Electrolyte Imbalances (physical from book 1st)

kelsscoot's version from 2015-11-21 16:50

Section 1

Question Answer
Hypokalemia - low serum potassium (K+) LevelBilateral muscle weakness that begins in quadriceps and may ascend to respiratory muscles, abdominal distention, decreased bowel sounds, constipation, cardiac dysrhymias; signs of digoxin toxicity at normal digoxin levels
Hyperkalemia - High serum potassium (K+) LevelBilateral muscle weakness in quadriceps, transient abdominal cramps and diarrhea, cardiac dysrhythmias, cardiac arrest
Hypocalcemia - low serum calcium (Ca2+) LevelPositive Chvostek's sign (contraction of facial muscles whenfacial nerve is tapped), positive Trousseau's sign (carpal spasm with hypoxia), numbness and tingling of fingers and circumoral (around mouth) region, hyperactive reflexes, muscle twitching and cramping, tetany, seizures, laryngospasm, cardiac dysrhthmias
Hypercalcemia - High serum Calcium ((Ca2+) LevelAnorexia, nausea and vomitting, constipation, fatigue, diminished reflexes, lethargy, decreased level of consciousness, confusion, personality change, cardiac dysrhthmias; possible flank pain from renal calculi; with hypercalcemia caused by shift of calcium from bone: pathological fractures, signs of digoxin toxicity at normal digoxin levels
Hypomagnesemia - low serum Magnesium (Mg2+) Levelpositive Chvostek's and Trousseau's signs, hyperactive deep tendon reflexes, insomnia, muscle cramps and twitching, grimacing, dysphagia, tachycardia, hypertension
Hypermagnesemia - High Serum Magnesium (Mg2+) LevelLethargy, hypoactive deep tendon reflexes, bradycardia, hypotension; acute elevation in magnesium levels: flushing, sensation of warmth; severe hypermagnesemia; flaccid muscle paralysis, decreased rate and depth of respirations, cardiac dysrhythmias, cardiac arrest

Section 2

Question Answer
Hypokalemia<3.5 mEq/L
Hyperkalemia>5.0 mEq/L
Hypocalcemia<8.4 mg/dl
Hypercalcemia>10.5 mg/dl
Hypomagnesemia<1.5 mEq/mL
Hypermagnesemia>2.5 mEq/mL
acidosisdrop in pH
alkalosisincrease in pH

Section 3

Question Answer
HyponatremiaGI losses, sweating, use of diuretics, Hypotonic tube feedings
Hypernatremiafever,diarrhea, DI, excessive salt intake, Hypertonic tube feedings without adequate water
HypokalemiaVomiting, gastric suction, loop diuretics, alcoholism, anorexia; always dilute IV K+, never give push, standard dosage is 20-40mEq
Hyperkalemiacan lead to cardiac arrest, renal failure, K+conserving diuretics, excessive/rapid infusion of IV K+
Hypocalcemiatetany with muscle spasms/paresthesias (numbness) to convulsions; surgical removal of thyroid gland, pancreatitis, malabsorption, alcoholism, sepsis
Hypercalcemiacalcium mobilized from skeleton, malignancy, prolonged immobilization
Hypomagnesemias/s like hypocalcemia, increase in neuromuscular excitability
HypermagnesemiaESRD, s/s lethargy and decrease deep tendon reflex

Section 4

Question Answer
ACE inhibitors and angiotensin II receptor blockersHyperkalemia
Antidepressants, SSRI (fluoxetine)Hyponatremia
Calcium carbonate antacids:Hypercalcemia, mild metabolic alkalosis
Corticosteroids (prednisone)Hypokalemia, metabolic alkalosis
Diuretics, potassium-wasting (furosemide, Lasix, thiazides)ECV deficit, hyponatremia (thiazides), hypokalemia, hypomagnesemia, milk metabolic alkalosis
Diuretics, potassium-sparing (spironolactone, aldactone)Hyperkalemia, mild metabolic acidosis
Effervescent (fizzy) antacids and cold medications (high Na+ content):ECV excess
Laxatives:ECV deficit, hypokalemia, hypocalcemia, hypomagnesemia, metabolic alkalosis
Magnesium hydroxide (Milk of Magnesium)Hypermagnesemia
Nonsteroidal antiinflammatory drugs (ibuprofen, Advil)Mild ECV excess, hyponatremia
Penicillins, high-dose (carbenicillin)Hypokalemia, metabolic alkalosis; hyperkalemia with penicillin G contains K+