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acute gero 1 > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

Hyponatremia

A

Na < 135

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2
Q

Signs & symptoms of hypotnatremia

A

Lethargy
Nausea
Malaise

Less common
- stupor
- seizures
- coma

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3
Q

Plasma osmolarity of hyponatremia

A

Usually low
<275

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4
Q

Urine osmolarity of hyponatremia

A

< 100

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5
Q

Treatment of symptomatic hyponatremia

A

3% Normal saline
100 ml bolus up to 3 does

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6
Q

Treatment for asymptomatic hyponatremia

A

Isotonic saline (0.9% saline )

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7
Q

Correction of hyponatremia should not exceed

A

8 mEqs/ day

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8
Q

Hypernatremia Na+ level

A

Na+ >145

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9
Q

Hypernatremia is usually due to

A

Na+ gain
water deficit
Osmotic diuresis
Diabetes insipidus

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10
Q

Signs and symptoms of Hypernatremia

A

Severe symptoms
- Altered mental status
- weakness
- coma
- seizures
- polyuria/ thirst

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11
Q

Diagnostic tests for Hypernatremia:
Urine osmolarity =

A

> 800

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12
Q

Rate of correction for Hypernatremia should not exceed

A

10-12 mEq/L/day

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13
Q

Treatment fluids for Hypernatremia

A

D5W or quarter NS (0.22%)

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14
Q

Hypokalemia range

A

K+ < 3.5

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15
Q

Causes of hypokalemia

A
  • decreased net intake
  • transcellular shift
  • increased renal k+ loss
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16
Q

S/S of hypokalemia

A
  • fatigue
  • muscle weakness
    -myalgias
  • Lowe extremity cramps
17
Q

Severe symptoms of hypokalemia

A

Complete paralysis
Hypoventilation
Rhabdomyolysis

18
Q

Testing for Hypokalemia

A

Urine k+
Acid base- usually metabolic alkalosis

19
Q

Hypokalemia EKG changes

A
  • flattened t waves or inversion
  • prominent U waves
  • Prolonged PR interval
  • widened QRS complex
20
Q

Treatment of hyperkalemia

A
  • Calcium gluconate
  • Insulin
  • NaHCO3
  • B2 Adrenergic agonist (albuterol)
    Dialysis
21
Q

Treatment of hypokalemia

A

40 Meq oral
or IV KCL- 10 Meq

22
Q

Calcium balance is regulated by

A

parathyroid hormone (PTH) and calcitriol.

23
Q

PTH increases serum calcium by

A

stimulating bone resorption, increasing calcium reclamation in the kidney, and promoting renal conversion of vitamin D to calcitriol

24
Q

Calcitriol

A

is the active form of vitamin D

25
Q

hypocalcemia diagnostics

A
  • albumin- pseudo eval
    PTH
    serum phosphorus
    vitamin D
    Magnesium
    Ecg- prolonged QT and bradycardia
26
Q

Hypocalcemia

A

serum calcemia- < 8.4
ionized calcium <4.2

27
Q

hypocalcemia causes

A
  • effective hypoparathyroidism
  • vitamin D deficiency
  • profound elevations in phosphorus
28
Q

clinical manifestation of hypocalcemia

A

SEVERE
laryngospasm,
confusion,
seizures, or vascular collapse with bradycardia
decompensated heart failure.

moderate
- excitability of nerves and muscles, paresthesia, tetany

29
Q

Trousseau’s sign

A

Trousseau sign is the development of carpal spasm when a blood pressure cuff is inflated above systolic pressure for 3 minutes.

30
Q

Chvostek sign

A

refers to twitching of the facial muscles when the facial nerve is tapped anterior to the ear.

31
Q

treatment of hypocalcemia

A
  • if hypomagnesemia is present that much be treated first
  • calcium supplement
  • IV for severe or symptomatic
    CACL or Calcium gluconate

initial dose of 90–180 mg of elemental calcium car
1–2 g of calcium gluconate

32
Q

hypercalcemia

A

A serum calcium >10.3 mg/dL with a normal serum albumin or an ionized calcium >5.2 mg/dL defines hypercalcemia.

33
Q

More than 90% of cases are due to

A

primary hyperparathyroidism or malignancy.

34
Q

Clinical manifestations generally are present only if serum calcium exceeds

A

12 mg/dL

35
Q

hypercalcemia manifestations

A

Renal manifestations include polyuria and nephrolithiasis. If serum calcium rises above 13 mg/dL, renal failure with nephrocalcinosis and ectopic soft tissue calcifications are possible.
GI symptoms include anorexia, vomiting, constipation, and rarely, signs of pancreatitis.
Neurologic findings include weakness, fatigue, confusion, stupor, and coma.

36
Q
A

acute gero 1 (8 decks)

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