Electrolytes Flashcards
ICF: prevalent cation/anion?
ECF: prevalent cation/anion?
ICF: K+, phosphate
ECF: Na+, Cl-
Most calcium, magnesium, and phosphate is stored in the _____
bones and teeth
____ maintains the concentration/volume of ECF, influences water distribution, and generates nerve impulses/muscle contractions/acid base balance
Sodium
____: 98% is inside the cells at 140mEq/L. Maintains the resting membrane potential of nerve and muscle cells
Potassium
What are the normal ranges:
Bicarbonate
Chloride
Phosphate
Bicarbonate: 22-26
Chloride: 98-106
Phosphate: 3.0-4.5
What are the normal ranges:
Calcium (total)
Calcium ionized
Magnesium
Potassium
Sodium
Calcium (total): 9.0-10.5
Calcium ionized: 4.5-5.6
Magnesium: 1.3-2.1
Potassium: 3.5-5
Sodium: 135-145
Explain the FRIED mneumonic
Hypernatremia symptoms
Fever- low grade/flushed skin
Restless
Increased fluid retention/BP
Edema
Decreased urine output, dry mouth
Explain the MODEL mneumonic
Hypernatremia causes
Medications/meals
Osmotic diuretics
Diabetes insipidus
Excessive H2O loss
Low H2O intake
How do you treat hypernatremia caused by water deficit?
Fluid replacement w/ isotonic solutions
How do you treat hypernatremia caused by sodium excess?
Fluids that are sodium free (D5W) and diuretics
Why are sodium imbalance patients put on seizure precautions?
Most dangerous symptoms are neurological, such as seizures
Explain the SALT LOSS mneumonic for hyponatremia
Stupor/coma
Anorexia
Lethargy
Tendon reflexes decreased
Limp muscles
Orthostatic hypotension
Seizures/headache
Stomach cramps
How do you treat hyponatremia caused by water excess?
Fluid restrictions
Diuretics
3% NaCl for seizures
How do you treat hyponatremia caused by fluid loss?
fluid replacement w/ isotonic sodium
Encourage oral intake
No diuretics
Vasopressin blockers
Seizure precautions
What is the first ECG sign of hypokalemia
Peaked t waves
What is the most common cause of hyperkalemia?
Renal failure
Extreme trauma/tissue injury
What is given first for critically high K levels?
Calcium gluconate: stabilizes myocardium
Why is insulin + glucose given for hyperkalema?
Insulin pulls K+ with it when it drags glucose into cells
Explain the C BIG K DROP mneumonic for hyperkalemia treatment
C: calcium gluconate
B: beta-agonists or bicarbonate
I,G: insulin + glucose
K: kayexalate enema
D: duiretics
ROP: renal unit for dialysis
Why is hypokalemia an airway and GI risk
Muscle weakness-respiratory muscles and GI peristalsis
What ECG change may be visible due to hypokalemia?
Prominent U wave
ST depression
What are the safety guidelines for IV K+ admin?
Always dilute
Use a pump only- no push or bolus
Invert bags repeatedly to distribute
Do not add KCl to hanging IV bag
No faster than 10 mEq/hr
Which food should be avoided for hypokalemic patients?
Licorice
What 2 things cause hypercalemia?
Hyperparathyroidism
Metastasis to bones (cancer)
