Fluid and electrolyte imbalance Flashcards by Michelle Mwangi

what is the electrolyte range for calcium?

2.2-2.6mmol/L

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what is the electrolyte range for magnesium?

0.6-1mmol/L

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what is the electrolyte range for phosphate?

0.87-1.45mmol/L

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what is the electrolyte range for sodium?

133-146mmol/L

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what is the normal range for potassium?

potassium 3.5-5.3mmol/L

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what side effects can occur from hypokalaemia?

muscle cramps, rhabdomyolysis, fatigue, palpitations, arrhythmias

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what side effects can occur from hyperkalaemia?

fatigue, numbness, nausea, SOB , chest pain, palpitations

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what side effects can occur from hyponatraemia?

nausea, headaches, confusion, fatigue, irritability , seizures

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what side effects can occur from hypernatraemia?

thirst, fatigue, confusion

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what side effects can occur from hypocalcaemia?

muscle cramp, confusion, depressed, forgetful

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what side effects can occur from hypercalcaemia?

nausea, lethargy, muscle cramp, confusion and arrhythmias

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what drugs can cause hypokalaemia?

ABCDE I
-aminophylline/ theophylline
-beta agonists
-corticosteroid’s
-diuretics (loop/thiazides)
-Erythromycin/ clarithromycin
Insulin

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what drugs cause hyperkalaemia?

THANKS, B
-Trimethoprim
-Heparins
-ACEi/ARBs
-NSAIDS
-K-sparing diuretics
-Beta blockers

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imbalances with potassium can lead to what occurring?

cardiac side effects such as arrhythmias

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what drug toxicity can hypokalaemia predispose a patient to?

digoxin and lithium toxicity

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what is the treatment from mild to moderate hypokalaemia?

oral replacements therapy (sando-K tablets)

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what is the treatment for severe hypokalaemia?

IV KCL in Nacl

in what type of patients do you have to replace potassium cautiously with?

renal impaired patients
risk of hyperkalaemia secondary to impaired potassium excretion

what is the treatment for acute severe hyperkalaemia? plasma conc >6.5mmol/L

-urgent treatment
-IV calcium chloride 10%/ calcium gluconate 10%
-IV soluble insulin (5-10 units) with glucose 50/5 given over 5-15mins
-salbutamol (nebulisation or slow IV injection
-drugs exacerbating hyperkalaemia should be reviewed and stopped

what is the treatment for mild-moderate hyperkalaemia?

-ion-exchange resins may be used to remove excess potassium (calcium resonium)

what drugs cause hyponatraemia?

Certain Drugs Ditch Salt
-carbamazepine
-diuretics
-desmopressins/vasopressin
-SSRIs

what drug drugs cause hypernatraemia?

-sodium bicarbonate/ chloride
-corticosteriods
-effectvescent formulations
-oestrogens/ androgens

what is the treatment for hyponatraemia mild?

oral supplements : sodium chloride ir sodium bicarbinate

what is the treatment for severe hyponatareamia?

IV NaCl

what is the recommendation of calcium for those with osteoporosis?

double recommend amount reduces rate of bone loss

what other medication is given with calcium?

vitamin D

what should be done in cases of severe acute hypocalcaemia?

-IV calcium gluconate 10% slowly. with plasma-calcium and ECG monitoring too fast can cause arrythmias -repeat if needed or follow with continuous infusion to prevent recurrence

what should be done to treat severe hypercalcaemia?

-correct dehydration -discontinue drugs , restrict dietary calcium -bisphophonates and pamidronate disodium used -corticodsteriods used if hypercalaemia is due to sarcoidosis or via d toxicity -calcitonin used n hypercalaemia with maligancy

what is the treatment for hypercalcuria?

-increase fluid intake and give bendroflumethaizide -reduce dietary calcium

what is hyperparathyroidism?

excess parathyroid hormone which can lead to hypercalcaemia, hypophosphataemia and hypercalciuria

what can hyperpararthyroidism cause?

-thirst, polyuria, constipation, fatigue, memory impairment, CVD, kidney stones and osteoporosis and affects women more than men most common in 50-6 years olde

what is treatment for hyperparathyroidism?

parathyroidecomy surgery then assess CVD risk and fracture risk drug therapy -cinacalcet if surgery has been unsuccessful/declined -secondary care measure vit D levels and supplement if needed give bisphosphonate to reduce fracture risk

what is magnesium used for?

essenial in enzyme systems, energy generation- stored in skeleton

how is magnesium excreted?

kidneys therefore retained in renal failure leading to hypermagnesaemia

what can cause hypermagnesaemia? and treatment

-can cause muscle weakness and arrhymias -calcium glutinate injection is used for management of magnesium toxicity

what is the treatment of hypomagnesaemia?

symptomatic: IV/IM magnesium sulfate mild: oral magnesium

What patients get hypophsphataemia?

alcohol dependance or severe DKA

What is the treatment for hypophosphateaemia?

phosphate supplements

what is the treatment for hyperphosphateamia?

-phosphate binding agents (calcium-based or non-calcium based preps)

patients with stage 4/5/ CKD what should be recommended to them with hyperphosphataemia?

manage diet + dialysis before starting agent

what is 1st, 2nd, 3rd line for hyperphostpahtaemia?

1st- calcium acetate 2nd- sevelamer 3rd- CaCO3 calcium-based or sucroferric oxygdroxide (non-calcium based