Electrolyte Imbalance Flashcards
Causes of hyperkalaemia (7)
Renal failure
Drug (ACEi, trimethoprim, K-sparring diuretics, NSAIDs, BB)
Tissue breakdown (rhabdo, haemolytic, tumour lysis)
Metabolic eg DKA
Endocrine: Addisons
Diet
Spurious
Symptoms of hyperkalaemia
Weakness progressing to flaccid paralysis
Decreased reflexes
Paraesthesia
ECG changes in hyperkalaemia
1st degree HB
Flattened/absent p waves
Widened QRS
Tall tented t waves
ST depression
S and T merging (sine wave)
VT
Bradycardia
Risks of hyperkalaemia treatment
Hypoglycaemia
Tissue breakdown due to calcium
Rebound hyperkalaemia
Causes of hypokalaemia (6)
GI losses
Drugs (diuretics, laxatives, steroids)
Renal loss (renal tubular disorders, diabetes insipidus , dialysis)
Endocrine (Cushings, hyperaldosteronism)
Metabolic alkalosis
Magnesium depletion
Symptoms hypokalaemia
Fatigue, weakness, leg cramps, constipation
If severe: rhabdo, paralysis, resp difficulties
ECG features hypokalaemia
U waves
T flattening
ST changes
Arrhythmias
Causes hypercalcaemia
Hyperparathyroid
Malignancy
Sarcoidosis
Drugs
Symptoms hypercalcaemia
Confusion, weakness, abdo pain, hypotension, arrhythmia
ECG features hypercalcaemia
Short QT
Wide QRS
Flat T waves
AV block
Treatment hypercalcaemia
Fluid replacement
Furosemide
Hydrocortisone
Pamidronate
Causes hypocalcaemia
Renal failure
Pancreatitis
CCB overdose
Toxic shock
Rhabdo
Tumour lysis
Symptoms hypocalcaemia
Paraesthesia
Tetany
Seizures
AV block
ECG features hypokalaemia
Long QT
TWI
Heart block
Treatment hypocalcaemia
Calcium
Magnesium
Causes hypermagnesaemia
Renal failure
Iatrogenic
Symptoms hypermagnesaemia
Confusion
Weakness
Resp depression
AV block
ECG features hypermagnesaemia
Long PR and QT
T Wave peaking
AV block
Treatment of hypermagnesaemia
Calcium
Ventilators support
Saline diuresis(saline + furosemide)
Haemodialysis
Causes hypomagnesaemia
GI loss
Polyuria
Starvation
Alcoholism
Malabsorption
Symptoms hypomagnesaemia
Tremor
Ataxia
Nystagmus
Seizures
Torsades de pointes
ECG features hypomagnesaemia
Long PR and QT
ST depression
TWI
flat p waves
Wide QRS
Torsades de pointes
Treatment of hypomagnesaemia
Magnesium sulfate
Managing arrest in dialysis
Trained nurse to operate and remove dialysis machine
Return patients blood volume with fluid bolus
Can use dialysis access for drug treatment
Prompt management of hyperkalaemia
