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NURS124 > Electrolyte Imbalances > Flashcards

Electrolyte Imbalances Flashcards

1
Q

normal K

A

3.5 - 5

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2
Q

normal Na

A

135 - 145

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3
Q

normal Cl

A

95 - 105 ish

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4
Q

normal Mg

A

1.3 - 2.1

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5
Q

normal Ca

A

9 - 11

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6
Q

how does hyperkalemia affect the heart

A

HIGH pumps
- peaked T waves & ST elevation
- V fib. if severe
- hypotension
- bradycardia

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7
Q

how does hyperkalemia affect the neuromuscular system

A

HIGH
- increased DTR
- paralysis & paresthesia
- muscle weakness

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8
Q

how does hyperkalemia affect the GI system

A

HIGH pumps
- diarrhea
- hyperactive bowel sounds

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9
Q

treatment for hyperkalemia

A

potassium binders: calcium sulfonate, sodium sulfonate

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10
Q

what are the causes of hyperkalemia

A
  • renal failure
  • cellular injuries (burns, trauma)
  • metabolic acidosis (shift from ICF to ECF)
  • low aldosterone (ACE inhibitors)
  • not enough insulin & DKA
  • rhabdomyolysis (think cell damage release K)
  • multiple blood transfusions (mechanical hemolysis)
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11
Q

what lab to monitor for mechanical hemolysis via multiple blood transfusions

A

lactate dehydrogenase

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12
Q

what lab to monitor for rhabdomyolysis

A

creatinine phosphokinase
urine myoglobin

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13
Q

what foods contain high potassium

A

potatoes, prunes, oj, yogurt

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14
Q

how does hypokalemia affect the heart

A

LOW & SLOW
- flat T waves, ST depression & U wave

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15
Q

how does hypokalemia affect the neuromuscular system

A

LOW & SLOW
- shallow respirations
- decreased DTR
- muscle cramping & flaccid paralysis

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16
Q

what are the causes of hypokalemia

A
  • diarrhea, suctioning
  • diuretics
  • high aldosterone
17
Q

how to treat hypokalemia

A

check urine output prior to IV K
give IV K without glucose, or else increases insulin for cell K uptake

18
Q

how does potassium affect digitalis toxicity

A

hypokalemia can lead to digoxin toxicity

19
Q

what are the signs of hypernatremia

A
  • cerebral edema
  • flushed red skin
  • increased muscle tone
  • swollen dry tongue
  • N&V
20
Q

what are the causes of hypernatremia

A
  • diabetes insipidus
  • rapid respirations
  • diarrhea
  • loss of thirst
  • hypertonic fluids
21
Q

what are the signs of hyponatremia

A

Brain - low n slow
- headache
- ALOC
- seizures & coma
- extreme thirst

Muscular
- fatigue & muscle cramps

Respiratory arrest

22
Q

what are the 3 main categories for causes of hyponatremia

A
  • hypovolemia: Na loss via renal or extra-renal (third spacing)
  • euvolemia: fluid loss without Na replacement (SIADH)
  • hypervolemic: too much fluids relative to Na (cirrhosis, HF)
23
Q

what are the causes of hyponatremia

A
  • cirrhosis, HF
  • excessive water intake
  • SIADH
  • V & D
  • diuretics
  • low aldosterone
24
Q

what inhibits the absorption of Mg

A
  • phytic acid
  • proton pump inhibitors (PPIs)
  • Ca
  • P
  • fats
25
Q

what foods contain Mg

A

green veggies
nuts
refined grains

26
Q

how does hypermagnesemia affect the heart

A

HIGH MELLOW
- heart block, dysrhythmias
- hypotension, bradycardia

27
Q

how does hypermagnesemia affect the muscles

A

hyporeflexia - decreased DTR

28
Q

how does hypermagnesemia affect the lungs & GI

A

depressed respirations

hypoactive bowel sounds

29
Q

causes of hypermagnesemia

A
  • excessive laxatives, antacids
  • hyperparathyroidism, hypothyroidism (Ca related)
  • hemodialysis
  • meds that decrease gastric motility (opioids)
  • renal disorders
30
Q

how does hypomagnesemia affect the heart

A
  • torsades de pointes
  • prolonged PR interval
  • v fib
31
Q

how does hypomagnesemia affect the muscles

A
  • hyperreflexia: increased DTR
  • trousseau/chvostek signs
32
Q

how does hypomagnesemia affect the GI system

A
  • diarrhea
  • hyperactive bowel sounds
33
Q

what are causes of hypomagnesemia

A
  • Crohn’s dx, Celiac dx
  • phytic acid, PPIs, Ca, phosphates, fat
  • kidney dx w/ creatinine clearance less than 20mL/min
  • alcohol use disorder
  • excessive sweating
  • diarrhea/ gastric bypass sx
34
Q

what relationship does Ca have with another electrolyte

A

Inverse relationship with phosphate
Ca high = PO4 low

friends with Mg
Mg high = Ca high

35
Q

what are the signs of hypercalcemia

A
  • kidney stones (renal calculi)
  • constipation
  • bone pain
  • severe muscle weakness & lethargy
  • encephalitis > 14, life threatening >15
36
Q

what are the causes of hypercalcemia

A
  • hyperparathyroidism
  • high PTH
  • cancer
  • immobility
  • acidosis
37
Q

what are the signs of hypocalcemia

A
  • Trousseau’s & Chvostek’s sign: tetany
  • diarrhea
  • weak bones, weak blood clotting
  • depression/anxiety
  • cardiac dysrhythmias: prolonged QT interval
  • seizures
38
Q

what are the causes of hypocalcemia

A
  • hypoparathyroidism, thyroidectomy
  • low PTH -> high calcitonin
  • renal failure (CKD)
  • alkalosis
  • low Mg, vit D
  • meds: bisphosphonates, denosumab (osteoporosis meds)
39
Q

normal GFR

A

90-120

NURS124 (6 decks)

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