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Pathophysiology Exam 1 > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

Sodium Range

A

135-145 mEq/L

<135 hyponatremia
>145 hypernatremia

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2
Q

Potassium Range

A

3.5-5.0 mEq/L

<3.5 hypophosphatemia
>5.0 hyperphosphatemia

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3
Q

Calcium Range

A

8.5-10.5 mg/dL

<8.5 hypocalcemia
>10.5 hypercalcemia

> 15 hypercalcemic crisis

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4
Q

Magnesium Range

A

1.8-2.6 mg/dL

<1.8 hypomagnesemia
>2.6 hypermagnesemia

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5
Q

Phosphorus Range

A

2.5-4.5 mg/dL

<2.5 hypophosphatemia
>4.5 hyperphosphatemia

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6
Q

Bicarbonate (HCO3-) Range

A

22-26 mEq/L

<22 acidic
>26 basic

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7
Q

pCO2 (reversed)

A

35-45 mmHg

> 45 acidic
<35 basic

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8
Q

pH

A

7.35-7.45

<7.35 acidic
>7.45 basic

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9
Q

pO2

A

80-100 mmHg

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10
Q

Hypotonic Hyponatremia

A

Na < 135 mEq/L

dilution from water retention (SIADH)

retention of water with dilution of sodium while maintaining the effusive circulatory volume within a normal range

excessive sweating, loss of sodium and water, GI losses, heart failure

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11
Q

Hypertonic Hyponatremia

A

Na <135 mEq/L

resulting from an osmotic shift of water from ICF to FCF

sodium in the ECF becomes diluted as water moves out of body cells in response to osmotic effects of the elevated blood glucose level

occurs with hyperglycemia

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12
Q

Hyponatremia

A

Causes:

  • excessive sweating (loss of NA and water)
  • GI losses
  • Heart Failure
  • Hyperglycemia

Symptoms:

* neuromuscular excitability increased at first, then decreased
* muscle cramps
* N/V
* Diarrhea
* HA
* Confusion
* Disorientation
* Lethargy, seizures, coma
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13
Q

Hypernatremia

A

Na >145 mEq/L and Serum Osmolality >295

Hypertonicity of ECF and intracellular dehydration

movement of water out of ICF (cells shrink)

Caused by: disproportional loss of body H2O in relation to Sodium

Symptoms:

* decreased neuromuscular excitability
* agitation, headache, seizures, coma
* decreased skin turgor
* decreased secretions
* decreased sweat/urine
* fever
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14
Q

People at Risk for Hypernatremia

A

infants, the elderly and developmentally delayed are at risk, anyone that cannot speak for themselves, and people with kidney failure or tube feeds (can’t tell when they’re thirsty)

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15
Q

Why is Potassium so important?

A
  1. Maintains intracellular osmolality
  2. maintains acid-base balance
  3. changes glucose into glycogen
  4. convert amino acids into proteins
  5. CRITICAL in conduction of nerve impulses and muscle excitability
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16
Q

Hypokalemia

A

K <3.5 mEq/L

Causes: inadequate dietary intake, excessive renal losses, kidney excretes too much K, ECF to ICF shift, diarrhea

Symptoms: decreased NM activity, weakness, paresthesia, cramping, arrhythmias, cardiac arrest

17
Q

Hyperkalemia

A

K >5.5 mEq/L

Causes: ICF to ECF shift, potassium has come out into the blood and concentration increases, decreased renal elimination (renal failure is the biggest cause), excessive oral or IV administration

Symptoms: (first) increased NM excitably, (severe) decreased NM excitability, neuro-parasthesia, paralysis, muscle weakness, CV (ECG changes, peaked T waves (mild) or lethal arrhythmias and cardiac arrest (severe)

Hyperkalemia raises resting potential toward threshold, cells fire more easily, mild hyperkalemia symptoms then severe

18
Q

Hypoparathyroidism

A

deficient PTH secretion

Causes: congenital, autoimmune (destroy gland), surgery, hypomagnesemia

Manifestations: same as hypocalcemia
Causes: Renal failure (kidney losses), hypoparathyroidism, hyperphosphatemia, protein binding and chelation

Manifestations: Increased NM excitability, decreased cardiac excitability

neuro: paresthesia, muscle spasms, tetany, hyperactive reflexes

Chvostek’s and Trousseau’s Sign

CV: hypotension, HF, cardiac arrhythmia

Skeletal: chronic fractures

Electrolytes: Low serum ionized Ca

19
Q

Hyperparathyroidism

A

causes: (primary) hyperplasia, adenoma or CA of gland
(secondary) chronic renal failure and chronic malabsorption of Ca

Manifestations: same as hypercalcemia

decreased NM excitability and muscle function, increased cardiac excitability

Neuro: lethargic, behavioral changes

CV: HTN, increased contractility, dysrhythmias

GU: renal calculi

Electrolytes: high Ca levels and renal osteodystrophy

20
Q

Hypocalcemia

A

Ca <8.5

Causes: Renal failure (kidney losses), hypoparathyroidism, hyperphosphatemia, protein binding and chelation

Manifestations: Increased NM excitability, decreased cardiac excitability

neuro: paresthesia, muscle spasms, tetany, hyperactive reflexes

Chvostek’s and Trousseau’s Sign

CV: hypotension, HF, cardiac arrhythmia

Skeletal: chronic fractures

21
Q

Hypercalcemia

A

Ca >10.5

Causes: hyperparathyroidism, cancer

Manifestations: decreased NM excitability and muscle function, increased cardiac excitability

Neuro: lethargic, behavioral changes

CV: HTN, increased contractility, dysrhythmias

GU: renal calculi

ABOVE 15, hypercalcemic crisis

22
Q

Calcium

A

kidneys convert Vitamin D from the skin into the active form of Vitamin D which goes into the intestine and causes your system to absorb calcium

without Vitamin D the body cannot absorb calcium

exerts an important effect on membrane potentials and neuronal excitability

participates in the release of hormones

necessary for the contraction in skeletal, cardiac and smooth muscle

influences cardiac contractility and automaticity by way of slow calcium channels

23
Q

Vitamin D

A

activation occurs in the kidneys and it effects the absorption of calcium

without vitamin D calcium cannot be absorbed by the body

Kidney Failure: Vit D not activated, calcium continuously secreted but unable to be absorbed, taken from bone instead

24
Q

Hypophosphatemia

A 
Causes: 
intentional absorption
renal losses
corticosteroids
antacids
malnutrition
increased PTH
chronic alcohol use

manifestations:
decreased NM excitability and muscle function, increased cardiac excitability

Neuro: lethargic, behavioral changes

CV: HTN, increased contractility, dysrhythmias

GU: renal calculi

25
Q

Hyperphosphatemia

A 
Causes: 
chronic kidney disease
tissue injury
muscle breakdown
antacids

manifestations:
Increased NM excitability, decreased cardiac excitability

neuro: paresthesia, muscle spasms, tetany, hyperactive reflexes

Chvostek’s and Trousseau’s Sign

CV: hypotension, HF, cardiac arrhythmia

Skeletal: chronic fractures

26
Q

Magnesium

A

Normal concentration 1.8-2.6 mg/dL

Second most abundant intracellular cation

important electrolyte

required for cellular energy metabolism

functioning of Na/K-ATPase pump

* Membrane stabilization 
* nerve conduction
* ion transportation (potassium and calcium transport)

can be used for pre-term labor and preeclampsia, stop the seizures and stop labor

27
Q

Hypomagnesemia

A

Mg <1.8 mg/dL

Causes: decreased intake, chronic alcoholism or malnutrition (loss-diarrhea, absorption, NG output, diuretics)

Manifestations: increased NM excitability, personality changes, confusions, tetany, paresthesia, tremors, hyperactive DT reflexes, seizures, (CV) tachycardia, HTN.

28
Q

Hypermagnesemia

A

> 2.6 mg/dL

Causes: renal insufficiency or failure, injudicious use of magnesium containing drugs (antacid, laxative)

Manifestations: decreased NM excitability, lethargy, hyporeflexia and muscle weakness (CV) Hypotension and cardiac arrest and arrhythmias

29
Q

Mechanisms of Water and Sodium Regulation

A

osmoreceptors-stimulation causes thirst and ADH release

Baroreceptors-stimulate sympathetic response, ADH release

Heart- ANP and BNP

Kidney’s- stimulate sympathetic response, renin release, RAAS (renin-angiotensin-aldosterone system)

Pathophysiology Exam 1 (7 decks)

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