specific electrolytes

Question 1

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

Answer 1

potassium

Question 2

how is potassium maintained

Answer 2

dietary intake and renal excretion

Question 3

where is most potassium located?

Answer 3

skeletal muscles

Question 4

when is hyperkalemia seen?

Answer 4

in oliguric phases (can’t excrete)

Question 5

clinical finding of hyperkalemia

Answer 5

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

Question 6

what EKG changes are in hyperkalemia

Answer 6

peaked t waves
prolonged QRS & PR
vfib/asystole

Question 7

treatment of hyperkalemia(4)

Answer 7

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

Question 8

clinical findings in hypokalemia

Answer 8

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

Question 9

treatment of hypokalemia

Answer 9

potassium replacement

Question 10

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

Answer 10

sodium

Question 11

what is sodium regulated by?

Answer 11

kidneys and ECF concentration

Question 12

how does sodium relate to dehydration?

Answer 12

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

Question 13

clinical findings of hyponatremia

Answer 13

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

Question 14

treatment if hyponatremia with AKI

Answer 14

fluid restriction
diuretics
renal replacement therapy

Question 15

clinical findings of hypernatremia

Answer 15

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

Question 16

treatment of hypernatremia

Answer 16

hypotonic IVF (0.45 NS) administered slowly

Question 17

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

Answer 17

calcium

Question 18

what is calcium regulated by at the renal level

Answer 18

PTH

Question 19

where is calcium mainly stored

Answer 19

skeletal system

Question 20

which electrolyte is important in neuromuscular impulses

Answer 20

calcium

Question 21

clinical findings of hypocalcemia

Answer 21

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

Question 22

what dysrhythmia is seen with hypocalcemia

Answer 22

prolonged QT interval

Question 23

what muscle spasms are seen in hypocalcemia

Answer 23

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

Question 24

treatment of hypocalcemia

Answer 24

calcium replacement
diet lowin phosphorus

Question 25

clinical findings of hypercalcemia

Answer 25

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

Question 26

what EKG changes are seen in hypercalcemia

Answer 26

shortened QT and heart block

Question 27

treatment of hypercalcemia

Answer 27

diet modification calcitonin therapy diuretics (to promote excretion)

Question 28

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

Answer 28

phosphorus

Question 29

what is phosphorus regulated by at renal level

Answer 29

PTH

Question 30

what relationship does phosphorus have to calcium

Answer 30

inverse if one is high, the other is low

Question 31

clinical findings of hyperphosphatemia

Answer 31

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

Question 32

examples of food with high phosphate

Answer 32

dairy, processed meat, nuts, carbonated beverages

Question 33

treatment of hyperphosphatemia

Answer 33

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

Question 34

clinical findings of hypophosphatemia

Answer 34

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

Question 35

treatment of hypophosphatemia

Answer 35

phosphate replacement

Question 36

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

Answer 36

magnesium

Question 37

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

Answer 37

decrease calcium and potassium

Question 38

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

Answer 38

magnesium can help fix the others

Question 39

clinical findings of hypomagnesemia

Answer 39

dysrhythmia (PVC) lethal dysrhythmais (Vtach and Vfib)

Question 40

which lethal and nonlethal dysrhythmias come from hypomagnesemia

Answer 40

nonlethal = PVC lethal = Vtac & Vfib

Question 41

treatment of hypomagnesemia

Answer 41

replacement (replace mag before potassium)