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AP II Test 1 > Fluids and Electrolytes Part 3 > Flashcards

Fluids and Electrolytes Part 3 Flashcards

1
Q

Signs/ symptoms of checking hypocalcemia include: (7)

A
  • mental status changes
  • tetany
  • laryngospasm
  • hypotension
  • dysrrhythmias
  • Chvostek’s sign
  • Trousseau’s sign

Tetany is due to hyperexcitable neurons caused by hypocalcemia.

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2
Q

Carpopedal spasm can be elicited by doing what?

This test is known as what?

A

inflating a BP cuff and maintaining the pressure above SBP

Trousseau’s sign

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3
Q

Chvostek’s sign involves which nerve? How do you test and what does the test elicit?

A

facial

tapping on the nerve anterior to the earlobe

twitching of the lip cause it to spasm at the corners of the mouth and indicates hypocalcemia

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4
Q

What electrolyte disorder is due to:

  • hyperparathyroidism
  • excessive vit D
  • renal failure
  • paraneoplastic disorder (cancer)

EKG changes?

A

Hypercalcemia

Man on a big round hill.

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5
Q

Symptoms are due to what electrolyte imbalance? Abdominal pain or discomfort
Bone pain and fractures
Decreased appetite
Difficulty concentrating
Excessive thirst
Excessive urination
Fatigue
Low back pain
Malaise or lethargy
Muscle twitching or weakness
Nausea and vomiting
Depression

A

hypercalcemia

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6
Q

What is the treatment for hypercalcemia disorders? (5)

A
  • parathyroidectomy
  • diuretics
  • fluid replacement
  • dialysis
  • calcitonin type medications
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7
Q

What electrolyte is this?

  • Essential for production/function of ATP
  • Essential for DNA, RNA, and protein synthesis.
  • Regulates calcium access into the cell and the actions of calcium in the cell.
  • Natural physiological calcium antagonist
A

Magnesium

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8
Q

________ is a membrane stabilizer useful in the treatment of arrhythmias.

A

Magnesium

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9
Q

Many times hypokalemia can not be fully corrected by administration of K + alone .

Magnesium is required for adequate processing of K+, and if the patient’s magnesium is low, they will have refractory ________.

A

hypokalemia

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10
Q

_________ stabilizes and slows everything down, while __________ speeds everything up!

A

Magnesium

Calcium

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11
Q

These patients are at risk for what imbalance?

Critical care patients, athletes, high metabolic states (pregnancy), diuretics/prolonged diarrhea, chronic alcoholics.

A

Hypomagnesemia

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12
Q

Hypomagnesemia <___ mEq/L

A

1.5

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13
Q

What is given?

  • Torsades de pointes . Note: It does not shorten the QT interval significantly but still effective in torsades. It is THE treatment
  • Any refractory VT especially , post MI.
A

magnesium

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14
Q

IV Mag has 100% ____ elimination.

Magnesium also potentiates the NMB, as well as anesthetics, opioids, and hypnotics. AVOID in patients with___ ____!!!!

A

renal

heart block

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15
Q

Hypermagnesemia >____ mEq/L

A

2.5

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16
Q

What condition does this describe?

  • Iatrogenic, laxatives, antacids, patients with renal failure
  • Depresses CNS (Anesthetic?!)
  • Anticonvulsant, due to cerebral vasodilatation.
  • Interferes with NT release, potentiates LA’s and NMB.
  • Decreases PVR
A

hypermagnesia

17
Q

What do these symptoms describe?

Decreased DTR’s, sedation, hypoventilation, bradycardia, hypotension, muscle weakness. EKG changes

DTR= deep tendon reflex

A

hypermagnesemia

18
Q

When do we sample blood gases? (3)

A

significant changes in hemodynamics, blood loss, and desaturation

19
Q

Treatment for hypermagnesemia: 3

A

Diuretics, fluid loading, dialysis

20
Q

Respiratory acidosis

pH < ______
PaCO2 > ___mmHg

A

7.35

45

21
Q

Respiratory alkalosis

pH is high or low?
PaCO2 is high or low?

A

high, >7.45

low, < 35 mmHg

22
Q

Metabolic acidosis

pH is high/low?
HCO3 is high/low?
BE >___ mEq/L (Base Excess)

Base Excess is the amount of proton needed to bring pH back to normal levels

A

low, < 7.35

low < 22 mEq/L

-2

23
Q

Metabolic alkalosis

pH is high/low?
HCO3 is high/low?

A

high, >7.45

high, > 26

24
Q

Treatment for what condition?

  HCO3- (mEq/L)=BE x kg x 0.3
  Treat underlying cause: (Hypovolemia, DKA, Hypoxia, etc)  Blood products, fluid, oxygen, insulin, respiratory compensation (hyperventilation).
A

Metabolic acidosis

25
Q

Treatment: Chloride administration, volume correction with NaCl, respiratory compensation (hypoventilation).
Treat underlying cause ( citrate toxicity, vomiting/GI suction, diuretics)

A

Metabolic alkalosis

26
Q

Signs and symptoms of hypomagnesemia: (3)

A

CNS irritability:

seizures, hyperreflexia, muscle spasm, signs are similar to hypocalcemia.

27
Q

Treatment for hypomagnesemia: (3)

A
  • Magnesium Sulfate (1-2 mEq/kg) over 8-12 hrs.
  • Arrhythmias: IV Infusion: 1-2 g (2-4 ml of a 50% solution) in 10 ml of D5W over 1-2 minutes
  • IV push in cardiac arrest
28
Q

__________ is 18 times more concentrated in the heart than in the plasma and acts as an anticoagulant and vessel dilator, which helps keep the coronary arteries patent.

A

Magnesium

29
Q

Alcohol is a _______ diuretic.

A

magnesium

30
Q

_______ reduces acetylcholine release at the nerve terminal, therefore _______will lead to hyperactive reflexes and ______will lead to hypoactive reflexes.

A

Magnesium

deficiency

overload

31
Q

Hypermagnesemia causes what on EKG? (4)

A

wide QRS

long P-R interval

hypotension

myocardial depression.

32
Q

What is an indicator of the metabolic component of pH in the blood.

A

base excess (BE)

33
Q

Hypoxemia is indicated by a PaO2 ratio less than ____.

A

300

AP II Test 1 (12 decks)

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