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PR - BLOOD + NUTRITION > FLUID + ELECTROLYTE IMBALANCE > Flashcards

FLUID + ELECTROLYTE IMBALANCE Flashcards

1
Q

Calcium

A

2.2-2.6

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2
Q

Which electrolytes are we concerned with?

A
  • Ca
  • Mg
  • K
  • Na
  • Ph
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3
Q

Magnesium

A

0.6-1

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4
Q

Phosphate

A

0.87-1.45

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5
Q

Potassium

A

3.5-5.3

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6
Q

Sodium

A

113-146

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7
Q

K - results

A
  • Normal: 3.5 - 5.3 mmol/L
  • Hyper: >6.5 (you might see changes in ECG)
  • Нуро: <2.5
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8
Q
A
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9
Q

Hypokalaemia - side effects

A

Muscle cramps, rhabdomyolysis, fatigue, palpitations, arrhythmias

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10
Q

Hyperkalaemia - side effects

A

Fatigue, numbness, nausea, SOB, chest pain, palpitations

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11
Q

Hyponatraemia - side effects

A

Nausea, heaHypernatraemia: Thirst, fatigue, confusiondache, confusion, fatigue, irritability, seizures

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12
Q

Hypernatraemia - side effects

A

Thirst, fatigue, confusion

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13
Q

Hypocalcaemia - side effects

A

Muscle cramp, confusion, depressed, forgetful

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14
Q

Hypercalcaemia - side effects

A

Nausea, lethargy, muscle cramps, confusion, arrythmias

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15
Q

Potassium

A

Imbalance leads to cardiac side-effects such as arrythmias

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16
Q

Hypokalaemia - drugs

A

Aminophylline / Theophylline
Beta Agonists
Corticosteroids
ACE-Inhibitors / ARBs
Diuretics (Loop / Thiazides)
Erythromycin / Clarithromycin
Insulin
ABCDE I

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17
Q

Hyperkalaemia - drugs

A

Trimethoprim
Heparins
ACE-Inhibitors / ARBs
NSAIDS
K-Sparing Diuretics
Insulin
Beta Blockers
THANKS, B

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18
Q

Hypokalaemia - digoxin

A

Hypokalaemia predisposes patients taking digoxin to toxicity

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19
Q

Mild-moderate hypokalaemia treatment

A

Oral replacement therapy (Sando-K tablets)

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20
Q

Severe Hypokalaemia treatment

A

IV KCL in NaCl

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21
Q

Hypokalaemia - renal impairment

A

Potassium replaced cautiously in patients with renal impairment

Risk of hyperkalaemia secondary to impaired potassium excretion

22
Q

Acute severe hyperkalaemia

A

(plasma concentration > 6.5 mmol/litre):

23
Q

Acute severe hyperkalaemia treatment

A
  • Urgent treatment
  • IV calcium chloride 10% / calcium gluconate 10%
  • IV soluble insulin (5-10 units) with 50 mL glucose 50% given over 5-15 minutes
  • Salbutamol (nebulisation or slow IV injection)
  • Drugs exacerbating hyperkalaemia should be reviewed and stopped as appropriate
24
Q

Mild-moderate hyperkalaemia treatment

A

lon-exchange resins may be used to remove excess potassium (Calcium Resonium)

25
Hyponatraemia - drugs
Carbamazepine Diuretics Desmopressin / Vasopressin SSRIs CERTAIN DRUGS DITCH SALT SALTY CEO Hyponatraemia: Mild - moderate: oral supplements (sodium chloride or sodium bicarbonate) Severe: IV NaCl Copyright property of RevisePharma. Unauthorised recording and reproduction of this lecture will result in being refferred to the GPhC under copyright infringement law. nation Classification: General 20
26
Hypernatraemia - drugs
Sodium Bicarbonate / Chloride Corticosteroids Effervescent formulations Oestrogens / Androgens SALTY CEO
27
Mild moderate Hyponatraemia - treatment
oral supplements (sodium chloride or sodium bicarbonate)
28
Severe hyponatraemia - treatment
Severe: IV NaCl
29
Hypocalcaemia - drugs
Rifampicin Phenytoin Phenobarbital
30
Hypercalcaemia - drugs
Thiazide diuretics Lithium
31
Hypocalcaemia - treatment
* Calcium supplements needed if dietary calcium intake is deficient * Osteoporosis: double recommended amount reduces rate of bone loss * Oral supplements of calcium given with vitamin D
32
Severe acute hypocalcaemia or hypocalcaemic tetany
* Initial slow IV calcium gluconate 10% with plasma-calcium and ECG monitoring (Arrhythmias if given rapidly) * Repeated if needed or follow with continuous IV infusion to prevent recurrence
33
Severe hypercalcaemia
Correct dehydration first with IV NaCl 0.9% Discontinue drugs which cause hypercalcaemia, restrict dietary calcium Bisphosphonates and pamidronate disodium used
34
hypercalcaemia is due to sarcoidosis or vitamin D toxicity
Corticosteroids
35
hypercalcaemia associated with malignancy
Calcitonin
36
Hypercalciuria
Increase fluid intake + give bendroflumethiazide Reducing dietary calcium intake but not severe restriction (harmful)
37
Hyperparathyroidism
Excess parathyroid hormone → hypercalcaemia, hypophosphataemia and hypercalciuria
38
Symptoms of hyperparathyroidism
Thirst, polyurea, constipation, fatigue, memory impairment, CVD, kidney stones and osteoporosis
39
Who does parathyroidism effect more?
Affects twice as many women than men - most common in women aged 50 to 60 years
40
Hyperparathyroidism - first line treatment
Parathyroidectomy surgery is the recommended first-line Assess CVD risk and fracture risk
41
Hyperparathyroidism - second line treatment
Cinacalcet if surgery has been unsuccessful / declined In secondary care, measure vitamin D levels, supplement if needed To reduce fracture risk: a bisphosphonate
42
Magnesium - function
Essential in enzyme systems, energy generation - stored in the skeleton
43
Magnesium - excreted in
Excreted by kidneys therefore retained in renal failure, which causes hypermagnesaemia
44
Hypermagnesaemia - symptoms
Causes muscle weakness and arrhythmias
45
Hypermagnesaemia - treatment
Calcium gluconate injection is used for the management of magnesium toxicity
46
Hypomagnesaemia Symptomatic - treatment
V / IM magnesium sulfate (IM = painful)
47
Hypomagnesaemia mild - treatment
PO magnesium
48
Hypophosphataemia
* In patients with alcohol dependence or severe DKA * Oral phosphate supplements
49
Hyperphosphataemia
Phosphate binding agents (calcium-based or non-calcium-based preparations) Patients with stage 4/5 CKD: manage diet + dialysis before starting agents 1st line: Calcium acetate 2a line: Sevelamer 3a line: CaCO, (calcium-based) or sucroferric oxyhydroxide (non-calcium-based)
50

PR - BLOOD + NUTRITION (13 decks)

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