Hyper and Hypo Conditions/"A Salty Tale" Flashcards
Kidney disease, water loss from diarrhea/sweat, vomiting, or too little water intake may result in _____.
a. hyponatremia
b. hyperkalemia
c. hypophosphatemia
d. hypernatremia
d. hypernatremia
S/S of hypernatremia.
Tachycardia Excessive thirst Anxiety Fatigue AMS Seizures
S/S of hyponatremia
MOA: Caused by the inability of neurons to depolarize. Fatigue Nausea Vomiting Muscle spasms Weakness
CHF, some kidney diseases, burns, and overhydration may result in _____.
a. hyponatremia
b. hyperkalemia
c. hypophosphatemia
d. hypernatremia
a. hyponatremia
Above 280 mEq/L, the body does what to produce a response to dilute increased osmolarity?
- Increases thirst
- Releases arginine vasopressin (ADH) to reduce water loss
Osmoreceptors in the ____ release vasopressin/ADH to combat increased serum osmolarity.
a. Carotid body
b. Hypothalamus
c. Frontal cortex
d. Juxtaglomerular apparatus
b. Hypothalamus
The thirst mechanism is so effective in prevent hypernatremia, that hypernatremia is often only found in individuals with _____.
little access to water.
Why is hypernatremia damaging to the brain?
How does the body correct this?
Increased ECF osmolarity causes diffusion of water OUT of brain cells, causing shrinking of said cells.
The cells begin to produce amino acids/proteins, polyols, etc, to increase the osmotic pressure within the cells, “pulling” water back into them, thereby restoring normal cellular volume.
Explain the pathophysiology of seizure in hypernatremia.
Increased [Na] ECF will lead to depolarization of neurons, and any additional depolarization may cause seizures.
Explain the pathophysiology of tachycardia in hypernatremia.
Hypernatremia acts as to increase osmotic pressure. Therefore, increased [Na]ECF will “pull” water from cells/vasculature. This will cause tachycardia 2/2 to hypovolemia.
List common causes of hyponatremia:
- liver disease
- overhydration
- CHF
- burns
What neurologic/neuromuscular symptoms are associated with hyponatremia?
- fatigue
- spasms/weakness
- seizures
In patient’s experiencing hypernatremia, when is the ONLY time that pre-hospital providers should provide normal saline (0.9%)?
When the patient is experiencing hemodynamic comprise 2/2 depletion of ECF volume.
Potassium is important in what stage of the action potential?
a. Phase 0
b. Phase 1
c. Phase 2
d. Phase 3
d. Phase 3
- Depolarization of cells opens the voltage gated potassium channels.
- This causes potassium to flow down its concentration gradient from inside to outside the cell, hyperpolarizing the cell.
Normal lab value for potassium.
3.5-5.0 mEq/L
Causes of hyperkalemia
- renal failure
- potassium sparing diuretics
- NSAIDs
- ACE inhibitors
- Heparin
S/S of hyperkalemia
- weakness/fatigue/numbness/tingling (inability to reset neuronal RMP)
- wide QRS complexes on EKG
- unusually tall, peaked T waves on EKG
- Both EKG changes are due to a higher ECF {K] than normal, preventing the repolarization of cells, so they remain in a depolarized state
Causes of hypokalemia
- kidney disease
- vomiting/diarrhea
- beta blocker overdose (moves K back into cells by unknown MOA)
- non-potassium sparing diuretics
- certain antibiotics
S/S of hypokalemia
- weakness
- fatigue
- cramping/constipation
Importance of chloride in physiology.
- maintain fluid balance
- prevent significant changes to pH
Causes of hyperchlorinemia
- massive diarrhea
- kidney disease
- PT glad disease
S/s of hyperchlorinemia
- headache
- nausea
- fatigue
- tachypnea 2/2 metabolic acidosis
S/S of hypochlorinemia
- tetany
- weakness
- trouble breathing
- fever
Causes of hypochlorinemia
- excessive sweating/urination
- vomiting
- adrenal gland disease
