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critical care > specific electrolytes > Flashcards

specific electrolytes Flashcards

1
Q

which electrolyte is essential for regulating nerve impulse conduction, cardiac & muscle contraction

A

potassium

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2
Q

how is potassium maintained

A

dietary intake and renal excretion

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3
Q

where is most potassium located?

A

skeletal muscles

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4
Q

when is hyperkalemia seen?

A

in oliguric phases (can’t excrete)

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5
Q

clinical finding of hyperkalemia

A

muscle weakness/flaccid paralysis
nausea
EKG changes (peaked T waves, prolonged PR, widened QRS, vfib/asystole)

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6
Q

what EKG changes are in hyperkalemia

A

peaked t waves
prolonged QRS & PR
vfib/asystole

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7
Q

treatment of hyperkalemia(4)

A

diuretics! (if kidneys can produce urine)
IV insulin countered with glucose
sodium polystyrene (kayexalate)!!!!
renal replacement (dialysis)

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8
Q

clinical findings in hypokalemia

A

EKG changes (depressed ST, flat/inverted T waves!!, dysrhythmia)
hypotension

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9
Q

treatment of hypokalemia

A

potassium replacement

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10
Q

which electrolyte is a major extracellular cation & major predictor of serum osmolality & movement of H2O in body?

A

sodium

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11
Q

what is sodium regulated by?

A

kidneys and ECF concentration

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12
Q

how does sodium relate to dehydration?

A

low sodium = over-hydration (diluting)
high sodium = dehydration

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13
Q

clinical findings of hyponatremia

A

weakness
lethargy
HA
confusion
tremor/convulsion/seizure
respiratory arrest (fluid overload)

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14
Q

treatment if hyponatremia with AKI

A

fluid restriction
diuretics
renal replacement therapy

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15
Q

clinical findings of hypernatremia

A

dehydration from diuresis
tachycardia/hypotension
neuro changes (muscle irritability, convulsions, restlessness, dec. LOC)

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16
Q

treatment of hypernatremia

A

hypotonic IVF (0.45 NS) administered slowly

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17
Q

which electrolyte has absorption from small intestine under the influence of vitamin D

A

calcium

18
Q

what is calcium regulated by at the renal level

A

PTH

19
Q

where is calcium mainly stored

A

skeletal system

20
Q

which electrolyte is important in neuromuscular impulses

A

calcium

21
Q

clinical findings of hypocalcemia

A

dec. CO & contraction strength
dysrhythmias (prolonged QT)
inc. bleeding
muscle spasms (Chvostek’s sign, facial / Trousseau sign, fingers contract with BP)

22
Q

what dysrhythmia is seen with hypocalcemia

A

prolonged QT interval

23
Q

what muscle spasms are seen in hypocalcemia

A

Chvostek’s (facial nerve spasm)
Trousseau’s (fingers contract when taking BP)

24
Q

treatment of hypocalcemia

A

calcium replacement
diet lowin phosphorus

25
Q

clinical findings of hypercalcemia

A

weakness, muscle flaccidity, bone pain
drowsy/lethargy
EKG changes (shortened QT / heart block)

26
Q

what EKG changes are seen in hypercalcemia

A

shortened QT and heart block

27
Q

treatment of hypercalcemia

A

diet modification
calcitonin therapy
diuretics (to promote excretion)

28
Q

which electrolyte is a major intracellular anion that is the source of ATP

A

phosphorus

29
Q

what is phosphorus regulated by at renal level

A

PTH

30
Q

what relationship does phosphorus have to calcium

A

inverse
if one is high, the other is low

31
Q

clinical findings of hyperphosphatemia

A

usually asymptomatic unless also having hypocalcemia
hyperreflexia/muscle weakness/flaccid paralysis
severe pruritis

32
Q

examples of food with high phosphate

A

dairy, processed meat, nuts, carbonated beverages

33
Q

treatment of hyperphosphatemia

A

calcium carbonate (OsCal/Tums), calcium acetate, sevelamer hydrochloride
dietary restriction (difficult)

34
Q

clinical findings of hypophosphatemia

A

muscle weakness (monitor resp fxn)
tissue hypoxia (lack of ATP)
dec. reflexes
bone pain

35
Q

treatment of hypophosphatemia

A

phosphate replacement

36
Q

which electrolyte is responsible for transmission of sodium and potassium across cell membrane and release of PTH

A

magnesium

37
Q

dec. levels of magnesium do what to calcium and potassium?

A

decrease calcium and potassium

38
Q

when magnesoum, calcium, and potassium are low, what do you replace 1st?

A

magnesium
can help fix the others

39
Q

clinical findings of hypomagnesemia

A

dysrhythmia (PVC)
lethal dysrhythmais (Vtach and Vfib)

40
Q

which lethal and nonlethal dysrhythmias come from hypomagnesemia

A

nonlethal = PVC
lethal = Vtac & Vfib

41
Q

treatment of hypomagnesemia

A

replacement (replace mag before potassium)

critical care (23 decks)

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