Electrolyte Imbalance

Question 1

What is the role of electrolytes?

Answer 1

• creates the action potential of cells
• creates osmotic gradient for fluid balance

Question 2

What are the 2 conditions affecting Na?

Answer 2

hyponatremia and hypernatremia
- sodium is primarily ECF

Question 3

What are the normal Na levels?

Answer 3

(hyponatremia) 135-145 (hypernatremia)

Question 4

Etiology or cause of hyponatremia?

Answer 4

• Excessive loss of NA = sweating
• Excessive gains in extracellular bodily fluid = excess ADH
• inadequate na intake = diet
• diuretic therapy = increase urination so increases loss of NA in urine
• Administration of hypotonic fluids to replace fluid losses = see too much free water

Question 5

What does hyponatremia cause?

Answer 5

• Shift of h20 from ECF to ICF
• cellular swelling
• adaptive decreases in thirst and ADH secretion

Question 6

What are some clinical manifestations of hyponatremia?

Answer 6

• Related to neurologic dysfunction induced by hypotonic condition = serum osmolality falls → water enters brain cells (intracellular fluid shift)
• Central nervous system response: headache, confusion, stupor, coma
• Muscle cramps or weakness and spasm, seizures
• Abdominal cramping, vomiting, diarrhea

Question 7

What causes Hypernatremia?

Answer 7

• Excessive gain in na RARE b/c of kidneys deal with eimination
• loss of free water

Question 8

What does Hypernatremia cause?

Answer 8

• shift of water from ICF to ECF
• cellular dehydration

Question 9

What are some clinical manifestations of Hypernatremia?

Answer 9

• Shrinkage of brain cells
• nervous system irritability: headache, confusion, sezures
• altered cellular metabolism
• increased thirst, dry mucous membranes as fluid shifts

Question 10

What are the 2 disorders related to K?

Answer 10

Hypokalemia and hyperkalemia
- PRIMARILY ICF key component of Action potentials

Question 11

What is hypokalemia caused by?

Answer 11

• decreased K+ intake
• shift of extracellular potassium into cells = can occur with alkalosis

Question 12

What are the normal levels of K?

Answer 12

hypokalemia 3.5-5.0 hyperkalemia

Question 13

What does hypokalemia cause?

Answer 13

• altered membrane potentials excitability
• ventricular repolarization delayed

Question 14

What are some clinical manifestations of hypokalemia?

Answer 14

cardiovascular = rhythm abnormalities
neuromuscular = postural hypertension - change of bp based on position = decreased tone and fatigue
gastrointestinal = abdominal distension and constipation

Question 15

What causes Hyperkalemia?

Answer 15

• Increased intake of K+
• mechanical disruption of cell membrane and K+ leaks out
• insufficient renal excretion of K+ = renal failure

Question 16

What does hyperkalemia Cause?

Answer 16

Alterations in the membrane potentials and excitability = can be fatal
- increased rate of depolarization

Question 17

What are some clinical manifestations of hyperkalemia?

Answer 17

cardiovascular
- = rhythm abnormalities, cardiac arrest, ventricular contraction
neuromuscular
- paresthesia = numbness or tingling, cramps decreased function
gastrointestinal cramping or diarrhea

Question 18

What are the normal levels of Calcium?

Answer 18

hypocalcemia 8.5 - 10.5 hypercalcemia

Question 19

What causes hypocalcemia?

Answer 19

• impaired ability to mobilize Ca from bone
• decreased intake or absorption
• increased renal losses = renal failure = loss of ca in urine
• inadvertent removal or injury to parathyroid glands during thyroid surgery

Question 20

What does hypocalcemia cause?

Answer 20

• altered neurotransmission = increased excitability of muscle cells
• shortens repolarization of cardiac cells = rhythm problems

Question 21

What are some clinical manifestations of hypocalcemia?

Answer 21

neuromuscular:
- paresthia = numbness or tingling
- skeletal muscle and abdoninal cramps
- hyperactive reflexes
- severe = sezures and tenany
- chvostek sign = LATE SIGN (facial twitching)
- trousseau’s = carpopedal spasm
Cardiovascular
- heart rate decreases
- hypotension (failure to respond to drugs
- ventricle rhythm problems
Skeletal Chronic deficiency
- bone pain, fractures
= occurs in kids bone development

Question 22

What are some causes of hypercalcemia?

Answer 22

• primary hyperparathyroidism = maybe tumor
• increased intestinal or bone reabsorption
• decreased excetion = kidney disease

Question 23

What does hypercalcemia cause?

Answer 23

Decreased neuromuscular irritability

Question 24

What are some clinical manifestations of hypercalcemia?

Answer 24

• precipitation of Ca = increased risk for kidney stones
• Flank pain
  cardiovascular
• hypertension
• heart blocks = blockage of Av node
  Gastrointestinal
• nausea, vomiting, and constipation

Question 25

What are the normal levels for Mg?

Answer 25

Hypomagnesium 1.5- 2.5 hypermagnesium

Question 26

What causes hypomagnesium?

Answer 26

• Decrease intake or absorption in K and Ca
• increased loss kidney disorders

Question 27

What does hypomagnesemia cause?

Answer 27

increased neromuscular and cardiac irritability

Question 28

What are some clinical manifestations of hypomagnesemia?

Answer 28

• Ataxia = lack of voluntary coordination problems, muscle spasms, seizures
  cardiovascular
• ventricular rhythm problems, hypertension

Question 29

What causes hypermagnememia?

Answer 29

• decreased renal function excretion
• increased intravenous or oral intake

Question 30

What are some clinical manifestations of Hypermagnesemia?

Answer 30

Neuromuscular
- lethargy, decreased reflexes, muscle weakness confusion
cardiovascular
- cardiac arrest, hypotension, bradycardia