Fluid & electrolyte disturbances Flashcards
1
Q
hyponatremia- Sx
A
- Nausea, malaise, HA, disorientation
- Seizure
- Coma
- Brain damage
- Resp arrest
- Brainstem herniation
- Often due to H2O inbalance rather than Na
2
Q
hyponatremia- Dx
A
- Serum electrolytes
- creatinine,
- osmolality,
- urine sodium
3
Q
hyponatremia- Tx
A
- Restrict water
- Isotonic fluids
- Diuretics
- Discontinue meds
- Vasopressin antagonists
4
Q
Hypernatremia- Sx
A
- Orthostatic hypotension
- Oliguria
- Lethargy, irritability, weakness
- hyperthermia, delirium, seizures, coma
- May not be specific in elderly
5
Q
Hypernatremia- Dx
A
- Urine osmolality
- Serum osmolality
6
Q
Hypernatremia- Tx
A
- Correct fluid loss with dextrose & saline water over 48 hrs
- Add K & phosphate as needed
7
Q
Hypokalemia- Sx
A
- Muscular weakness, muscle cramps
- Hyporeflexia, hypercapnia, tetany, rhabdomyolysis
- Hypertension
8
Q
Hypokalemia- Dx
A
- ECG- U waves
- Serum & urine concentration
- TTKG
- Hypomagenesmia
9
Q
Hypokalemia- Tx
A
- Dietary to IV K
- Mg required to replete
10
Q
Hyperkalemia- Sx
A
- Abd distension & diarrhea
- Musc weakness, flaccid paralysis, ileus
- Cardiac arrythmias
11
Q
Hyperkalemia- Dx
A
- Plasma potassium
- Creatinine, lytes
- ABG
ECG- peaked T waves
12
Q
Hyperkalemia- Tx
A
- Withhold K
- Insulin, bicarb, beta agonists to shift K into cells
- IV Ca++ to stabilize myocardium
- Hemodialysis
13
Q
Hypocalcemia- Sx
A
- Extensive spasm- cramps & tetany
- Laryngospasm with stridor
- Covulsions, paresthesias, abd pain
- Trousseau sign
- Chvostek sign
14
Q
Hypocalcemia- Dx
A
- Serum calcium
- Elevated serum phosphate
- PTH
- Low serum Mg
- Vit D levels
- ECG- Prolonged QT interval
15
Q
Hypocalcemia- Tx
A
- Calcium infusion over 4-6 h
- Oral/ IV Ca++ carbonate
- Vit D
Thiazide diuretic to reduce renal loss
