Urinary System, Fluids and Electrolytes Flashcards
(109 cards)
1
Q
Straw colored urine with mild odor
A
normal urine spec gravity 1.010 to 1.050
2
Q
Cloudy Urine
A
may indicate the presence of large amts of protein, blood, bacteria and pus
3
Q
Dark urine
A
may indicate hematuria, excessive bilirubin or highly concentrated urine
4
Q
unpleasant or unusual odor
A
infection or result from certain dietary components or medication
5
Q
Urinary Infection
A
heavy purulence and presence of gram-neg and gram-pos
6
Q
Hematuria
A
Blood in urine
small amt: infection, inflammation, or tumors in urinary tract
large amt: increased glomular permeability or hemorrhage
7
Q
proteinuria / albuminuria
A
leakage of albumin or mixed plasma proteins into filtrate due to inflammation and increased GFR
8
Q
bacteriuria
A
Bacteria in urine
infection in urinary tract
9
Q
Urinary casts
A
microcopic sized molds of teh tubule, consisting of one or more cells, bacterial, protein and others
indicated inflammation of kidney tubules
10
Q
specific gravity
A
indicates ability of tubules to concentrate urine
low spec gravity = dilute urine (with normal hydration)
high spec gravity = concentrated urine (with normal hydration
11
Q
Glucose and ketones
A
found when diabetes mellitus is not will controlled
12
Q
High serum urea or serum creatinine
A
indicate failure to excrete nitrogen wastes
caused by decreased GFR
13
Q
Metabolic acidosis
A
indicates decreased GFR
failure of tubules to control acid-base balance
14
Q
Anemia
A
indicates decreased erythopoietin secretion and/or bone marrow depression
15
Q
Electrolytes
A
depend on related fluid balance
16
Q
antibody level
A
antistreptolysin O or antisteptokinease titers
used to diagnose poststrep. glomerulonephritis
17
Q
Elevated renin levels
A
indicate kidney as a cause of hypertension
18
Q
incontinence
A
loss or voluntary control of the bladder
19
Q
enuresis
A
involuntary urination by child age older than 4
-often related to developmental delay, sleep pattern or psychosocial aspect
20
Q
Stress incontinence
A
common in women
increased intra-abdominal pressure forces urine through sphincter
coughing, lifting, laughing, multiple pregnancies
21
Q
overflow incontinence
A
incompetent bladder sphincter
older adults
- weakened detrusor muscle may prevent complete emptying of bladder
spinal control injuries or brain damage
- neurogenic bladder - may be spastic or flaccid
- interference with CNS and ANS voluntary controls of the bladder
22
Q
Retention
A
inability to empty the bladder
may be accompanied by overflow incontinence
spinal cord injury at sacrallevel blocks micturition reflex
may follow anathesia
23
Q
Urinary Tract infections
A
very common infections urine is an excellent growth medium lower urinary tract infections - cystitis (bladder) - urethritis (urethra) upper urinary tract infections - pyelonephritis (Kidneys, upper tract) common causative organism - e. coli
24
Q
People who get UTIs
A
Most common in women - shortness of urethra and proximity to anus Older men - prostatic hypertrophy -urine retention Congenital abnormalities in children Other common predisposing factors - incontinence -retention of urine -direct contamination with fecal material
25
Cystitis and Urethritis
bladder wall (cystitis) and urethra (urethritis) are inflammed
- hyperactive bladder and reduced capacity
pain is common in pelvic area
Dysuria, urgency, frequency, and nocturia
systemic signs may be present
- fever, malaise, nausea, leukocytosis
Urine is cloudy with unusual odor
Urinalysis indicates bacteriuria, pyuria and microscopic hematuria
26
Pyelonephritis
one or both kidneys involved
from ureter into kidney
purulent exudate fills pelvis and calyces and the medulla is inflammed
abscesses and necrosis can be seen in the medulla and may extend to the cortex to the surface of the capsule
if exudate is severe, it can compress the renal artery and vein and obstruct urine flow to the ureter
Recurrent or chronic infection can lead to scar tissue formation over the calyx
- loss of tubule fuction
- obstruction on aollection of filtrate
- eventual chronic renal failure if untreated
27
Signs or Pyelonephritis
All signs of cystitis plus pain associated with renal disease
- dull aching pain in lower back or flank area
Systemic signs include high temp
Urinalysis
- similar to cystitis
-urinary casts are present***** important ******
28
Glomerulonephritis
many forms
presence of antistreptococcal (ASO) antibodies
- formation of antigen-antibody complex
- activates complement system - hypersensitivity type III
- inflammatory response to glomeruli
--> increased capillary permeability - leakage of some protein and large numbers of erythrocytes
Severe inflammatory response
- congestion and cell proliferation
--> decreased GFR - rentention of fluid and wastes
29
Glomerulonephritis S&S
```
Urine is dark and cloudy
Facial and periorbital edema - initially
- general edema follows
elevated blood pressure
- caused by renin secretion and decreased GFR
Flank or back pain
- edema and stretching of renal capsule
General signs of inflammation
Decreased urine output
```
30
Glomerulonephritis Tests
Blood tests : elevated serum urea and creatinine, elevated anti-DNase B, streptococcal antibodies, antistreptolysin, antistreptokinase, complement levels decreased
Metabolic acidosis
Urinalysis: Proteinuria, hematuria, erthrocyte casts, no evidence of infection
31
Glomerulonephritis treatment
restrict sodium
protein and fluid intake decreased in severe cases
drug treatment: glucocorticoids to reduce inflammation, antihypertensives
32
Nephrotic Syndrome
Abnormality in glomerular capillaries, increased permeability, large amounts of plasma proteins escape into filtrate
May be idipathic in children 2-6
May be 2Nd to SLE, exposure to nephrotoxins or drugs
33
Nephrotic Syndrome Patho
1. Abnormality in the glomerular capillaries and increase in GFR
- large amts of plasma protein (albumin) escape into filtrated
2. Hypoalbuminemia with decreased plasma osmotic pressure
- subsequent generalized edema
3. Blood pressure remains low or normal
- may be elevated depending on angiotensin II levels
4. Increased aldosterone secretion in response to reduced blood volume
- more severe edema
5. High blood cholesterol, lipoprotein in urine, lipiduria with milky appearance to the urine (cause not very clear may be related to liver response to heavy protein loss)
34
Nephrotic Syndrome S & S
Proteinuria, lipiduria, cast
Massive edema
Sudden increase in girth
35
Nephrotic Syndrome Treatment
Glucocorticoids: inflammation
ACE inhibitors: may decrease protein loss in urine
Antihypertensives
Sodium intake may be restricted
36
Nephrosclerosis
vascular disorder
Involves vascular changes in the kidneys - some normal with age
Thickening and hardening of the walls of arterioles and small arteries
Narrowing of the blood vessel lumen
- reduction of blood supply to kidney
- stimulates renin to increase BP
There is continued ischemia because of hardening
- destruction of renal tissue and chronic renal failure
37
Nephrosclerosis Treatment
Antihypertensives
Diuretics
Beta Blockers
Sodium intake should be reduced
38
Polycystic Kidney disease
Autosomal dominant gene on Chromosome 16
No indications in child and young adults - develop around 40
Mulitple cysts develop in both kidneys
- enlargement of kidneys
- compression and destruction of kidney tissue
-chronic renal failure
Diagnosis by CT or MRI
39
Wilms Tumor
Most common tumor in children
Defects in tumor suppressor genes on chromosome 11
Usually unilateral - large encapsulated mass
Pulmonary metastases may be present at diagnosis
40
Acute Kidney Failure
happens abruptly
Kidneys fail to function
Can recover
41
AKI - Pre renal
Due to impaired blood flow
Something happens before the kidney
Example: hemorrhage, shock, heart failure
42
AKI - Intra renal
Something happens to the kidney
| glomerulonephritis, medications, toxins
43
AKI - Post renal
something happens after the kidney
obstruction of urinary outflow (kidney stones, tumor, clots)
blocks urine flow beyond the kidneys
44
S & S of AKI
rapid onset
sharp decrease in urine output: decrease GFR - oliuria - anuria
Increase in BUN & creatinine
Involves both kidneys
Failure is reversible if primary problem is treated early and successfully
Metabolic acidosis & hyperkalemia
- results from the failure of the kidneys to remove wastes
45
Phases of AKI
```
Onset/Initiating Phase: hrs to days from tubular injury
Oliguric Phase (Maintenance Phase): decrease GFR causing sudden retention of metabolites. decrease Urine output - edema, water intoxication and pulmonary congestion. Prolonged oliguria - HTN and uremia
Diuretic phase (Recovery): repair of renal tubules, gradual increase of urine output and decrease serum creatinine - nephrons recovering
```
46
Diagnosis of AKI
important to diagnose early
identify those at risk
urinalysis and bloodwork
Urine panel: Na+, K+, Cl-, creatinine, urine osmolarity
Serum: Urea, nitrogen and creatinine levels
Metabolic acid and high potassium
47
Chronic renal failure
gradual irreversible destruction of the kidneys over a long period of time
Asymptomatic in early stages
May result from:
- CKD
- congenital PKD
- systemic disorders
- low level exposure to nephrotoxins over sustained period of time
48
Chronic renal failure Stages
1. Decreased renal reserve
- decrease in GFR
- higher than normal serum creatinine levels
- no apparent clinical symptoms
2. Renal insufficiency
- decreased GFR to about 20% of normal
- significant retention of nitrogen wastes
- excretion of large volumes of dilute urine
- decreased erythropoiesis
- elevated blood pressure
3. End stage
- negligible GFR
- fluid, electrolytes and wastes retained in body
- Azotemia, anemia, and acidosis (three A's)
- all body systems affected
- oliguria or anuria
- regular dialysis or transplant needed
49
Chronic renal failure Early signs
increased urinary output
general signs
- anorexia, nausea, anemia, fatigue, unintended weight loss, exercise intolerance
Bone marrow depression and impaired cell function
- caused by increased wastes and altered body chemistry
Elevated blood pressure
50
Chronic renal failure Complete Failure
```
Oliguria
Dry pruritic, hyperpigmented skin, easy bruising
Peripheral neuropathy
impotence in men, menstrual irregularities in women
Encephalopathy
Congestive heart failure, dysrhythmias
Failure to activate Vit D
Possible uremic frost on the skin
systemic infection
```
51
Chronic renal failure - Tests
Metabolic acidosis becomes decompensated
Azotemia (cant get rid of nitrogen)
Anemia becomes severe
Serum electrolyte levels may vary depending on the amount of water retained in the body. Usually hyponatremia and hyperkalemia occur and hypocalcemia and hyperphosphatemia.
52
Chronic renal failure - treatment
Dialysis or Transplant
53
Dialysis
provides filtration and reabsorption
two forms: hemodialysis and peritoneal dialysis
sustains life during kidney failure
used to treat patients with acute until problem is resolved
for patients in end stage until kidney becomes available
54
Hemodialysis
Blood moves from implanted shunt or catheter in an artery to machine
- exchange of wastes fluids and electrolytes
- semi permeable membrane btw blood and dialysis fluid (dialysate)
- after exchange is completed blood is returned to patients vein
Usually 3 times a week - 3 to 4 hours
shunt can become effected
blood clots can happen - heparin can be added
shunt can become sclerosed
more likely to get infection
55
Peritoneal dialysis
outpatient
takes whole night most do while sleeping
catheter goes in with entry and exit points in the peritoneal cavity
peritoneal membrane serves as semipermeable membrane
dialyzing fluid is instilled into cavity
dialysate is drained from cavity via gravity into container
major complication: peritonitis
56
Filtration
movement of water and solutes from blood (high pressure) to ISF (low pressure) area
57
Diffusion
movement of solutes (Na+, glucose) from high conc to low conc
58
Osmosis
movement of water from low solute conc to high solute conc
59
active transport
movement of solute using carrier and energy from low conc to high conc
60
capillary exhange
filtration, diffusion, active transport and osmosis happen over capillary membrane
61
How does the body balance water and electrolytes?
1. Thirst - osmoreceptors in the hypothalamus
2. Antidiuretic hormone - reabsorption of water from the kidney tubules (loop of henle)
3. Aldosterone - reabsorption of sodium and water (convuluted tubule)
4. Atrial natriuretic peptide (ANP) and T=type natriuretic peptide - made by myocardial cells, regulates fluid, sodium and potassium levels
62
Fluid Excess - Edema
excessive amt of fluid in the interstitial compartment
- causes swelling or enlargement of tissue
- may be localized or throughout the body
- may impair tissue perfusion
- may trap drugs in ISF
63
Edema causes
1. increased capillary hydrostatic pressure
- caused by high BP or Blood volume
- forces increased fluid out of capilaries into tissue
- cause of pulmonary edema
2. Loss of plasma proteins
- particularly albumin
- results in decreased plasma osmotic pressure
3. obstruction of the lymphatic system
- causes localized edema, might be inflammatory response, infection or burn wounds
64
effects of edema
1. swelling - local area
- pale or red in color
2. pitting edema
- presence of excess interstial fluid
- moves aside when pressure is applied by finger
- depression - pit remains when finger is removed
3. increase in body weight
- with generalized edema
4. functional impairment
- restricts movement of joints
reduced vital capacity
impaired diastole
5. Pain
- edema exerts pressure on nerves locally
- headache with cerebral edema
- stretching of capsule in organs
6. impaired arterial circulation
7. dental complications
8. edema in skin
65
Fluid Deficit - dehydration
1. insufficient body fluid
- inadequate intake
- excessive loss
- both
2. fluid loss often measured by change in body weight
3. dehydration more serious in infants and older adults
4. water loss may be accompanied by loss of electrolytes and proteins
66
Causes of dehydration
1. vomiting and diarrhea
2. excessive sweating with loss of sodium and water
3. diabetic ketoacidosis
4. insufficient water intake in older adults or unconscious persons
5. use of concentrated formula in infants
67
dehydration effects
dry mucous membranes in the mouth
decreased skin turgor
low blood pressure, weak pulse, and fatigue
increased hematocrit
decreased mental function, confusion, loss of consciousness
68
compensate for fluid loss
```
increasing thirst
increasing heart rate
constriction of cutaneous blood vessels
producing less urine
- concentration of urine
```
69
Potassium levsl
normal 3.5-5
hyperkalemia greater than 5.0
hypokalemia less than 3.5
70
Hyperkalemia
```
MACHINE
M medication - ace inhibitors, spironolactone, and ibuprofen
A acidosis
C cellular destruction
H hypoaldesternonism
I increase in potassium intake
N nephrons (broken) - kidneys renally impaired
E excretion problems (dialysis)
```
71
Hyperkalemia S & S
Heart:
1. irregular HR, hypotension and bradycardia
2. arrythmias, Vfib or cardiac standstill
Respiratory: resp failure
GI: Diarrhea, hyperactive bowel sounds
Neurologic: confused, increased DTR
Neuromuscular:
1. profound weakness
2. paralysis in extremeties
3. tingling, burning and numbness around the hands, feet and mouth
72
Hyperkalemia MGMT
MDKID
M monitor EKG
D Diet: No salt substitutes, no fruits, no green leafy veggies
K Kayexalate
I Iv solutions
- IV sodium bicarbonate corrects acidosis
- IV calcium gluconate helps decrease neuromuscular irritability
-Insulin and albuterol B-2 agonist, push potassium inside the cell
D diuretics and dialysis
73
Hypokalemia causes
```
GOTSHOT
G GI loss - vomiting and diarrhea
O osmotic diuresis, frequent urination
T thiazides and loop diuretics
S severe acid base imbalance (alkalosis)
H hyperaldosteronism
O other medications that deplete potassium: corticosteroids, insulin, and antibiotics
T transcellular fluid shit: insulin, albuterol, pushes potassium into the cell
```
74
Hypkalemia S & S
low and slow
Heart: vital signs early tachy, sever late brady, orthostatic hypotension, arrythmias
Resp: slow shallow breathing diminished breath sounds, resp arrests with sever
GI: decreased motility, hypo bowel sounds, constipation, abdominal distension, paralytic ileus, paralyzed intestine, small bowel obstruction
Neuro: confusion, LOC, anxiety, lethargy and fatigue
Neuromusc: low and weak DTR, muscle cramping, weakness resulting in flaccid paralysis
75
hypokalemia treatment
AID
A administer K-dur (oral potassium)
I IV potassium chloride (IV piggyback) K or KCL in normal saline. NEVER PUSH
D diet - salt substitutes fruits, avocado, green leafy vegetables
76
Sodium
```
primary cation in ECF
Large and in charge
- water follows sodium
-major determinant of ECF volume
-determinant of BP
transports into and out of cell by pump
actively secreted
regulated by the kidneys through
- ADH
-Aldosterone holds sodium inside the body by blocking Na at the kidneys
```
77
Sodium
norm 135-145
hyper >145
hypo <135
78
hypernatremia causes
```
FAIR AD
Fluid loss
ADH insufficiency
Increased Na intake
Renal problems
Aldosterone excess (cushings disease)
deprivation of fluids
```
79
Hypernatremia S& S
```
Big and bloated
Heart
- hypertension, bounding pulses, tachy
Resp
- SOB, fluid overload, crackles
GI
- Nausea and vomiting
GU
- decreased urinary output
neuro
- CSF is thick and salty brain cells shrink leads to seizures and coma
neuromusc
- increased muscle tone
- muscles twitching, cramps
- increased DTR
Integumentary
- edema. pitting edema, dry mouth and mucus membranes, swollen dry tongue
```
80
Hyponatremia causes
-excessive sweating nausea, diarrhea
-use of certain diuretic drugs with low salt diet
- hormonal imbalances
- insuf aldosterone, adrenal insuffic. excess ADH
excess water
81
Hyponatremia types
two types
Hypovolemic - loss of fluid and sodium together
Hypervolemic - increase in body water greater than sodium
82
Hyponatremia S&S Heart
Heart:
•Hypovolemic
1.Increased heart rate ( heart pumps harder)
2.Decreased BP ( not enough fluid volume)
3.Increased RR (not enough fluids, not enough oxygen, and body tries to compensate)
•Hypervolemic
1.Increased HR ( too much fluid, heart needs to work more)
2.Increased BP ( too much fluid in veins)
3.Decreased RR ( due to fluid volume overload)
•EKG_ cardiac dysrhythmias
•Elevation on EKG, ventricles are cramping up
83
Hyponatremia S&S Lungs, GI, Neuro, Musc
Lungs- fluid imbalance in compartments, cells are filled with fluid and not proper air exchange
1.Shortness in breath and dyspnea
•GI- fluid imbalance in compartments
1. nausea and vomiting
2. Abdominal cramping
•Neurological- decreased osmotic pressure is CSF and cerebral edema
1.Restlessness, confusion, seizures, and coma
•Muscular:
1.General weakness
84
Hyponatremia treatment
Administer IV solutions salty solutions
1.Hypovolemic hyponatremia:•Isotonic solution like NS or LR
2.Hypervolemic hyponatremia•Fluid restriction + loop diuretics ( furosemide)
•For severe cases_ hypertonic sodium like 3% saline
•Limit water intake- hypervolemic hyponatremia
•diet high in salt canned food, processed meat, cheese, anything packaged
85
Chloride
Major extracellular anion
•Chloride levels regulated by Sodium
•Function: Helps Na to maintain
-Blood Volume, Blood pressure, pH of body fluids •Chloride and bicarbonate ions can shift in response to acid-base imbalances.
- Low serum chloride lead to high serum bicarbonate or alkalosis
86
Chloride Levels
Normal chloride level is 97- 107 mEq/dl
•Hyperchloremia high chloride in the blood, > 107 mEq/dl
•Hypochloremia , low chloride level in the blood < 97 mEq/dl
87
Hyperchloremia causes
Hypernatremia
•Dehydration& hemoconcentration (such as with severe diarrhea & metabolic acidosis (low HCO3)
•Respiratory alkalosis (hyperventilating, blowing off CO
88
Hyperchloremia S & S
```
Same as hypernatremia-
•Edema
•Weight gain
•Hypertension
•Tachypnea
```
89
Hypochloremia main causes
CHAMP
C: chloride loss from fluid loss ( vomiting, diarrhea, NGT suction, sweating, fever & burns)
Hyponatremia
Addison’s disease and adrenal crisis
M: medications- diuretics that increase excretion of chloride as well as Na and K
Ph imbalances metabolic alkalosis ( vomiting)
90
Hypochloremia S &S
Same as hyponatremia- Depressed and deflated
•Heart: hypotension, dysrhythmias
•Respiratory: Dyspnea, Shortness of breath
•Neurological: Agitation, confusion , seizures, and coma
•GI: Diarrhea, N/V
•Musculoskeletal: Tremors, twitching, muscle cram
91
Calcium
•Important extracellular Cation
•Ingested in food
•Stored in bone
•Excreted in urine and stool
•Balance controlled by
:•Parathyroid hormone: increase Calcium concentration in the blood
•Calcitonin: puts calcium into the bones
•Vitamin D promotes calcium absorption from intestine.
•Ingested or synthesized in skin in the presence of ultraviolet rays
•Activated in kidneys
92
Calcium Functions
Function to keep three B’s
•Blood
•Bone
•Beats (heart beats)
* Friends with Magnesium- fills function of Mg
* Enemy with phosphate- levels of Phosphate and calcium are in opposite directions when abnormal
93
Calcium levels
* Normal calcium plasma levels is 9- 10.5 mg/ dl
* Hypercalcemia is plasma level > 10.5 mg/dl
* Hypocalcemia is a plasma level of < 9
94
Hypercalcemia causes
HAM-LI
H: Hyperparathyroidism
A: Anti-acids containing Calcium like Tums
M: Malignancies causing uncontrolled release of Calcium ions from bones, paraneoplastic syndrome with bronchogenic carcinoma
L: Low phosphate
I: Immobility- decreases stress on bones leading to bone demineralization
95
hypercalcemia S&S
Swollen and slow
Heart: Decreased HR as conduction slows, Decreased RR, Decreased BP, arrythmias- heart block
Lungs: Shortness of Breath & weak respiration
GI: Hypoactive bowel sounds, Constipation, Nausea and Vomiting (trying to get rid of that extra Calcuim)
GU: kidney stones, Interfere with ADH, and less absorption of water and polyuria
Neurologic: altered mental status, decreased DTR, Loss of consciousness
Musculoskeletal: Decrease excitability, Severe muscle weakness, Bone pain
96
Hypocalcemia causes
```
Hypoparathyroidism
•Malabsorption syndrome
•Deficient serum albumin
•Increased serum pH level
•Renal failure
```
97
Hypocalcemia 3 B's
* Weak bones: fractures
* Weak blood clotting, risk for bleeding
* Weak heart beats , dysrhythmia
98
Hypocalcemia S&S
Organs shows symptoms of “excited”
•Heart: Ventricular tachycardia, severe, Slow clotting factors, Congestive heart failure
•Lungs: Laryngospasm ( spasm of vocal cords), Dyspnea and crackle
GI: Diarrhea and intestinal cramping
•Neurological: Confusion, personality changes, seizure, dementia or psychosis
•Musculoskeletal: Trousseau ( arm twerks with BP cuff), Chvostek ( twitching when touching temporal area)
99
Phophate
Bone and tooth mineralization
•Important in metabolism―ATP
•Phosphate buffer system―acid-base balance
•Reciprocal relationship with serum calcium
•Regulated by:
•Parathyroid hormone
•Calcitriol
100
Phosphate levels
Normal serum phosphate level is 3- 4.5
•Hyperphosphatemia is high phosphate level more than 4.5
•Hypophosphatemia is low phosphate level less than 3
101
Hyperphoshatemia causes
Excess vitamin D (suppress Parathyroid and decrease renal execration of Ph)
•Hypoparathyroidism ( causing hypocalcemia)
•Low calcium (hypocalcaemia)
•Decreased excretion by kidneys
102
Hyperphosphatemia S&S
same as low calcium
Heart: arrythmias
•Respiratory: crackles
•Neurological: Altered level of consciousness and confusion, seizure
•GI: diarrhea, N & V
•Musculoskeletal: •muscle weakness, and hyperreflexes •Troussaeu •Chvestok
103
Hypophosphatemia causes
```
Malabsorption
•Diarrhea
•Antacids (like tums increase Calcium)
•Alkalosis
•Low Magnesium, low potassium •Hyperparathyroidism
•Alcohol withdrawal
```
104
Hypophosphatemia S&S
Same as hypercalcemia - Low and lonely
•Heart: Slow weak pulses, dysrhythmias
•Respiratory: Shallow & rapid respiration
•Renal: kidney stones
•Neurologic: Altered mental status & CNS depression
•GI: Constipation
•Musculoskeletal: Decreased DTR, and muscle weakness
105
Magnesium function & levels
Function:•Keeps the peace in the muscles •Calm muscles down, mainly in the uterus and heart
•Normal Serum Magnesium Levels from 1.3 - 2.1
•Hypermagnesemia serum level more than 2.1
•Hypomagnesemia serum level less than 1.3
106
Hypermagnesium causes
renal failure
107
Hypermagnesium S&S
Calm and Quiet
•Heart: Bradycardia ( less than 60 b/min), Hypotension, Arrythmias
•Lungs: depressed respirations, slow and shallow
•GI: hypoactive bowel sounds
•Neurological: drowsiness and lethargy that progress to Coma
•Musculoskeletal: weakness, diminished or absent D
108
Hypomagesium causes
Diuretics
•Diabetic ketoacidosis
•Hyperparathyroidism
•Hyperaldosteronism
109
hypomagnesium S&S
Buck Wild
•Heart: tachycardia, arrythmias, Severe: V fib
•Lungs: dyspnea, rapid shallow respirations
•GI: diarrhea
•Neurologic: confusion, irritability, insomnia
•Neuromuscular: increased DTR, hyperflexion ( clonus), Muscle twitching, numbness ( paresthesia
