Metabolic and Electrolyte Emergencies Flashcards
Major plasma electrolytes
Na
Cl
HCO3
Major intracellular
K
Mg
Lack of insulin treatment
Insulin
Excess insulin
Diet and meds
Metformin
Excess supply
Reduction, insulin
TPN composition
Describe DKA
Patient lacks insulin and produces ketone bodies.
Problem of dehydration
Abdominal pain
Fluid of choice
Lactated ringers
Classic presentation of hypoglycemia
Altered mental status
Hypoglycemia treatment
IV glucose Glucagon Thiamine Octreotide Oral glucose/food
Hypernatremia presentation is typically…?
Neurologic
Hypernatremia causes
Loss of free water
Central DI
Primary hypodipsia
Hypernatremia cause
Treat the cause and slowly correct over 2-3 days
The risk is dehydrated cells will swell
Hyponatremia treatment
Restrict free water best
Hypertonic saline
Hyperkalemia presentation
Weakness
Paralysis
Dysrhythmias
Cardiac death
Hyperkalemia causes
Dehydration Renal failure Aldosterone disorders pH-dependent Pseudohyperkalemia
Hyperkalemia treatment
Act first, think later IV glucose/insulin Albuterol inhalation Fluids and loop diuretics Exchange resins Dialysis
Hypokalemia Labs
U-waves on EKG
Alkalosis
Hypokalemia causes
Renal loss
Insensible
Redistribution
Binding
Hypokalemia treatment
ORAL** 40mEq now liquid, 40 mEq in matrix
IV only if GI tract inoperative
The primary presentation of hypercalcemia
Primarily neurologic
Hypercalcemia EKG
Short QT
Osborn waves
Hypercalcemia treatment
Severity of symptoms will determine how rapid you treat
IV saline
Bisphosphonates
Glucocorticoids
Hypocalcemia presentation
Neuromuscular
Chvostek’s sign
Trousseau’s sign
Prolonged QT
Hypocalcemia cause
Impaired PTH production
Hypocalcemia treatment
IV CaGluconate
Replete Mg
