Minerals Flashcards
Of all body tissues, which is least hydrated
adipose
The most clinically important fluid compartment is
extracellular (ECF)=intravascular/interstitial spaces
What is the dominant extracellular osmole that acts to hold water in the ECF
Sodium
Regulates cell volume
Na, K, ATPase
Plasma oncotic and hydrostatis pressures that govern the movement of fluid between plasma and ICF
Starling forces
Normal plasma osmolality
275-290 mOsm/kg
This regulates water balance
thirst sensation and control of water excretion by ADH
Regulate ECF volume & water distribution in the body
Sodium
Average Sodium intake in diet/day
2.3-5.7 grams
Sodium loss occurs primarily through
urine
High Body Fluid of Sodium in these organs
duodenum, ileum, pancreas, bile (140)
High content K+ in these body fluids
saliva, colon
Minimum amt Sodium (without sweating/healthy)
8 mEq/day
Adequate intake for young adults
65 mEq/day
Sodium correction should not exceed
5-10 mEq/kg/day
Normal Saline (.9%) Sodium content
154 mg Na/154 mg Cl
LR Sodium content
130 mg Na/109 Cl, 4K, 3Ca
Bicarb from what body fluid
pancreatic
Macromineral inside of the cells that plays a role in cell metabolism incl pro/glycogen synthesis
Potassium
Stool losses of potassium in what condition
chronic renal insufficiency
Average Intake Potassium Adults
120 mEq/day
Low K+ levels (below 3) can cause this GI s/s
constipation
Metabolic acidosis can cause
hypokalemia/hyperkalemia
IV K+ repletion not to exceed
10-20 mEq/hr
Meds that increase renal K+ losses
ampho-B, Diuretics, steroids, penicillins
Tissue catabolism
Hyperkalemia
What Macromineral infused to aid hyperglycemia
IV Calcium gluconate
Also aid Hyperkalemia
insulin +dextrose,Na Bicarb, albuterol, lasix, HD
Mineral found ICF
Magnesium (50% in bone), cardiac muscle, skeletal muscle, liver
Enzyme reactions governed by this mineral
Magnesium
Mag absorbed
distal jejunum/ileum
Mag in PN
8-20 mEq/day
Hypomagnesium refractory to treatment if these lytes are abnormal
Low K & Ca
Diseases cause low Mag
P-C Malnutrition, Mag free IVF, ETOH, malabsorption, short bowel, intestinal bypass
Intracellular shifts in Mag with these conditions
DKA, refeeding, MI, hyperthyroidism
Replete Magnesium ENT vs IV
IV preferred d/t GI intolerance
Treat Elevatd Mag with
IV Ca Gluconate/chloride
Under hormonal control mediated by PTH, Vit D and calcitonin
Calcium
Metabolic acidosis and high PO4 do what to Calcium
decrease the % of ionized Calcium
Low Calcium assoc with these d/o
dec VIt D, dec PTH activity, hungry bone syndrome, sepsis, rhabdo, massive bld transfusions
Drugs that decrease Ca
lasix, calcitonin, phenobarb, dilantin
Calcium is absorbed in
duodenum
Calcium is excreted via
urine
Tetany
Low Calcium
Hypercalcemia seen with
hyperparathyroidism, cancer with bone mets, toxic levels Vit A & D, TB, lithium, thiazide diuretics
Treat severe high Ca
IV NS @ 200/300cc/hr then lasix or HD
Main intracellular anion with functions incl bone/cell membrane composition and maintenance of normal pH.
Phosphorus
REquired in all cellular functions requiring energy
Phosphorus
What causes shifts Phos ICF
glucose/insulin, alkalosis
What causes release Phos to ECF
cell destruction, acidosis
Phosphorus absorbed in
jejunum
Phosphorus extreted via
urine
Low Phos is these d/o
chronic ETOH, critical illness, resp/metabolic alkalosis, following treatment for DKA, refeeding
Phos repletion enterally may cause
diarrhea with ? absorption
IV Phos with Na or K+?
Potassium
K+ Phos IV may cause
thombophlebitis at rates over 7mmos/hr
High Phos in what d/o
massive trauma, cytotoxins with leukemias, lymphomas, rhabdo, resp/metabolic acidosis
Treat high Ca in pt with normal renal fx
volume repletion and diuretics