Fluids and Electrolytes

Question 1

Hyponatremia

Answer 1

salt loss
s-stupor/coma
a-anorexia nausea vomiting
l-lethargy
t-tendon reflex decreased
l-limp/weak muscles
o-orthostatic htn
s-seizure headache
s-stomach cramping

Question 2

Hypernatremia

Answer 2

fried swine salt model

f-flushed skin
r-restlessness
i-⬆️fluid retention⬆️BP
e-edema
d-⬇️ urinary output, dry mouth

s-sleepy
w-weakness
i-irritability
n-neuromuscular excitability
e-edema

s-skin flushed
a-agitated
l-low grade fever
t-thirst

m-medications /meals
o-osmotic diuretics
d-diabetes insipidus
e-excessive water loss
l-low water intake

Question 3

Hypokalemia

Answer 3

6 Ls

L-lethargy
L-leg cramps
L-limp muscles
L-low shallow respirations
L-lethal cardiac dysrhythmias
L-lots of urine output

Question 4

Hyperkalemia MACHINE

Answer 4

MACHINE

Medications - ACE Inhibitors, NSAIDS, potassium-sparing diuretics
Acidosis - Metabolic and respiratory
Cellular destruction - burns, traumatic injury, hemolysis
Hypoaldosteronism - Addison’s
Intake- excessive
Nephrons- renal failure
Excretion - Impaired

Question 5

Hyperkalemia MURDER

Answer 5

MURDER

Muscle weakness
Urine- oliguria, anuria
Respiratory distress
Decreased cardiac contractility
ECG changes
Reflexes- hyperreflexia, or areflexia (flaccid)

Question 6

Hyperkalemia AIRED

Answer 6

AIRED
Administer IV Calcium - to immediately decrease cardiac toxicity

Increase excretion - via both stool (kayexlate) and urine (diuretics)

Remove sources of potassium - from all sources, including enteral, pareteral, IV, and PO

Enhance potassium uptake into cells - insulin, glucose, sodium bicarb, beta-adrenergic antagonists

Dialysis - emergent response for patients with lethal hyperkalemia

Question 7

Hypocalcemia

Answer 7

CATS of hypocalcemia

Convulsions
Arrhythmias
Tetany
Spasms stridor seizure

Question 8

Hypercalcemia

Answer 8

GMO BS
Groans - constipation
Moans - joint pain
Overtones - psychiatric overtones (confusion, depression)
Bones - loss of calcium from bones
Stones - kidney stones

Question 9

Hypo/Hypermagnesemia

Answer 9

same with Hypo/Hypercalcemia respectively

Question 10

Hypo/Hypermagnesemia

Answer 10

same with Hypo/Hypercalcemia

Question 11

Hypo/Hyperphosphatemia

Answer 11

opposite of Hypo/Hypercalcemia respectively

Question 12

ECG Hypokalemia

Answer 12

ST depression
Shallow, flat, or inverted T wave
Prominent U wave

Question 13

ECG Hyperkalemia

Answer 13

Tall peaked T waves
Flat P waves
Widened QRS complexes
Prolonged PR interval

Question 14

ECG Hypocalcemia

Answer 14

Prolonged ST segment
Prolonged QT interval

Question 15

ECG Hypercalcemia

Answer 15

Shortened ST segment
Widened T wave
Heart block

Question 16

ECG Hypomagnesemia

Answer 16

Tall T waves
Depressed ST segment

Question 17

ECG Hypermagnesemia

Answer 17

Prolonged PR interval
Widened QRS complexes

Question 18

IV Potassium

Answer 18

-no push, IM or subq
-rotate & invert bag
-labeled visibly
-infusion pump
-cardiac monitor
-iv site
-i&o

Question 19

chvostek’s sign

Answer 19

hypocalcemia
-facial reaction after light tapping over facial nerve in front of ear

Question 20

trousseau’s sign

Answer 20

hypocalcemia
-italian hand sign after inflating BP cuff

Question 21

sources of insensible (fluid) loss

Answer 21

perspiration
lung expiration

Question 22

liquid potassium chloride

Answer 22

given with juice or another liquid

Question 23

sodium polystyrene sulfonate

Answer 23

kayexalate
for pat c kidney diseases
K excretion, Na absorption

Question 24

salt subsitutes

Answer 24

high potassium containing

Question 25

fresh blood for hyperkalemia

Answer 25

old blood has more K than fresh

Question 26

lithium toxicity

Answer 26

hyponatremia ⬇️ lithium excretion

Question 27

Vitamin D

Answer 27

aids absorption of Ca

Question 28

insulin + glucose

Answer 28

fastest way to decrease K

Question 29

⬆️ K + ECG changes

Answer 29

Calcium Gluconate first before insulin+dextrose