium gluconate/ carbonate
Lab value defining hypomagnesemia
< 1.8
Causes of hypomagnesemia
GI losses in malabsorption
RFs: alcoholics, diuretics, PPIs
Sxs of hypomagnesemia
Muscle weakness
Hyperreflexia
NM/ CNS hyperirritability
EKG findings of hypomagnesemia
Prolonged QT
Torsades de pointes
V-tach
Flat T waves
Associated electrolyte imbalances with hypomagnesemia
Hypocalcemia
Hypokalemia
Treatment for hypomagnesemia
IV magnesium sulfate Oral magnesium (chronic)
Lab value defining hypokalemia
< 3.5
What is the most common electrolyte mediated ileus
hypokalemia
Sxs of hypokalemia
Muscle cramps/ weakness
Hyporeflexia/ decreased DTRs
Constipation
EKG findings of hypokalemia
Broad, flat/ inverted T waves
U waves
Associated electrolyte imbalances with hypokalemia
Hypomagnesemia
Treatment for hypokalemia
Potassium repletion
What type of liquids should NOT be given for hypokalemia
Dextrose
Lab value defining hyponatremia
< 135
Causes of hypervolemic hyponatremia
CHF, nephrotic, RF, cirrhosis
Causes of euvolemic hyponatremia
SIADH, steroids, hypothyroid
Causes of hypovolemic hyponatremia
Sodium loss, diuretics
Sxs of hyponatremia
CNS dysfunction (cerebral edema)- HAs, AMS, seizures
Decreased DTRs
Muscle cramps
N/V
Treatment for hyponatremia
Free water restriction, IV NS
Hypervolemic = hypertonic saline
Correct slowly
Lab value defining hypophosphatemia
< 3.4
Causes of hypophosphatemia
Chronic alcohol abuse
Diuretics
Vit D deficiency
Hyperglycemia
Sxs of hypophosphatemia
Mild asx
Sxs affecting: nervous, MSK, cardiac (low ATP)
Treatment for hypophosphatemia
Mild: PO phosphate
Severe/ sxs: IV phosphate
Hemodialysis if renal failure