electrolyte imbalances (exam 2) Flashcards
what is a cation?
- positively charged molecules
what is an anion?
- negativity charged molecule
what is the most prevalent cation in the ICF (intercellular fluid)
- POTASSIUM (in a cell) (K+)
what is the most prevent cation in the ECF (extracellular fluid)?
- SODIUM (na+)
- OUTSIDE OF CELL
what is the most prevalent anion in the ICF?
- phosphate (PO4^3-)
- inside the cell
what is the most prevalent anion in the ECF?
- Chloride (CL^-)
- outside of the cell membrane
what is the function of potassium?
- major intracellular electrolyte (!)
- regulates ICF osmolarity and fluid (!)
- maintains resting membrane potential (!)
- required for glycogen/glucose deposit in liver and muscles (not as important)
how does potassium effect resting membrane potential? (-90 mV to hit action potential regularly)
- if too high: too much firing, and too easy for an action potential (- 70 mV to hit action potential)
- if to low: too little firing or too hard to reach an action potential (-100 mV to hit action potential)
what regulates potassium?
- pH changes = acidosis = hyperkalemia
- kidney
- aldosterone
- insulin
how does pH changes in acidosis regulate potassium?
- H+ ions collect in the ICF, shifting K out of the EFC resulting in hyperkalemia (too much K+ in the blood)
how does kidney regulate potassium?
- increase/decrease the amount of K+ excreted in urine in response to plasma concentration
how does aldosterone regulate potassium?
- in high levels of K+ stimulates the secretion of K+ in urine and sweat
how does insulin regulate potassium?
- stimulates NA/K pumps to move K+ into cell after eating (need ATP to work tho)
what is the expiatory and inhibitory diseases for potassium
- excitatory = hyperkalemia
- inhibitory = hypokalemia
what is the expiatory and inhibitory diseases for calcium?
- excitatory = hypokalemia
- inhibitory = hyperkalemia
what is the expiatory and inhibitory diseases for parathyriod?
- excitatory = hypoparathyroidism
- inhibitory = hyperparathyroidism
what is the expiatory and inhibitory diseases for phosphate?
- excitatory = hyperphosphatemia
- inhibitory = hypophosphatemia
what is the expiatory and inhibitory diseases for magnesium?
- excitatory = hypomagnesemia
- inhibitory = hypermagnesemia
what does kalemia stand for?
- potassium
- hypokalemia = low potassium
- hyperkalemia = low potassium
what is hypokalemia?
- low blood potassium levels
- “decreased potassium ion concentration in extracellular fluid” official def
etiology of hypokalemia? / what can cause
- decreased fluid intake, usually in conditions that cause a decreased oral intake
- shift into the cell
- increased excretion of urination =
- typically renal but can be w/ feces, sweat, GI track
- EMESIS, DIARRHEA, DIURETICS (!), LAXATIVES (!) (bc the pt is losing lots of k+
what are the clinical manifestations of hypokalemia?
- inhibitory so it makes the muscles and GI track slower
- slow respirations
- thready pulse = low bp & pulse
- arrhythmias
- weakness & fatigue
- muscle weakness / cramps
- constipation
- ALKALOSIS
what’s the treatment of hypokalemia
- replacement of K through diet & IV
- correct acid base imbalance
what are the abdominal clinical manifestations of hypokalemia?
- altered smooth muscle function bc inhibitory
- distention
- diminished bowel sounds
- paralytic ileus
what are the skeletal muscle clinical manifestations for hypokalemia
- bilateral muscle weakness (myopathy) ; begins in legs
- raspatory paralysis
what are the cardiac symptoms hypokalemia?
- ectopic beats
- alterations in conduction
- dysrhythmias may be serve enough to cause sudden death
- polyuria (excessive urination)
what is hyperkalemia
- increased potassium levels in the blood
what is the etiology of hyperkalemia
- increased potassium intake (maybe through IV)
- shift of potassium form inside the cells to the extracellular fluid (crushing injuries)
- decreased potassium excretion =
- from drugs that reduce aldosterone effects, are nephrotoxic, oliguria
- ACIDOSIS
what are the clinical manifestations for hyperkalemia
- muscle dysfunction due to changes in resting membrane potential
- early = intestinal cramping, diarrhea
- late = muscle weakness in lower extremities
- cardiac dysthymias & cardiac arrest
what is the treatment for hyperkalemia
- treat contributing cause
- correct imbalance
what is the function of calcium?
- metabolic process
- structure of bone & teeth
- transmission of never and muscle impulses
what regulates calcium
- PARAPTHYRIOD
- vit d.
- calcitonin
what is hypocalcemia?
- low calcium IN THE BLOOD, may be normal in the body
- EXCITORY
- DECREASES THE THRESHOLD POTENTIAL, CAUSING HYPEREXCITABILITY OF NEUROMUSCULAR CELLS
what is the etiology of hypocalcemia?
- decreased calcium intake or absorption (poor diet, lack of vit. d)
- decreased physiologic availability of calcium
- excessive phosphate
- HYPOPARATHYRODISM
- increase calcium excretion (steatorrhea)
what are the clinical manifestations of hypocalcemia?
- muscle twitching and cramping/spasms
- trousseau (wrist shaking) (Chvostek cheek twitching)
- hyperactive reflexes
- tetany
- seizures
- cardiac dysthymias
- action PT’s are generated more easily
what is hypercalcemia?
- when calcium concentration raises above upper level
- calcium too high
etiology of hypercalcemia
- increased calcium intake or absorption
- vit D OD - shift of calcium from bone to extracellular fluid
- HYPERPARATHYROIDISM, immobilization, bone tumor
- decreased calcium excretion
what are the clinical manifestations of hypercalcemia?
- INHIBITORY, causing decreased neuromuscular excitability
- muscle weakness
- diminished reflexes
- cardiac dysthymias
what is the treatment for hypercalcemia?
what IV solution should be given?
- correct hyperparathyroidism
- increase renal excretion
- decrease intestinal absorption of calcium
- check for bone conditions
- removal of calcium from circulatory system
- 0.9 NS should be given
what electrolyte has a inverse relationship w/ phosphate?
- CALCIUM = opposite relationship
what is the function of phosphate?
- energy for muscle contraction (bc ATP)
- regulation of acid/base
- builds bones/teeth
what is the etiology of hypophosphatemia?
- decreased phosphate intake or absorption (chronic alcoholism, chronic diarrhea, antiacids)
- shift of phosphate from extracellular fluid to cells (refeeding after starvation)
- increased phosphate excretion (alcohol withdrawal, emesis)
what are the clinical manifestations of hypophosphatemia?
- not normally seen till severe
- due in part to decreased ATP within cells (phosphate is the P in ATP)
- muscle weakness
- seizures
- impaired cardiac function
- INHIBITORY
what is the treatment for hypophosphatemia
- treat underlying cause
- oral / IV supplement
what is the etiology of hyperphosphatemia?
- increased phosphate intake / absorption (overuse of enemas or laxatives)
- shift of phosphate from cells to extracellular fluid
- decreased phosphate excretion
- chronic kidney disease, oliguric renal failure
what are the clinical manifestations of hyperphosphatemia?
- EXCITABILITY
- increased neuromuscular excitability
- causes hypocalcemia signs & symptoms
- excessive phosphate salts may deposit in soft tissue
- may cause aching and stiffness of joints
- itching
what is the treatment for hyperphosphatemia?
- limit intake, enhance excretion
what are the functions of magnesium
- neuromuscular excitability (muscle contraction & relaxation) = HELPS MUSCLE RELAX
what regulates magnesium?
- intestinal absorption and renal excretion balance
what is the etiology of hypomagnesemia?
- decreased magnesium intake or absorption (chronic alcoholism, malnutrition, chronic diarrhea)
- decreased physiologic availability of magnesium
- increased magnesium excretion = diuretics, steatorrhea, emesis
what are the clinical manifestations of hypomagnesemia?
- EXCITABILITY
- hyperactive reflexes
- muscle cramps
- muscle twitching / grimacing
- positive chvoske sign & trousseau
- seizers
- cardiac dysthymias
what is the treatment for hypomagnesemia?
- oral supplements
- iv magnesium
what is the etiology of hypermagnesemia?
INCREASED MAGNESIUM INTAKE OR ABSORPTION
- LAXATIVES, ANTACIDS (!!!!)
DECREASED MAGNESIUM EXCRETION
- OLIGURIC RENAL FAILURE (pee too much)
what are the clinical manifestations for hypermagnesemia?
- inhibitory
- muscle weakness/paralysis
- raspatory depression
- hypotension
- lethargy
- decreased deep tendon reflexes
what is the treatment for hypermagnesemia?
- IV calcium
- dialysis
Is hyperkalemia excitory or inhibitory
- excitatory!!
Is hypokalemia excidtory or inhibitory?
- inhibitory
What does k+ effect?
- the heart
What does NA+ effect (majorly)
- THR BRAIN
Is hypocalcemia excitatory or inhibitory?
- inhibitory
Is hypocalcemia excitatory or inhibitory
- excitatory
Is hypoparathyroidism excitatory or inhibitory?
- excitatory
Is hyperparathyrodism excitatory or inhibitory?
- inhibitory
Is hyerphosphatemia excitatory or inhibitory?
- excitatory
Is hypophosphatemia excitatory or inhibitory?
- inhibitory
Is hypomagnesemia excitatory or inhibitory?
- excitatory
Is hypermagnesemia excitatory or inhibitory?
- inhibitory
