Sodium Imbalances
Potassium Imbalances
Calcium Imbalances
100

This is a recommended treatment for hyponatremia.

Hyponatremia is low level or concentration of sodium.

Treatment involves slow replacement of Na+,  correcting the fluid imbalance (0.9% NACL), or restricting oral fluid itake.

100

These are at least two causes of hypokalemia.

What are:

-GI fluid loss including NG suction

-Kidney disease impairing reabsorption of potassium

-Cushing syndrome

-Medications: meds that increase kidney potassium loss include diuretics, corticosteroids, and beta-adrenergic agonists or antagonists. 

S/sx: slow shallow breathing, hypoactive bowel sounds, hyperglycemia, lethal ventricular arrhythmias.

100

These are at least two causes of hypocalcemia. 

What are:

•Dietary: Lack of Ca+ intake, inadequate Vit D or lack of protein, malabsorption

•ESKD

•Pancreatitis

•Damage to or removal of parathyroid hormones

A normal range for calcium is 8.6–10.2 mg/dL.

S/sx: frequent painful muscle spasms to legs/feet during sleep, muscle twitching, paresthesia in hands/feet/lips/nose/ears.

200

These are at least two causes of hyponatremia.

What are:

-Actual sodium deficits (insensible fluid loss, vomiting, diarrhea, medications, etc.)

-Relative Na+ deficits (diluted):  excessive water intake/polydipsia, kidney failure, SIADH, HF, liver cirrhosis

200

These are at least two causes of hyperkalemia.

What are:

-Excessive K+ intake, IV K+ infusions

-Decreased renal function

-Meds: K+ sparing diuretics

-Tissue damage, crush injuries, burns (K+ released from ICF)

S/sx: muscle twitching, leg weakness, bradycardia, hypotension, lethal cardiac arrythmias like heart block or v-fib), numbness hands/feet, increased bowel motility 

200

This is at least one treatment for hypocalcemia.

What are:

•Oral Calcium with Vit D

•10% IV Calcium Gluconate in D5W

•Nutrition therapy


300

This electrolyte imbalance manifests as muscle weakness, irritability, confusion, weak/rapid pulse/hypotension, and possible seizures.

What is hyponatremia?

-Normal Na+ level is 136–145 mEq/L

-Results in: reduced excitable membrane depolarization and cellular swelling

300

This is at least one treatment for hyperkalemia.

What is:

-IV insulin (after IV dextrose)

Insulin increases the activity of sodium-potassium pumps, which move potassium from the ECF into the cell through administration of IV fluids containing glucose and insulin.

-Withhold/stop K+ containing medication, including K+ sparing diuretics

-ECG monitoring

•NO LONGER Kayexalate (sodium polystyrene sulfonate) due to adverse GI effects


Treatment for hypokalemia:

-ECG monitoring

-Oral, liquid, or IV K+ replacement

-Medication adjustment (hold diuretics)


300

Flaccidity, weakness, bone tenderness, renal calculi, and cardiac arrhythmias are all manifestations of this electrolyte imbalance.

What is hypercalcemia?


Causes:
• Excessive oral intake of calcium/vit D

•Chronic kidney disease

•Medications: diuretics, thiazides, overuse of Ca+ containing antacids

•Increased parathyroid hormone (PTH), Immobility

•Metastasis Neoplastic Disease –breast , prostate, melanomas, bone, others

•Cellular destruction, bone tumor

400

This electrolyte imbalance can cause muscle twitching, excessive thirst, confusion, restlessness.

What is hypernatremia?

-Normal Na+ level is 136–145 mEq/L

-Can be caused by actual Na+ excesses (kidney failure, excessive oral intake/IV fluid intake, corticosteroids) or by relative sodium excesses (dehydration, infection, meds)

400

A flattened T-wave & prominent u-wave on a ECG monitor would be indicative of this electrolyte imbalance.

What is hypokalemia?


Tall peaked T-waves, & wide QRS complexes is associated with hyperkalemia.


400

The name of these signs found in A, and B/C can indicate this electrolyte disorder.

What is hypocalcemia?

A. is the Chvostek's sign It is a contraction of a facial muscle in response to a light tap over the facial nerve

B and C is the Trousseau's sign a carpal spasm incudes by inflating the BP cuff above the systolic pressure for a few minutes


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