RENAL: TO KNOW Flashcards
What do the kidneys do initially when they shut down?
How does the urine look when this happens
conserve Na and H2O
-Decreased urine Na
-Amber urine
what does the loop of henle do?
reabsorbs Na, H2O, and concentrates the urine
what does aldosterone do?
Na and H20 reabsorption
e.g. increase in serum K will trigger a release of aldosterone
what is normal UOP?
0.5ml/kg/hour
what is normal eGFR?
80-120 ml/min
how quickly to correct sodium?
Why?
6-8 mEq/day
Prevent osmotic demyelination syndrome
normal sodium level
according to nicole kupchik
136-145 mEq/L
normal K level
3.5-5.5
hypokalemia can potentiate the toxicity of WHAT drug
digoxin
do you give k or mag first when replacing both?
why?
give mag first.
magnesium deficiency can cause or worsen hypokalemia (low potassium levels), making it difficult to correct potassium deficiencies
sx of hypokalemia
PVCs/vtach (in <2.8)
muscle spasms/cramping
flat T waves
ST depression
u wave
long QT
digoxin toxicity
sx of hyperkalemia
wide QRS
decreased automaticity
P waves disappear
QRS merges with T to form sine wave
can see bradycardia
asystole or v fib
decreased contractility
what are 3 things that cause transcellular shifting of K?
insulin
bicarb
albuterol
bicarb given if pH <7.0.
calcium chloride given as a CARDIOPROTECTANT
normal mag level
1.5-2.5
sx of hypomagnesemia
tachycardia
depressed ST
long QT
PACs, PVCs
hypotension
TORSADES DE POINTES
twitching
cramps
tremors
mentation changes
seiures
sx of hypermagnesemia
MILD: peripheral dilation
hypotension
facial flushing
SEVERE: drowsiness
lethargy
*muscle weakness
what to watch for when giving Mag IV?
hypotension! Mag can vasodilate and cause hypotension, especially if given too quickly. typically given over an hour.
what type of relationship do K and Mag have?
K and Mag go up and down together.
what type of relationship do Phos and Ca have?
inverse relationship
what is a common symptom with hypocalcemia?
prolonged QTc
sx of hypocalcemia
** prolonged QTc
hypotension
low CO (ca is + inotrope)
tingling
spasms
Chvostek’s/Trousseau’s
confusion
bronchospasm
bleeding
PRBC transfusions d/t binding of ca and citrate
normal ical
normal calcium level
ical: 1.1-1.35
ca: 8.5-12
sx of hypercalcemia
this is rare!
N/V
bone and muscle weakness
muscle cramping
bradycardia
lethargy, depression
K imbalances effect the ____ (ECG)
Ca imbalances effect the ____ (ECG)
K imbalances effect the T wave
Ca imbalances effect the QT interval
hypocalcemia = prolonged qtc
hypophosphatemia
