Electrolyte Imbalances Flashcards
Sodium
functions to regulate osmotic forces (water); has roles in neuromuscular irritability, acid base balance, cellular chemical rxns, and membrane transport
Hypernatremia
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
Causes of Hypernatremia
fluid deprivation, excessive na intake, heatstroke, near drowning in ocean water, excessive use of sodium bicarbonate
Manifestations of Hypernatremia
thirts, wt gain, bounding pulse, increased BP, restlessness, weakness, postural hypotensio, dry, flushed skin, hyperreflexia, confusion
Hyponatremia
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)
Causes of Hyponatremia
sweating, n/v, burns, anticonvulsants, diuretics
Manifestations of Hyponatremia
cerebral edema, increased intracranial pressure, lethargy, HA, confusion, decreased reflexes, seizures
Potassium
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
Hyperkalemia
rare due to efficent renal excretion but common in those with chronic kidney dz, (main use for hemodialysis)
Causes of Hyperkalemia
increased intake, acidosis, cell hypoxia, shift of K from ICF to ECF, decreased renal excretion, insulin deficiency, cell trauma, use of whole blood
Manifestation of Hyperkalemia
restlessness, intestinal cramping, diarrhea, muscle weakness (to paralysis), premature ventricular contractions, tachycardia, muscle weakness, sudden cardiac arrest
Causes of Hypokalemia
decreased intake, debilitated, insulin OD, alkalosis, diuretics, renal dz
Manifestation of Hypokalemia
muscle weakness, fatigue, irregular weak pulse, smooth muscle, cramps, numbness, n/v, constipation, anorexia, cardiac dysrythmias
Calcium and Phosphate are both…
rigidly controlled by PTH, vitamin D, and calcitonin
Causes of Hypercalcemia
hyperparathyroidism, increased bone resorption, sarcodosis, increased intestinal absorption, tumors, prolong immobility, decreased elimination, renal transplant
Effect of Hypercalcemia
fatigue, weakness, lethargy, anorexia, nausea, constipation, kidney stones, dysrythmias, bradycardia, cardiac arrects, HTN, bone pain
Causes of Hypocalcemia
decreased absorption, deposition into bone, blood administration, renal failure, alkalosis, alcohol abuse, hypomagnesemia, pancreatitis, decreased PTH, and Vitamin D
Manifestations of Hypocalcemia
increased neuromuscular excitability, tingling, muscle spasms, intestinal cramping, hyperactive bowels, osteoporosis, prolonged QT interval, cardiac arrest, abnormal blood clotting, depression
Causes of Hyperphosphatemia
renal failure, tx of metastatic timor, long term laxative/enema use, hypoparathyroidism,
Effects of Hyperphosphetemia
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
Causes of Hypophosphetemia
intestinal malabsorption, respiratory alkalosis, increased renal excretion associated with hyperparathyroidism
Effects of Hypophosphetemia
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
Magnesium
intracellular cation, cofactor in intravellular enzymatic rxns, increased neuromusclular excitability, alters ca transport, role in smooth and cardiac muscle contractions
Causes of Hypermagnesema
usually renal insufficiency or failure, magnesium containing meds, adrenal insufficiency, addisons dz, extensive soft tissue loss, sepsis, hypothermia, untreated DKA
Effects of Hypermagnesemia
loss of deep tendon reflexes, n/v, abnormal heart rhythms (heart block), decreased BP, clotting abnormalities, muscle weakness, hypotension, bradycardia, respiratory distress
Causes of Hypomagnesemia
malnutrtion, increased intake, malabsorption syndromes, low albumin levels, alcoholism, increased urinary losses
Effects of Hypomagnesemia
behavioral changes, irritability, increased reflexes, muscle cramps, ataxia, nystagmus, tetany, convulsions, tachycardia, hypotension, tremors
What is given to decreased K?
kayexalate
