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Electrolytes
n/a
47
Health Care
Graduate
09/20/2008

Additional Health Care Flashcards

 


 

Cards

Term
HYPOKalemia
Definition

plasma [K] < 3.5

 

loss by intracellular shift, NOT LOW INTAKE

Term
Relative Hypokalemia
Definition
acid-base changes shift K into cells => lower plasma conc when total body conc is NORMAL!!
Term
Absolute Hypokalemia
Definition
BOTH intracellular and extracellular K decrease
Term

Clinical features of Hypokalemia

Definition

K < 2.5 = muscle weakness

 

<1.5 aneflexic paralysis and resp. depression

 

Decr. gastric and sm. intestine motility => paralytic ileus

Term
Cardiac Clinical features of hypokalemia
Definition
  • Premature Vent contraxn
  • ectopic tachycardia
  • heart failure
  • FLAT T wave, U wave
  • 1st degree AV block
Term
GI causes of hypokalemia
Definition
  • decr. intake=Starvation
  • Loss of HCL=Vomiting, gastric aspiration
  • Defective K absorption-Fistulas
  • Incr. intestinal secretion of K-Diarrhea
Term
Renal Causes of Hypokalemia
Definition
  • Diuretic Therapy **#1 Cause!!!
  • Renal Tubular disease
  • Magnesium depletion
  • Adrenal steroids
Term
#1 cause of Hypokalemia
Definition
Diuretic therapy
Term
Intracellular shift of K caused by
Definition
  • Metabolic, Respiratiory Alkalosis (Tx w/ KCl)
  • Infusion of lg amts of glucose or insulin therapy

 

Term
Tx of Hypokalemia
Definition

PO NOT IV

Term

HYPERKalemia

Definition
>5
Term
Relative Hyperkalemia
Definition
intracellular K->extracellular fluid W/O incr. in K values
Term
Absolute Hyperkalemia
Definition
BOTH intracellular and extracellular K INCR
Term
Clinical Features of Hyperkalemia
Definition
  • muscle strength, nerve velocity changes
  • cardiac contractility NOT affected but, arrythmias may occur
  • Peaked T wave, widening QRS, Sine waves
  • Atrial asystole folled by Ventr. Standstill
Term
Causes of Hyperkalemia
Definition
  • Renal failure (acute, chronic)=Kidney fxn #1
  • Acidosis
  • Mineralcorticoid deficiency
  • Hemolysis
  • Rhabdomyolysis
  • NSAIDS, ACE inhibs, TOO MUCH K= #1
Term
TX of Hyperkalemia
Definition
  • Stop meds
  • Ca
  • Glucose and insulin
  • Beta agonist (albuterol)
  • Exchange resin, diuretic
  • Hemodialysis
Term
HYPONatremia
Definition

Decr. in Na

 

#1 Electrolyte d/o

**Esp in hospitalized pts and Marathon runners

 

<135 = MORE H20 than Na

 

Comorbidities=hyperglycemia, CHF;  Incr Stress

Term
Clinical features of Hyponatremia
Definition
  • rare symptoms unless < 125
  • mild lethargy -> coma
  • Anorexia, nausea

 

Term
Causes of Hyponatremia
Definition
  • Psuedohyponatremia
  • Hypertonic Hyponatremia
  • Hypotonic Hyponatremia

-Hypovolemic

-Euvolemia

-Hypervolemia

Term
TX of Acute Hyponatremia
Definition
Hypertonic saline soln, NS w/ lasics
Term
Tx of Chronic Hyponatremia
Definition
  • H2O restriction
  • antagonize renal action of ADH
Term
Hypovolemic
Definition
Na loss w/ H20 gain
Term
Euvolemic
Definition
H2O gain with seconday Na loss
Term
Hypervolemic
Definition
Na gain w/ XS H2O gain
Term
ADH (aka AVP)
Definition
  • Influenced by Osmotic pressure (sensitive to sm. changes in osmolarity)
  • Kidneys  sensitive to sm changes in plasma AVP
  • Anterior hypothalamus = most sensetive osmoreceptors

 

Term
HYPERNatremia
Definition
  • >145
  • ALWAYS reflect hyperosmolar state-> Na gain or H2O loss (H2O loss most often)
  • Na, H2O metabolism->hypernatremia (iatrogenic)
Term
Causes of Hypernatremia
Definition
  • fever, high temp
  • diabetes insipidis, and osmotic diuresis
  • nasuea, vomiting, dyphagia
Term
Clinical features of Hypernatremia
Definition
  • Dehydration of brain->confusion to convulsions/coma
  • most pts elderly w/ dehydration, tachycardiac, poor skin tugor
Term
Tx of Hypernatremia
Definition

***Give FREE WATER

  • If we cause->IVF, TF soln, diuretics, meds
  • Hypervolemic->Diuretics + D5W
  • Hypovolemic->isotonic NaCl then 1/2 NS or D5W
Term

HYPERCalcemia

 

Definition
d/t hyperparathyroidism and malignancy
Term

Primary Hyperparathyroidism

Definition

borderline-mild hypercalcemia

 

<11

Term
hypercalemia d/t malignancy
Definition
very ill, > 13
Term
Steps to asses/diagnose Hypercalcemia
Definition

1) Asses data and draw PTH level

2)Analyze PTH level (elevated intact PTH=primary hyperparathyroidism or lithium)

3)Analyze PTH related protein=primary indicator

4)Analyze vit D metabolite levels if no other obvious causes

5)Think hard and look for other causes

Term

Tx of hypercalcemia

Definition
  • Hydration and diuresis
  • calcitonin
  • hydrocotrisone
  • dialysis
Term
HYPOCalcemia
Definition

Not usu. OUTPATIENT!!

 

Corrected by Incr. PTH

 

d/t decr. PTH or chronic def of vit d pppt hypocalcemia

Term

Causes of Hypocalcemia

Definition
  • Decr albumin
  • Acute pancreatitis
  • Chronically ill
  • Alkalosis
  • Meds
Term
Sx of Hypocalcemia
Definition
  • Chvosteks sign (face)
  • Trousseaus sign (bp cuff and hand)
  • NM irritability, parasthesis
  • Tetany
  • Seizures
Term
Tx of Acute Hypocalcemia
Definition
  • Ca glutonate
  • CaCl
  • Magnesium
Term
Tx of Chronic Hypocalcemia
Definition
  • vit D supp
  • w/ malabsorption->SUNLIGHT
Term
Edema
Definition
Palpable swelling produced by expansion of ISF volume
Term
Anasarca
Definition
massive and generalized edema
Term
Dx-Hx of Edema
Definition

1) Disease (Heart, Lung, Kidney)

2)  Location of Edema

Term

Pulmonary Edema

 

Definition

Associated w/ cardiac and renal disease

 

w/o indicates cirrhosis, hypoalbuminemia

Term
PE findings for edema
Definition
  • Pulmonary Edema
  • Central Venous Pressure
  • Distribution reflects hemodynamic forces
  • Peripheral Edema (pitting after pressure)
Term
Non-Pitting Peripheral Edema
Definition

indicates lymphatic obstruction or thyroid

Term
Periorbital Edema
Definition
indicates nephrotic syndrome
Term

#1 Electrolyte d/o

 

Affects hospitalized pts. and marathon runners

Definition
Hyponatremia
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