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Med Surg 2 > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

What is the sodium level that indicates hypernatremia?

A

> 145 mEq/L

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2
Q

What mnemonic is used to remember the signs of hypernatremia?

A

FRIED SALT

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3
Q

List three signs or symptoms of hypernatremia.

A
  • Flushed skin
  • Restless, anxious, confused, irritable
  • Increased BP & fluid retention
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4
Q

What does the phrase ‘Where sodium goes, water flows’ imply?

A

If there is a lot of sodium in the vessels, there will also be a lot of water in the vessels.

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5
Q

What are two ways sodium can be ingested?

A
  • Oral ingestion
  • Administration of IV fluids with sodium
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6
Q

What is a common cause of sodium loss leading to hypernatremia?

A
  • Fever
  • Burns
  • Diabetes insipidus (DI)
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7
Q

What is the sodium level that indicates hyponatremia?

A

< 135 mEq/L

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8
Q

What mnemonic is used to remember the signs of hyponatremia?

A

SALT LOSS

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9
Q

List three signs or symptoms of hyponatremia.

A
  • Stupor/coma
  • Anorexia (nausea/vomiting)
  • Lethargy (weakness/fatigue)
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10
Q

What are the two types of hyponatremia?

A
  • Hypovolemic
  • Hypervolemic
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11
Q

What is a common cause of hypovolemic hyponatremia?

A
  • Loss of sodium from diaphoresis
  • Diarrhea & vomiting
  • Diuretics
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12
Q

What is a common cause of hypervolemic hyponatremia?

A

Excess levels of water in the body which dilutes sodium

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13
Q

What is the treatment for hypernatremia?

A
  • Restrict sodium intake
  • Administer IV fluids if due to fluid loss (isotonic or hypotonic solutions)
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14
Q

What should be done for a patient with hyponatremia?

A

Treat the underlying cause.

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15
Q

What precautions should be taken for a patient with seizures due to hyponatremia?

A

Place the patient on seizure precautions.

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16
Q

Fill in the blank: Hypertonic solutions contain ______ amounts of salt.

A

high

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17
Q

True or False: It is safe to give food or water to a patient who is lethargic, confused, or in a comatose state.

A

False

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18
Q

What should be done if a patient is in fluid volume overload due to SIADH?

A

Place the patient on fluid restriction.

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19
Q

What is the potassium level that indicates hyperkalemia?

A

> 5 mEq/L

Hyperkalemia is characterized by muscle contractions that last too long and can lead to severe complications.

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20
Q

What does the acronym ‘MURDER’ represent in the context of hyperkalemia symptoms?

A
  • Muscle cramps & weakness
  • Urine abnormalities
  • Respiratory distress
  • Decreased cardiac contractility
  • EKG changes
  • Reflexes (+ DTR)

These symptoms are critical for identifying hyperkalemia in patients.

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21
Q

What are EKG changes associated with hyperkalemia?

A

Tall, peaked T-waves

Hyperkalemia can lead to distinctive changes in heart rhythm observable on an EKG.

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22
Q

What is the potassium level that indicates hypokalemia?

A

< 3.5 mEq/L

Hypokalemia can lead to significant muscle weakness and other systemic issues.

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23
Q

List some symptoms of hypokalemia.

A
  • Generalized weakness in muscles
  • Weak muscles & less contraction
  • Shallow breathing
  • Slowing of GI system (constipation)
  • Nausea, vomiting, bloating
  • EKG changes

These symptoms reflect the consequences of low potassium levels on bodily functions.

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24
Q

What EKG changes can occur with hypokalemia?

A

Flattened T-wave or conversion of the T-wave

These changes can also indicate underlying cardiac issues.

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25
Q

What are some causes of hyperkalemia?

A
  • Intake of too much potassium (e.g., IV fluids with K)
  • Adrenal gland issues (insufficiency)
  • High levels of acid in blood (acidosis)
  • NSAIDs (e.g., ibuprofen, naproxen)
  • Potassium-sparing diuretics (e.g., spironolactone)

Understanding the causes helps in managing and preventing hyperkalemia.

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26
Q

What are some causes of hypokalemia?

A
  • Low potassium intake (not eating, NPO diet)
  • Vomiting & diarrhea
  • Gastric suction
  • Alkalosis
  • Potassium-wasting diuretics (loop or thiazide)

Identifying these causes is crucial for treatment and prevention.

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27
Q

What is the primary treatment for hyperkalemia?

A

Stop potassium intake and administer medications like sodium bicarbonate and IV calcium gluconate

Timely treatment can prevent life-threatening complications.

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28
Q

What monitoring is necessary for both potassium imbalances?

A

EKG monitoring

Cardiac dysrhythmias are a significant risk in both hyperkalemia and hypokalemia.

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29
Q

What is the recommended method for administering potassium?

A

Always dilute in fluid and infuse slowly

Potassium can irritate veins and cause complications if administered too quickly.

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30
Q

What is the normal calcium level in the blood?

A

11 mg/dL

Normal calcium levels are typically around 8.5 to 10.5 mg/dL.

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31
Q

What condition is indicated by calcium levels greater than 11 mg/dL?

A

HYPERCALCEMIA

Hypercalcemia can lead to various symptoms and complications.

32
Q

List the signs and symptoms of hypercalcemia.

A
  • Bone pain
  • Arrhythmias
  • Cardiac arrest (bounding pulses)
  • Kidney stones
  • Muscle weakness
  • Excessive urination

Kidney stones are also called renal calculi.

33
Q

What condition is indicated by calcium levels less than 9 mg/dL?

A

HYPOCALCEMIA

Hypocalcemia can cause various neurological and muscular symptoms.

34
Q

What does the acronym ‘CATS GO NUMB’ represent in hypocalcemia?

A
  • C: Convulsions/seizures
  • A: Arrhythmias
  • T: Tetany
  • S: Spasms & stridor
  • GO NUMB: Numbness in fingers, face, limbs

This acronym helps remember the symptoms associated with low calcium levels.

35
Q

What is a positive Trousseau’s sign?

A

Carpal spasm caused by inflating a blood pressure cuff

This sign indicates hypocalcemia.

36
Q

What is Chvostek’s sign?

A

Contraction of facial muscles with a light tap over the facial nerve

This sign is another indicator of hypocalcemia.

37
Q

What are some risk factors for hypercalcemia?

A
  • Kidney disease
  • Use of thiazide diuretics
  • HYPERparathyroidism & HYPERthyroidism
  • Bone breakdown from metastatic cancer
  • Highly concentrated blood (hemoconcentration)

Dehydration can also contribute to hemoconcentration.

38
Q

What conditions can lead to hypocalcemia?

A
  • Issues absorbing calcium from the GI tract
  • Too much calcium leaving the body from excretion
  • Kidney disease
  • Diuretics
  • Diarrhea
  • Drainage from wounds

Phosphorus and low vitamin D levels can also contribute to hypocalcemia.

39
Q

What is the primary treatment for hypercalcemia?

A

STOP calcium intake (IV or PO)

Additional treatments may include administering medications to lower calcium levels.

40
Q

What medication helps tone down calcium levels in the blood?

A

Calcitonin

Calcitonin is used to reduce elevated calcium levels.

41
Q

What dietary recommendations can help manage calcium levels?

A
  • Calcium intake in diet
  • Calcium supplements
  • Vitamin D
  • Calcium gluconate

Adequate vitamin D is essential for calcium absorption.

42
Q

What precautions should be initiated for a patient with hypocalcemia?

A

Initiate seizure precautions

Patients with low calcium levels are at high risk for seizures.

43
Q

What is the condition characterized by magnesium levels greater than 2.5 mg/dL?

A

HYPERMAGNESEMIA

Symptoms include sedation, decreased deep tendon reflexes, drowsiness, bradycardia, hypotension, bradypnea, shallow respirations, and reduced bowel sounds.

44
Q

What are the signs of hypermagnesemia?

A

LOW everything - SEDATED

This includes diminished deep tendon reflexes, energy levels, heart rate, blood pressure, respiratory rate, and bowel sounds.

45
Q

What is the condition characterized by magnesium levels less than 1.5 mg/dL?

A

HYPOMAGNESEMIA

Symptoms include increased excitability, hyperreflexia, tachycardia, hypertension, shallow respirations, twitches, paresthesias, tetany, seizures, irritability, and confusion.

46
Q

What are the signs of hypomagnesemia?

A

HIGH everything - NOT SEDATED

This includes increased deep tendon reflexes, heart rate, blood pressure, and various neuromuscular symptoms.

47
Q

What is the relationship between calcium and magnesium levels?

A

Ca & Mg rise and fall together!

This indicates that changes in one can affect the other.

48
Q

What are some risk factors that can lead to hypermagnesemia?

A
  • Increased magnesium intake
  • Magnesium-containing antacids & laxatives
  • Excessive administration of magnesium IV
  • Renal insufficiency
  • Diabetic ketoacidosis (DKA)

These factors can lead to elevated magnesium levels in the blood.

49
Q

What are common causes of hypomagnesemia?

A
  • Insufficient magnesium intake
  • Malnutrition/vomiting/diarrhea
  • Malabsorption syndrome
  • Increased magnesium excretion
  • Diuretics or chronic alcoholism
  • Hyperglycemia & insulin administration
  • Sepsis

These conditions can contribute to decreased magnesium levels in the body.

50
Q

What is a positive Trousseau’s sign?

A

Carpal spasm caused by inflating a blood pressure cuff

This sign indicates hypocalcemia or hypomagnesemia.

51
Q

What is Chvostek’s sign?

A

Contraction of facial muscles with a light tap over the facial nerve

This sign suggests hypocalcemia and is often associated with magnesium deficiency.

52
Q

What are some treatment options for hypermagnesemia?

A
  • Restrict dietary intake of magnesium-containing foods
  • Avoid the use of laxatives & antacids containing magnesium
  • Use of hemodialysis in severe cases
  • Administration of calcium chloride or calcium gluconate

These treatments aim to reduce magnesium levels in the body.

53
Q

What are some treatment options for hypomagnesemia?

A
  • Administer magnesium sulfate IV or PO
  • Place patient on seizure precautions
  • Instruct patient to increase intake of magnesium-containing foods

Foods rich in magnesium include nuts, seeds, legumes, whole grains, and milk.

54
Q

What is the phosphorus level that indicates hyperphosphatemia?

A

> 4.5 mg/dL

Hyperphosphatemia is characterized by elevated phosphate levels in the blood, which can lead to various health issues.

55
Q

What condition directly results from hyperphosphatemia?

A

Hypocalcemia

Hypocalcemia is a condition of low calcium levels in the blood, often resulting from elevated phosphate levels.

56
Q

List three symptoms of hyperphosphatemia.

A
  • Muscle spasms & tetany
  • Cardiac arrhythmias
  • Seizures

These symptoms arise due to the imbalance of calcium and phosphorus in the body.

57
Q

What is the phosphorus level that indicates hypophosphatemia?

A

< 2.5 mg/dL

Hypophosphatemia is characterized by low phosphate levels in the blood.

58
Q

List three symptoms of hypophosphatemia.

A
  • Fatigue & weakness
  • Delayed growth & development in children
  • Poor bone density & frequent fractures

These symptoms are indicative of insufficient phosphate in the body, affecting energy and bone health.

59
Q

What are two risk factors for phosphorus imbalance?

A
  • Kidney dysfunction
  • Consistent use of enemas and/or laxatives

Both factors can disrupt the body’s ability to regulate phosphate levels.

60
Q

True or False: Rhabdomyolysis can be a risk factor for phosphorus imbalance.

A

True

Rhabdomyolysis can lead to elevated phosphate levels due to muscle breakdown.

61
Q

What dietary modification can be made for patients with end-stage renal disease (ESRD)?

A

Use dialysis

Dialysis helps to filter excess phosphate from the blood in patients with kidney failure.

62
Q

Fill in the blank: Foods that are high in phosphorus include _______.

A

Red meat, beans, dairy products, nuts, & lentils

These foods contribute to the phosphorus intake in the diet.

63
Q

What should be monitored to control phosphorus levels in patients?

A

Hypertension

Managing hypertension helps maintain kidney function, which is crucial for phosphorus regulation.

64
Q

What is a treatment consideration for patients with a history of starvation?

A

Reintroduce nutrients slowly

This approach is necessary to prevent refeeding syndrome, which can occur with rapid nutrient reintroduction.

65
Q

What is the inverse relationship mentioned in the content?

A

Ca* and P

Calcium and phosphate levels in the body are inversely related, meaning that as one increases, the other typically decreases.

66
Q

What is the condition characterized by chloride levels exceeding 105 mEq/L?

A

HYPERCHLOREMIA

Associated with hypertension, fluid retention, generalized swelling, peripheral edema, cardiac arrhythmias, and hypernatremia.

67
Q

What are some symptoms of HYPERCHLOREMIA?

A
  • Hypertension
  • Fluid retention
  • Generalized swelling
  • Peripheral edema
  • Cardiac arrhythmias
  • Hypernatremia

Additional symptoms may include renal damage and dehydration.

68
Q

What are the common causes of HYPERCHLOREMIA?

A
  • Overuse of IV sodium chloride
  • Metabolic acidosis
  • Renal damage
  • Dehydration
  • Uncontrolled glucose levels
  • Diabetes insipidus

Renal damage occurs when kidneys fail to filter and excrete excess chloride.

69
Q

What is the condition characterized by chloride levels falling below 95 mEq/L?

A

HYPOCHLOREMIA

Symptoms can be similar to those of hyponatremia.

70
Q

What are some symptoms of HYPOCHLOREMIA?

A
  • Hypotension
  • Tachycardia
  • Mental status changes
  • Muscle weakness
  • Fatigue

Symptoms can overlap with those of low sodium levels.

71
Q

What are the common causes of HYPOCHLOREMIA?

A
  • Dehydration from fluid loss (vomiting, diarrhea)
  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
  • Overuse of diuretics
  • Addison’s Disease
  • Metabolic alkalosis
  • Excessive suctioning of gastric contents
  • Potassium imbalance

Each of these factors can lead to significant electrolyte imbalances.

72
Q

What are some dietary modifications for managing HYPERCHLOREMIA?

A
  • Sodium restriction
  • Fluids to flush salt
  • Oral or IV fluids
  • Blood glucose management or insulin
  • Dialysis in renal disease patients

These modifications aim to restore electrolyte balance and manage fluid levels.

73
Q

What are some dietary modifications for managing HYPOCHLOREMIA?

A
  • Dietary salt intake with meals
  • Administer IV potassium
  • Administer IV sodium chloride
  • Rehydration
  • Limit or reduce diuretic use

These interventions help to restore chloride and sodium levels in the body.

74
Q

True or False: An increase in chloride concentration is associated with an increase in sodium levels.

A

True

The relationship indicates that as chloride increases, sodium levels tend to rise as well.

75
Q

Fill in the blank: A chloride level of less than _______ mEq/L indicates hypochloremia.

A

95

This threshold is critical for diagnosing hypochloremia.

Med Surg 2 (15 decks)

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