Electrolyte Imbalances

Question 1

Sodium

Answer 1

functions to regulate osmotic forces (water); has roles in neuromuscular irritability, acid base balance, cellular chemical rxns, and membrane transport

Question 2

Hypernatremia

Answer 2

either Na gain or water loss; occurs when more NA ingested or retained than water; serum osmolality INCREASES; rare bc it is normally caused by insufficient water intake

Question 3

Causes of Hypernatremia

Answer 3

fluid deprivation, excessive na intake, heatstroke, near drowning in ocean water, excessive use of sodium bicarbonate

Question 4

Manifestations of Hypernatremia

Answer 4

thirts, wt gain, bounding pulse, increased BP, restlessness, weakness, postural hypotensio, dry, flushed skin, hyperreflexia, confusion

Question 5

Hyponatremia

Answer 5

plasma hypoosmolatlity, and cellular swelling (bc Na is a ECF ion and if there is less of it the ECF become hypotonic to the cell; either caused by actual sodium deficits (fluid loss) or relative sodium deficits (dilution such as drinking excessive amt of water)

Question 6

Causes of Hyponatremia

Answer 6

sweating, n/v, burns, anticonvulsants, diuretics

Question 7

Manifestations of Hyponatremia

Answer 7

cerebral edema, increased intracranial pressure, lethargy, HA, confusion, decreased reflexes, seizures

Question 8

Potassium

Answer 8

major intracellular cation; regulates intracellular electrical neutrality, nerve impulses, membrane potentials, insulin DECREASES K (bc K follows insulin), effects normal cardiac rhythms, pH effects it and kidneys main regulator

Question 9

Hyperkalemia

Answer 9

rare due to efficent renal excretion but common in those with chronic kidney dz, (main use for hemodialysis)

Question 10

Causes of Hyperkalemia

Answer 10

increased intake, acidosis, cell hypoxia, shift of K from ICF to ECF, decreased renal excretion, insulin deficiency, cell trauma, use of whole blood

Question 11

Manifestation of Hyperkalemia

Answer 11

restlessness, intestinal cramping, diarrhea, muscle weakness (to paralysis), premature ventricular contractions, tachycardia, muscle weakness, sudden cardiac arrest

Question 12

Causes of Hypokalemia

Answer 12

decreased intake, debilitated, insulin OD, alkalosis, diuretics, renal dz

Question 13

Manifestation of Hypokalemia

Answer 13

muscle weakness, fatigue, irregular weak pulse, smooth muscle, cramps, numbness, n/v, constipation, anorexia, cardiac dysrythmias

Question 14

Calcium and Phosphate are both…

Answer 14

rigidly controlled by PTH, vitamin D, and calcitonin

Question 15

Causes of Hypercalcemia

Answer 15

hyperparathyroidism, increased bone resorption, sarcodosis, increased intestinal absorption, tumors, prolong immobility, decreased elimination, renal transplant

Question 16

Effect of Hypercalcemia

Answer 16

fatigue, weakness, lethargy, anorexia, nausea, constipation, kidney stones, dysrythmias, bradycardia, cardiac arrects, HTN, bone pain

Question 17

Causes of Hypocalcemia

Answer 17

decreased absorption, deposition into bone, blood administration, renal failure, alkalosis, alcohol abuse, hypomagnesemia, pancreatitis, decreased PTH, and Vitamin D

Question 18

Manifestations of Hypocalcemia

Answer 18

increased neuromuscular excitability, tingling, muscle spasms, intestinal cramping, hyperactive bowels, osteoporosis, prolonged QT interval, cardiac arrest, abnormal blood clotting, depression

Question 19

Causes of Hyperphosphatemia

Answer 19

renal failure, tx of metastatic timor, long term laxative/enema use, hypoparathyroidism,

Question 20

Effects of Hyperphosphetemia

Answer 20

mostly related to low ca levels and similar results to hypocalcemia; increased phosphate make your bones weaker because it moves calcium out of the bone into blood, lungs, and eyes, so can have more fractures, and deposits of calcium phosphate in soft tissue occurs with prolonged elevation of phosphates causing PURITITS

Question 21

Causes of Hypophosphetemia

Answer 21

intestinal malabsorption, respiratory alkalosis, increased renal excretion associated with hyperparathyroidism

Question 22

Effects of Hypophosphetemia

Answer 22

reduced o2 transport of RBC, leukocyte and platelet dysfunction, deranged, nerve and muscle function, irritability, confusion, numbness, coma, convulsion, possible respiratory failure, cardiomyopathy, bone resorption

Question 23

Magnesium

Answer 23

intracellular cation, cofactor in intravellular enzymatic rxns, increased neuromusclular excitability, alters ca transport, role in smooth and cardiac muscle contractions

Question 24

Causes of Hypermagnesema

Answer 24

usually renal insufficiency or failure, magnesium containing meds, adrenal insufficiency, addisons dz, extensive soft tissue loss, sepsis, hypothermia, untreated DKA

Question 25

Effects of Hypermagnesemia

Answer 25

loss of deep tendon reflexes, n/v, abnormal heart rhythms (heart block), decreased BP, clotting abnormalities, muscle weakness, hypotension, bradycardia, respiratory distress

Question 26

Causes of Hypomagnesemia

Answer 26

malnutrtion, increased intake, malabsorption syndromes, low albumin levels, alcoholism, increased urinary losses

Question 27

Effects of Hypomagnesemia

Answer 27

behavioral changes, irritability, increased reflexes, muscle cramps, ataxia, nystagmus, tetany, convulsions, tachycardia, hypotension, tremors

Question 28

What is given to decreased K?

Answer 28

kayexalate