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Electrolytes Flashcards

1
Q

normal serum K+

A

3.5 - 5.5 mEq/L

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2
Q

most abundant intracellular cation

A

K+

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3
Q

regulates RMP

A

K+

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4
Q

low K+ hyperpolarizes/depolarizes membrane

A

hyperpolarizes

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5
Q

high K+ hyperpolarizes/depolarizes membrane

A

depolarizes

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6
Q

Which organ is the most important regular of K+ homeostasis?

A

kidneys

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7
Q

Etiologies of hypokalemia ( < 3.5)

A
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8
Q

S/S hypokalemia

A
  • skeletal muscle cramps
  • weakness
  • paralysis
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9
Q

EKG findings hypokalemia

A
  • long PR & QT interval
  • flat T wave
  • U wave
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10
Q

Etiologies of hyperkalemia (> 5.5)

A
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11
Q

S/S hyperkalemia

A

cardiac rhythm disturbances

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12
Q

EKG findings hyperkalemia

A

5.5 - 6.5 = peaked T waves

6.5 - 7.5 = flat p wave, prolonged PR interval

7.0 - 8.0 = prolonged QRS

8.5 or greater = sine wave –> VFIB

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13
Q

Hyperkalemia Tx

A
  • Calcium
  • insulin + D50
  • bicarb
  • hyperventilate
  • B2 agonist (albuterol)
  • K+ wasting diuretics
  • Kayexalate
  • Dialysis
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14
Q

Max rate K+ should be administered through peripheral line

A

10 mEq/hour

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15
Q

Max rate K+ should be administered through central line

A

20 mEq/hour

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16
Q

normal serum Na+

A

135 - 145 mEq/L

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17
Q

Most abundant extracellular cation

A

Na+

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18
Q

Primary determinant of serum osmolarity

A

Na+

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19
Q

At what Na+ level should you consider delaying surgery?

A

less than 130

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20
Q

Hyponatremia

A

< 135

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21
Q

S/S hyponatremia

A

130 - 135 = no s/s to mild s/s

125 - 129 = N/V, malaise

115 - 124 = HA, lethargy, altered LOC

115 or less = SZ, coma, cerebral edema, resp arrest

22
Q

Hyponatremia Tx

A

Goals:

  • restore Na+ by manipulating serum osmolality & fluid balance w/ H2O restriction
  • IVF based on tonicity

-diuretics

23
Q

Hypernatremia

24
Q

S/S hypernatremia

A

Based on serum osmolality:

350 - 375 = HA, agitation, confusion

376 - 400 = weakness, tremors, ataxia

401 - 430 = hyperreflexia, muscle twitching

431 or more = SZ, coma, death

25
Hypernatremia Tx
same goals as hyponatremia
26
Na+ should be corrected no more than ____ mEq/L/hour
1-2
27
Treating hyponatremia too quickly may cause:
central pontine myelinolysis
27
Treating hypernatremia too quickly may cause:
cerebral edema
27
normal serum Ca+ (total)
8.5 - 10.5 mg/dL
28
normal ionized Ca+
4.65 - 5.28 mg/dL or 2.2 - 2.6 mEq/L
29
Parathyroid hormone & calcitonin feedback loop
30
Etiologies of hypocalcemia
- hypoparathyroidism - vit D deficiency - renal osteodystrophy - pancreatitis - sepsis
31
S/S hypocalcemia
- skeletal muscle cramps - nerve irritability --> paresthesia & tetany - laryngospasm - mental status changes --> SZ - Chvostek sign: tapping on angle of jaw --> facial contraction ipsilateral side - Trousseau sign: inflate BP cuff 3 min --> muscle spasm of hand & forearm
32
EKG hypocalcemia
long QT interval
33
Hypocalcemia Tx
- Ca+ - vit D
34
Etiologies of hypercalcemia
- hyperparathyroidism - CA - thyrotoxicosis - thiazide diuretics - immobilization
35
S/S hypercalcemia
- nausea - abdominal pain - HTN - psychosis - mental status changes --> SZ
36
EKG hypercalcemia
short QT interval
37
Hypercalcemia Tx
- 0.9% NaCl - Loop diuretic (lasix)
38
What hormone raises Ca+?
parathyroid hormone
39
What hormone lowers Ca+?
calcitonin
40
normal serum Mg+
1.7 - 2.4 mg/dL or 1.5 - 3 mEq/L
41
Calcium antagonist
Mg+
42
Clinical uses of Mg+
- pre-eclampsia - opioid-sparing technique - acute bronchospasm - cardiac rhythm disturbance (torsades)
43
Which is correct about magnesium sulfate? A. produces vasoconstriction B. decreases sensitivity to NDNMBs C. NMDA receptor blockade D. increases uterine tone
C
44
Which is false about magnesium sulfate? A. tocolytic B. bronchodilator C. antiepileptic D. potentiates catecholamine release
D
45
Etiology of hypomagesemia
- poor intake - alcohol abuse - diuretics - critical illness - common w/ hypokalemia
46
S/S hypomagnesemia
EKG findings not significant unless very low --> long QT
47
Etiologies of hypermagnesemia
- excessive administration - renal failure - adrenal insufficiency
48
S/S hypermagnesemia
EKG changes not significant unless very high --> heart block
49
Hypermagnesemia can ___________ neuromuscular blockade with sux & nondepolarizers.
potentiate
50
How does Mg+ work as an opioid-sparing drug?
antagonizes NMDA receptor

APEX: Flashcards (13 decks)

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