255 electrolytes

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elevatedsound7
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255 electrolytes
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2013-09-11 03:36:41
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255 electrolytes
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255 electrolytes
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  1. potassium maintains the...
    intracellular osmolality
  2. normal potassium levels =
    3.5 - 5.0 mEq/L
  3. what is exchanged for H+ to buffer blood pH changes
    Potassium
  4. what stimulates the Na/K pump to move K into the liver and muscle cells
    Insulin
  5. where is 90% of body's K excreted
    the kidneys
  6. when you think about issues with Na you should think....
    • neurological issues
    • water imbalances
  7. when you think about issues with potassium what should you immediately think
    • Cardiac
    • Renal
  8. if someones kidneys are not functioning appropriately what happens to potassium levels
    they go up
  9. if someone is on a lot of diuretics what happens to the potassium levels
    they go down
  10. Potassium is critical for what
    • neuromuscular transmission of impulses
    • all muscle contraction
    • electrical activity and cardiac muscle contraction
    • regulation of INTRACELLULAR osmolality
    • acid base balance (H+ ion exchange)
    • cell's electrical neutrality
  11. what causes potassium to move from ECF to ICF
    • Insulin
    • Alkalosis
    • Stress (beta adrenergic stimulation)
    • tissue repair (rapid cell building)
  12. Factors causing potassium to move from ICF to ECF
    • Acidosis
    • trauma to cells
    • exercise
    • Digoxin and beta blocking agents can impair K movement into cells
  13. what can elevate serum K levels =
    • trauma to cells
    • exercise
  14. how much potassium does body need per day
    40-60 mEq/day
  15. foods high in potassium
    • oranges, bananas, cantaloupe, green leafy vegetables, avocados, dried fruit, bran cereal molasses, dry lentils, nuts, potatoes, lima beans
    • SALT SUBSTITUTES
  16. CELLS FIRE LESS EASILY WITH
    HYPOKALEMIA
  17. cells fire more easily with
    hyperkalemia
  18. things that can cause hypokalemia
    • hyperaldosteronism
    • Diuretics
    • low magnesium levels
    • alkalosis
    • lack of potassium intake
  19. hypokalemia S&S =
    • SLOWS DOWN MUSCLE CONTRACTION
    • dysrythmias
    • cardiac arrest
    • fatigue
    • leg cramps
    • parasthesis
    • hyporeflexia
    • costipation
    • lethargy
    • decreased bowel motility
  20. management of hypokalemia =
    • oral replacement
    • IV replacement
    • Diet
  21. potassium should NEVER be administered by
    IV push or IM
  22. IV PB potassium cannot be infused faster than
    • 20 mEq/hr
    • through a central line and if patient is on cardiac monitor
  23. high doses of potassium should be given through
    central vein
  24. when potassium is administered through a peripheral vein you should do what
    decrease rate to avoid irritating the vein and causing a burning sensation
  25. you should never give Potassium via
    • IV push
    • it can be fatal
  26. a decrease in urine volume to less than what would cause you to stop potassium and why
    • 20-30mL/h for 2 consecutive hours
    • because kidneys eliminate 90% of potassium
  27. most common cause of hyperkalemia =
    kidney failure
  28. causes of hyperkalemia
    • excess intake
    • acidosis
    • addison's disease
    • renal disease
    • hemolyzed sample
    • potassium sparing diuretics
  29. addison's disease =
    • lack of hormones in the adrenal cortex
    • DO NOT HAVE ALDOSTERONE
  30. if you give pt PRBC what happens to K levels
    K goes up because you are giving them CELLS and potassium is in CELLS
  31. hyperkalemia S&S
    • cardiac dysrhymias
    • heart block
    • irritability
    • dyspnea
  32. management of Hyperkalemia =
    • limit intake
    • Kayexalate
    • administer insulin and dextrose (moves K into cells)
    • IV calcium gluconate to prevent cardio toxicity
  33. why would you give IV calcium gluconate
    to protect the heart from high potassium levels
  34. pseudohyperkalemia problems can be caused by
    • hemolysis of blood sample
    • clenched fist during blood draw
  35. parasthesis =
    tingling, prickling
  36. hyperaldosterone levels K levels would
    • decrease
    • because aldosterone eliminates K
  37. cell firing threshold goes up or down with hyperkalemia
    threshold goes down so cell fires more rapidly
  38. cell firing threshold goes up or down with hypokalemia
    threshold goes up so cells fire less rapidly
  39. Calcium is need for
    • contraction
    • conduction
    • coagulation
  40. where is Calcium mainly found
    in the bones where it is stored
  41. calcium is the guard that does not allow what into the cell
    Na
  42. inregards to calcium cells fire more rapidly with
    • hypocalcemia
    • because the cell doesn't have a lot of calcium to block sodium entering the cell
  43. cells fire when
    Na enters the cell and K leaves the cell
  44. hypercalcemia is similar to
    hypokalemia because cells fire less rapidly
  45. normal serum calcium levels
    • 8.6 -10.2 Mg/dl total calcium
    • 4.6 - 5.3 mg/dl (ionized)`
  46. functions of calcium =
    • contraction
    • conduction
    • coagulation
    • automaticity
    • formation of teeth and bones
    • hormone secretion and function of cell receptors
  47. calcium is present in 3 forms
    • 40% is bound to protein
    • 50% is ionized (calcium that is free or unbound)
    • 10% is bound to other substance
  48. Calcitonin makes serum calcium levels go
    • down
    • calcitonin makes it go bone in
    • it is secreted when calcium levels are high
  49. calcium resorption =
    calcium is released from the bone
  50. PTH hormone makes serum levels of calcium
    • go up
    • PTH job is to make calcium levels go up
  51. hypomagnesimia looks like
    hypocalcemia
  52. causes of hypocalcemia
    • hyoparathyroidism
    • decreased levels of magnesium
    • decreased levels of vitamin D
    • alcoholism
    • blood transfusions (becasue citrate can bind up calcium)
  53. S&S of hypocalcemia =
    • tetany -
    • tingling
    • hyperreflexia
    • trousseau's and Chvostek's sign
    • cardiac dysrythmias
    • increased bleeding
    • laryngeal spasms
  54. management of hypocalcemia =
    • diet
    • oral supplements
    • IV calcium gluconate
  55. trousseaus sign
    • muscle spasms of hand when BP cuff on
    • hypocalcemia
  56. chvosteks sign
    • tap on facial nerve results in ipsilateral facial muscle contraction
    • hypocalcemia
  57. hypercalcemia is serum level
    greater than 10.2 mg/dL
  58. if you have malignant done disease you will have
    hypercalcemia
  59. management of hypercalcemia =
    • decrease calcium intake
    • diuretics
    • maintain hydration
    • calcitonin
  60. PTH hormone job
    makes calcium levels go up
  61. calcitonin job =
    • makes calcium levels go down
    • move calcium into bone
  62. causes of hypercalcemia =
    • malignant bone disease
    • hyperparathyroidism
    • vitamin D overdose
    • immonilization
  63. S&S of hypercalcemia =
    • slows muscles down - anything attached to this ie muscle weaknes, decrease in reflexes
    • polyuria
    • thirst
    • nephrolithiasis - kidney stones
  64. biggest treatment for hypercalcemia =
    hydrate hydrate hydrate because you pee off electrolytes with water
  65. vitamin D causes
    absorption of calcium in the gut
  66. hypermagnesemia looks like
    hypercalcemia
  67. hypomagnesemia looks like
    hypocalcemia
  68. normal level of magnesium =
    1.5 - 2.5 mEq/L
  69. First line drug for women with eclampsia =
    magnesium
  70. what powers the sodium potassium pump =
    Magnesium  because it generates ATP
  71. what is necessary for PTH function and bone function
    Magnesium
  72. what should you think when you see alcoholism
    alcoholism
  73. hypomagnesemia resembles
    hypocalcemia
  74. hypermagnesemia resembles
    hypercalcemia
  75. hypokalemia resembles
    • hypercalcemia
    • CHILLED OUT
  76. hyperkalemia resembles
    • hypocalcemia
    • OVER ACTIVE
  77. management of hypomagnesemia
    • diet magnesium salts
    • Maalox or mylanta
    • IV mag sulfate
  78. serum levels in hypermagnesemia =
    greater than 3.0
  79. causes of hypermagnesemia =
    • renal failure
    • chronic use of antacids or laxatives
  80. IV calcium gluconate given when
    • hypermagnesemia
    • hyperkalemia
  81. management of hypermagnesemia =
    • promote urinary excretion with fluid diuretics
    • no Mg containing drugs
    • IV calcium gluconate
  82. primary anion in the ICF
    phosphate
  83. phosphate is essential for function of
    muscle, RBC's, and nervous system
  84. normal phosphate levels
    2.7 - 4.5 mg/dL
  85. phosphorous levels are often evaluated with what other levels
    calcium
  86. phosphate has a reciprocal relationship with
    calcium
  87. hyperPhosphatemia
    • > 4.5
    • looks like hypocalcemia
  88. management of hyperphosphatemia
    • adequate hydration
    • correction of hypocalcemia
    • phosphate binding agents
    • calcium supplements
  89. causes of hypophosphatemia =
    • malnourishment
    • alcohol withdraw
    • parenteral nutrition

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