Potassium
Hypokalemia is indicated by a potassium level less than ___?
3.5 mEq/L
Where is magnesium absorbed?
small intestine
Normal phosphorous level?
2.5-4.5 mg/dL
Albumin
symptoms of severe hyponatremia include (name at least one)
cellular swelling causing headaches, lethargy, seizures, coma
An example of SENSIBLE fluid losses contributing to hypokalemia?
NGT output, diarrhea, excessive UOP
Monitoring to consider during mag replacement
deep tendon reflexes
hyperparathyroidism, liver resection, re-feeding syndrome
Hallmark EKG finding in hypocalcemia?
prolonged QT
cerebral edema
2 physical exam findings associated with hypokalemia?
diminished deep tendon reflexes, skeletal muscle weakness, paralysis, constipation, abdominal pain
Role of magnesium in the body? (name at least two)
Cofactor for ATP, modulates calcium influx, myocardiocyte contraction, and insulin release.
Inorganic function of phosphorous? (majority of phos)
bone strength and structure
Describe how hypomagnesemia causes hypocalcemia
decreased mag reduces PTH activity
examples of euvolemic hyponatremia (must name 2)
SIADH, psychogenic polydipsia, adrenal insufficiency, hypothyroidism, hyperglycemia
When a patient is acidotic, what happens to the plasma concentration of potassium? (describe phys response)
Potassium levels increase. As H+ ions are brought to the intracellular space, K+ ions are then exchanged to the extracellular space.
Name the 2 reasons we see hypomagnesemia in an alcoholic?
dietary deficiencies and diuretic effects of alcohol
Physiologic cause of hypophosphatemia in re-feeding syndrome?
abrupt increase in insulin and ATP synthase when transitioning to carbohydrate metabolism
Symptoms associated with acute hypercalcemia (must name 3)
polyuria, polydipsia, dehydration, anorexia, nausea, muscle weakness, and sensory changes
complete lab work up for hyponatremia
BMP, serum osm, urine osm, urine na
Describe EKG findings associated with HYPOKalemia (must get 3/5)
Life threatening arrythmia associated with hypomagnesemia AND appropriate treatment based on AHA guidelines?
Torsades, 1-2 g of mag bolus over 5 min
Reduction of which molecule causes decreased tissue oxygenation in hypophosphatemia and what exam finding can you see as a result from this?
2,3-diphosphoglycerate, muscle weakness
Formula for corrected calcium?
[0.8 × (normal albumin – patient's albumin)] + serum calcium level.
maintenance fluid calculation and goal sodium rate of correction
4 cc/kg per hour for the first 10 kg
2 cc/kg per hour for the next 10 kg
1 cc/kg per hour for every kg over 20 kg
0.5 to 1 mEq/L per hour