Electrolytes Flashcards
How do you treat asymptomatic but severe hyponatremia (<110)?
Water restriction
How slow should you raise sodium to avoid osmotic demyelination syndrome?
No more than 8 mEq/L/24 hours
How do you treat acute symptomatic hyponatremia?
Hypertonic Saline (seizures is a common symptom to treat that shows it’s symptomatic)
What is the classic ECG change you would see with hypokalemia?
U Waves
What ECG changes would you see in patient with hyperkalemia?
Mild (5.5-6.5) is peaked T waves, Moderate (6.5-7.5) is prolongation of the P-R interval, Severe (>7.5) you would see loss of P-wave, wide QRS, sine wave, and V-fib (arrhythmias)
Why can chronic diarrhea cause hypokalemia?
RAAS activation
What can cause hypomagnesemia?
Chronic alcoholism, pancreatitis, severe burns, digestive system disorders, excessive diuretic use
Can glucose increase sodium?
yes, you raise the sodium 2.0-2.5 for every 100mg/dL glucose is over 100.
Does SlowMag have magnesium chloride?
YES
What does Mag-Tab have in it?
Magnesium Lactate
What do MagOx400 and Mag-Tab have in them?
Magnesium Oxide
How does accumulation of potassium in extracellular fluid effect resting membrane potential?
It decreases it, leading to increased depolarization and increased muscle excitability
How does hyperaldosteronism lead to hypokalemia?
Retaining sodium and water
How much does each 10 mEq of potassium raise serum potassium?
0.1 mEq/L.
Can SPS cause hypokalemia?
YES
What are zoledronic acid’s side effects?
Acute renal failure, osteonecrosis of the jaw, musculoskeletal pain, and hypocalcemia
What can cause hypokalemia?
Albuterol (beta agonists), and extensive 2nd or 3rd degree burns.
What is beer potomania?
Unique syndrome of hyponatremia, manifests as altered mental status, weakness, and gait disturbance with an average serum sodium concentration of 108mEq/L, hypokalemia, and low blood urea nitrogen and urine sodium levels.
What are the risk factors for sudden cardiac death in a patient with hyperkalemia?
CHF, CAD, and/or DM
Why is calcium used in a patient with heart arrhythmia due to hyperkalemia?
Stabilizes the cardiac membrane.
How should calcium chloride be administered?
Central line. Also 2-3 grams of calcium gluconate equals one gram of calcium chloride.
Can regular insulin + D50 with the potential addition of a B2 agonist be used to shift potassium intracellularly?
YES
What classes of medications can cause SIADH?
SSRIs, carbamazepine, barbiturates, and narcotics.
What classes of medication can cause hypernatremia?
Aminoglycosides, lithium, amphotericin, and phenytoin
What is sodium’s normal serum level?
135-145 mEq/L
What is serum magnesiums normal level?
1.5-2.2 mEq/dL
What is serum calcium’s normal level?
2.1-2.7 mmol/L
How much elemental calcium is in calcium chloride vs gluconate?
Chloride is 272 mg, Gluconate is 90 mg.
What medications can cause hyperkalemia?
NSAIDs, beta blockers, succinylcholine, digoxin, ACEi, ARBs, and renin inhibitors
What are signs of hypokalemia?
weakness/paralysis, fasciculations and/or tetany, U waves, N/V/D, and ileus
What are signs of hypercalcemia?
N/V, thirst, fatigue, and constipation
What are the differences in the 4 and 5 mg dose of zoledronic acid?
4 is for hypercalcemia of malignancy, 5 is for prevention and treatment of osteoporosis
What is the corrected calcium equation?
Measured calcium + 0.8 (4- albumin)
