Electrolytes Flashcards
Fluid volume deficit
Manifestations
General Management strategies
Acute weight loss ≥5%, decreased skin turgor, dry mucous membranes, oliguria or anuria, increased hematocrit, BUN level increased out of proportion to creatinine level, hypothermia
Fluid challenge, fluid replacement orally or parenterally
Fluid Volume Excess
Acute weight gain ≥5%, edema, crackles, shortness of breath, decreased BUN, decreased hematocrit, distended neck veins
Fluid and sodium restriction, diuretic agents, dialysis
Hyponatremia (sodium deficit)
Nausea, malaise, lethargy, headache, abdominal cramps, apprehension, seizures
Diet, normal saline or hypertonic saline solutions
Hypernatremia (sodium excess)
Dry, sticky mucous membranes, thirst, rough dry tongue, fever, restlessness, weakness, disorientation
Fluids, diuretic agents, dietary restriction
Hypokalemia (potassium deficit)
Anorexia, abdominal distention, paralytic ileus, muscle weakness, ECG changes, arrhythmias
Diet, oral or parenteral potassium replacement therapy
Hyperkalemia (potassium excess)
Diarrhea, colic, nausea, irritability, muscle weakness, ECG changes
Dietary restriction, diuretics, IV glucose, insulin and sodium bicarbonate, cation-exchange resin, calcium gluconate, dialysis
Hypocalcemia (calcium deficit)
Abdominal and muscle cramps, stridor, carpopedal spasm, hyperactive reflexes, tetany, positive Chvostek or Trousseau sign, tingling of fingers and around mouth, ECG changes
Diet, oral or parenteral calcium salt replacement
Carpopedalspasms are frequent and involuntary muscle contractions in the hands and feet with associated pain
Hypercalcemia (calcium excess)
Deep bone pain, flank pain, muscle weakness, depressed deep tendon reflexes, constipation, nausea and vomiting, confusion, impaired memory, polyuria, polydipsia, ECG changes
Fluid replacement, etidronate, pamidronate, mithramycin, calcitonin, corticosteroids, phosphate salts
polydipsia- abnormally great thirst as a symptom of disease (such as diabetes)
Metabolic acidosis (bicarbonate deficit)
Headache, confusion, drowsiness, increased respiratory rate and depth, nausea and vomiting, warm flushed skin
Bicarbonate replacement, dialysis
Metabolic alkalosis (bicarbonate excess)
Depressed respirations, muscle hypertonicity, dizziness, tingling of fingers and toes
Fluid replacement if volume depleted; ensure adequate chloride
Hypoalbuminemia (protein deficit)
Chronic weight loss, emotional depression, pallor, fatigue, soft flabby muscles
Diet, dietary supplements, hyperalimentation, albumin
Hypomagnesemia (magnesium deficit)
Dysphagia, muscle cramps, hyperactive reflexes, tetany, positive Chvostek or Trousseau sign, tingling of fingers, arrhythmias, vertigo
Diet, oral or parenteral magnesium replacement therapy
Hypermagnesemia (magnesium excess)
Facial flushing, nausea and vomiting, sensation of warmth, drowsiness, depressed deep tendon reflexes, muscle weakness, respiratory depression, cardiac arrest
Calcium gluconate, mechanical ventilation, dialysis
Hypophosphatemia (phosphorus deficit)
Deep bone pain, flank pain, muscle weakness and pain, paresthesia, apprehension, confusion, seizures
Diet, oral or parenteral phosphorus supplementation therapy
QT interval is longer…
Hypermagnesemia-
