Electrolytes Flashcards

1
Q

Sodium Normal ECF Concentration

A

135 mEq/L-145mEq/L

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2
Q

Role of Sodium

A

Sodium is the key regulator of water balance in the body. Also, Sodium is also involved in establishing electrical gradients that allow for transmission of nerve impulses

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3
Q

Regulation of Sodium

A

Aldosterone is the principal regulator of sodium reabsorption in the distal tubule and cortical collecting duct

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4
Q

Hyponatremia concentration

A

Less than 135 mEq/L. Severe is less than 120 mEq/L

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5
Q

Cause of Hyponatermia

A

INCREASE in free water relative to sodium in the ECF either by true loss of sodium or dilution of sodium by water

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6
Q

Treatment of Hyponatermia

A

Iso/Hypertonic saline corrected at ≤ 0.5 mEq/L/hr Given SLOWLY so don’t cause demyelination in CNS

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7
Q

Hypernatremia concentration

A

Greater than 145 mEq/L

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8
Q

Cause of Hypernatermia

A

Decreased access to free water. Lack of ADH (such as Diabetes Insipidus), or excess sodium intake

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9
Q

Treatment of Hypernatermia

A

Correct water loss with hypotonic fluids, and/or correct sodium overload with diuretics

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10
Q

Normal Potassium ECF Concentration

A

3.5 – 5.3 mEq/L

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11
Q

Role of Potassium

A

Potassium is responsible for maintaining the membrane potential of the cell. Also, Important for muscle/heart contraction, nerve signal transmission, acid/base regulation, and intracellular water/electrolyte balance

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12
Q

Regulation of Potassium

A

: Potassium is completely filtered in the glomerulus, and about 15% is excreted. Aldosterone causes excretion of Potassium and reabsorption of Sodium

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13
Q

Hypokalemia Concentration

A
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14
Q

Hypokalemia Causes

A

Total body loss of K+(GI/renal)
Transcellular shifts in K+
Inadequate intake

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15
Q

Hypokalemia Treatment

A

If potassium is below 2.6, treat with IV Potassium Chloride. 20 mEq should be diluted into 100 mL NS, and should not be infused faster than 10 mEq/hr in a peripheral IV, and 20 mEq/hr through a Central line. Monitor the EKG continuously

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16
Q

Hyperkalemia Concentration

A

> 5.5 mEq/L

17
Q

Hyperkalemia Causes

A

Psuedohyperkalemia from venipuncture
Impaired renal excretion
Drugs such as Succinylcholine

18
Q

Hyperkalemia Treatment

A

Calcium antagonized the cardiac membrane actions of hyperkalemia. Give an agent to shift K+ into the cell such as Insuline (with Dextrose), or Sodium Bicarbonate

19
Q

Normal Calcium ECF Concentration

A

Total 8.5-10.5 mg/dL

Ionized 1.1-1.3 mmol/L

20
Q

Roles of Calcium

A

Important for muscle/heart contraction, endocrine and exocrine secretions, cell growth, blood coagulation, transport and secretion of fluids and electrolytes

21
Q

Regulation of Calcium

A
Parathyroid Hormone (PTH)-Increased calcium reabsorption in the kidney and decreased excretion.  It also causes bone resorption, therefore increasing calcium
Calcitonin-increases excretion of calcium in the kidneys acutely, but has little effect on chronic calcium homeostasis
22
Q

Hypocalcemia Concentration

A

Total Calcium less than 8.5 mg/dL, or ionized less than 1.1 mmol/L.

23
Q

Hypocalcemia Causes

A

Low or ineffective PTH
Iatrogenic in the OR (blood products or after a thyroidectomy).
Low Albumin (only affects total Ca).

24
Q

Hypocalcemia Treatment

A

10% Calcium chloride (1.36 mEq/mL) or Calcium gluconate .45mEq/mL (is less potent).

25
Q

Hypercalcemia Concentration

A

Total Calcium greater than 10.5 mg/dL, or ionized greater than 1.3 mmol/L

26
Q

Hypercalcemia Causes

A

Most often hyperparathyroidism
Excess of Vitamin D
Renal failure

27
Q

Hypercalcemia Treatment

A

parathyroidectomy, diuretics, fluid replacement, dialysis, calcitonin-type medications

28
Q

Normal Magnesium ECF Concentration

A

1.5–2.5 mEq/L

29
Q

Roles of Magnesium

A

Activates 300 enzyme systems, including many involved in energy metabolism.
Essential for production/function of ATP.
Essential for DNA, RNA, and protein synthesis
Natural physiological calcium antagonist

30
Q

Regulation of Magnesium

A

The majority of the body’s magnesium stores are found in the bone, with little found in the blood.
Excess magnesium is excreted in urine or stool.
Dietary intake is essential to maintain normal magnesium levels.

31
Q

Hypomagnesemia Concentration

A

Serum Magnesium less than 1.5 mEq/L

32
Q

Hypomagnesemia Causes

A

Metabolic and nutritional disorders predominately.
Critical care patients
Athletes
high metabolic states (pregnancy

33
Q

Hypomagnesemia Treatment

A

Magnesium Sulfate (1-2 mEq/kg) over 8-12 hrs while monitoring vital signs and deep tendon reflexes.

34
Q

Hypermagnesemia Concentration

A

Greater than 2.5 mEq/L in blood serum.

35
Q

Hypermagnesemia Causes

A

Very rare unless excess magnesium is given to people in renal failure, or in patients on magnesium infusions

36
Q

Hypermagnesemia Treatment

A

Diuretics, fluid loading, dialysis