exam 2: electrolyte imbalances (SN) Flashcards
What depletes electrolytes?
THINK FLUID
V: vomiting = fluid
P: pee = fluid
P: poo= diarrhea
S: sweating= fluid
Potassium (K+) Review
3.5-5.0 mEq/L
PPP- Potassium Priority Pumps (heart and muscles)
-action and contraction in the heart and skeletal muscles
-keeps cells polarized via sodium potassium pump
-major ICF cation
metabolism balance=potassium balance
-hydrogen ions accumulate in ICF during states of acidosis»_space; potassium goes out to ECF to neutralize it (causing an increase in potassium in ECF)
obtained: diet, fruits & green leafy vegetables
absorbed: intestines
excreted: by kidneys and bowels
regulated by kidneys!
-slow changes to be tolerated more
-replacement a bit damaging to veins due to irritation and pt report of tenderness (needs to be diluted)
Sodium (Na+) Review
135-145 mEq/L
LMFAO, little love affair with potassium (works together!)
SS- Sodium Swelling
seen in brain cells !! look at cues related to brain
can be related to gain and loss of water not just sodium
-primary ECF cation (+)
-regulates osmotic forces, thus water
-nerve impulse conductions
-maintain neuromuscular irritability
-where sodium goes, fluid flows!
-major cation in ECF
-maintain bp and bv and keep pH balance
-works very closely with K+ in sodium potassium pump to energize cells and buffer out acid/base imbalances
Obtained: canned food, processed meats and cheeses, fast food
absorbed: small intestines
excreted: by kidneys
regulated by:
ADH- holds water in body
Aldosterone hormone- holds sodium in body
Chloride (Cl) Review
96-106
“always following behind and in shadow of sodium”
-primary ECF anion (-)»_space; provide electroneutratility
- help sodium (function similar); maintain bv, (mainly for…)bp and pH of body fluids
obtained: where salt is; table salt, sea salt, seaweed, tomatoes, olives and others
absorbed: small intestines
excreted: by kidneys
Sodium and Chloride Balance
-know RAAS
ang 1 precursor to aldosterone release»_space;
natriuretic peptides: sodium in urine, protein we regulate with natriuretic peptides
water balance:
-ADH (vassopressin) secretion: in the posterior pituitary gland
^very low BP to help with any blood volume to stay in ICF (vascular space)
^^ can help regulate BP
look for cognitive symptoms !!!
Hypervolemia, what’s happening and from what?
kidney failure, rapid infusion of IVF
decrease in osmolality; hyponatremia ; h2O excess in ECF
weight gain; bounding pulse; high bp; JVD
too little ADH
Hypovolemia, what’s happening and from what?
loss in bp or bv: weak, thready pulse; ALOC; thirst; tachycardia; low urine output (dark); poor capillary refill; weight loss; respiratory arrest
increase in osmolality; hypernatremia; h2O deficit in ECF (dehydration)
from trauma; burns; heart failure; dehydration (no water intake) shifting fluid into third space (in tissue) and not in vascular space
too much ADH
Magnesium (Mg) Review
1.3-2.1 mg/dL
MM- Magnesium Mellows Muscles
-law and order in muscles of body via protein synthesis, nerve function and blood sugar control
-stimulates parathyroid hormone which regulates calcium
required for calcium and vitamin D absorption
-act as cofactor in ICF enzymatic reactions (increase neuromuscular excitability)
obtained: spinach, almonds, yogurt
absorbed: small intestines
excreted: by kidneys
Calcium (Ca2+) Review
8.6-10.2 mg/dL
-most abundant cation in body
-strong Bones, Blood (clotting factors), Beats (heartbeat)
CCC- calcium contracts and calms muscles
BBB- keep strong: bone, blood, beats + teeth + transmission of nerve impulses
lovessss magnesium
obtained: fruits, veggies, almonds, dairy products, green vegetables
absorbed: small intestine
excreted: kidney
calcium + magnesium = BFFF lmfao, calcium moves the same as magnesium
-when magnesium is low, calcium is treatment of choice as filling in
regulated:
PTH: increases calcium concentration in blood
calcitonin: puts a ton of calcium into bones
calcitriol: controls release of calcitonin; reverse ton on calcium in bone and release it back into blood
Phosphate (P) Review
2.4-4.4 mEq/L
(calcium’s worst enemy- complete opposite and works INVERSELY)
-most located in bone
-provides energy for muscle contraction
obtained: meats, poultry, fish, nuts, beans and dairy products
absorbed: small intestine
excreted: by kidneys
work for: bone and teeth formation and repair cell tissues
regulated by (JUST LIKE CALCIUM):
-PTH (one high’s the other is low)
Potassium K+ Imbalance: HYPERkalemia
> 5.0
icf to ecf
cardio: high pumps
-peak T waves & ST Elevation
-severe: V fib & cardiac arrest
-hypotension & bradycardia (as heart cramps up from over pumping)
neuromuscular:
-increased DTR (deep tendon reflexes)
-paralysis & paresthesia (tingling)
-muscle weakness (general feeling of heaviness)
GI= high pumps:
-diarrhea
-hyperactive bowel sounds
causes: renal failure, low aldosterone
Add sodium , Loses potassium
Potassium K+ Imbalance: HYPOkalemia
<3.5
potassium shifts from ecf to icf
cardio: low & slow pumps
- flat T waves, ST depression & U wave
neuromuscular: low & slow
-shallow respirations (most DEADLY): as diaphragm muscle is low and slow
-decreased DTR (deep tendon reflexes)
-muscle cramping & flaccid paralysis (paralyzed limbs)
quadriceps weakness early sign + fatigue, muscle weakness, anorexia, N/V
GI: low & slow
-constipation
-hypoactive bowel sounds
-paralytic ileus (paralyzed intestine)- PRIORITY as risk for SBO (small bowel obstruction)
causes: fluid loss (main)/ electrolyte loss, diarrhea, diuretics, diet (low potassium), DKA (thick sugary blood»_space; high blood osmolality (thickness)»_space; fluid out of cell to balance and into blood stream»_space; potassium moves with it
and aldosterone (we have low potassium if we have too much aldosterone)
-put on heart monitor to look for life-threatening dysrhythmias
Sodium Na+ Imbalance: HYPERnatremia
SS- Sodium Swells to maintain BP, BV, pH balance
>145
cells shrink!!!
body: big and bloated (fluid is drawn out of the cell and into the body)
-edema
-flushed, red, rosey skin
-increased muscle tone !!
-swollen dry tongue
-nausea and vomiting
causes:
-low ADH (TRICK: add H2O to body) so without it, you get DI
aldosterone is needed to ADDDD sodium to body , and L is to lose potassium
-rapid respirations
-watery diarrhea (diarrhea makes body dry, so we get an increase in sodium)
-loss of thirst
Sodium Na+ Imbalance: HYPOnatremia
<135
decrease in osmolality
brain: low & slow
-headache= cerebral edema (CRITICAL)
-mental status changes
-seizures and coma from brain swelling
muscular: low & slow
-fatigue and muscle cramps
respiratory: low & slow
-respiratory arrest (CRITICAL)
low bp
causes:
hemodilution
-sweating
-excessive water intake
^ when running in extreme heat
-SIADH (excess ADH) : too much water to body»_space; leading to dilution in labs
electrolyte depletion
- vomiting and diarrhea
-diuretics and diuresisis (drain fluid from body and into potty)
-diet low in salt
-low aldosterone
Chloride (Cl-) Imbalances: HYPERchloremia
<106
nearly same as HYPERnatremia:
- swollen dry tongue
-nausea and vomiting (alkalosis from vomiting)
-weakness
-lethargy
