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ECCO: Renal Electrol
Electrolytes II
| Question | Answer |
|---|---|
| The major extracellular electrolyte | sodium |
| sodium | 135 - 145 mEq/L |
| when sodium and water loss happen together, which loss is more? Water or sodium | water |
| The clinical signs seen in hypernatremia are related to sodium's primary functions of maintaining _______ ______ and ______ _______ _____ | fluid balance, nerve impulse conduction |
| most common signs of hypernatremia | extreme thirst, fever, dry mucous membranes, altered mentation, which in later stages, may progress to seizures |
| primary management of a patient with hypernatremia is geared toward what? | treating the underlying cause |
| IV solutions will be given for hypernatremia. Would they be sodium containing or nonsodium containing | nonsodium containing |
| Excessive vomiting, diarrhea, and gastrointestinal suctioning can result in hyponatremia. Why | They are sodium-rich GI fluids |
| aldosterone insufficiency can result in _______ in which _______ ________ is impaired | hyponatremia, sodium reabsorption |
| What class of drugs can lead to hyponatremia | loop diuretics |
| primary intervention for hyponatremia | treat the underlying cause |
| what specific conditions that cause hyponatremia would possibly require a fluid restriction | SIADH, water intoxication |
| The major intracellular electrolyte | potassium |
| this electrolyte is responsible for maintaining the osmotic pressure of the intracellular fluid, regulating neuromuscular excitability, and maintaining the acid-base balance | potassium |
| potassium | 3.5 - 5.5 mEq/L |
| What are some causes of hyperkalemia | injury to cells: burns, surgery, trauma, myocardial infarction, metabolic acidosis inability to excrete potassium: renal failure, decreased aldosterone, potassium-sparing diuretics |
| hyperglycemia results in potassium moving into or out of the cell? | out |
| hemolysis results in what potassium condition | pseudohyperkalemia |
| hyperkalemia signs and symptoms | arrhythmia, tachycardia, decreased cardiac output, numbness, tingling, muscle weakness, apathy and confusion, decreased deep tendon reflexes, nausea, vomiting, diarrhea, hyperactive bowel sounds |
| what might you see on an ECG of a patient with hyperkalemia | tall peaked T waves, flattened P waves, lengthening PR interval, and widening QRS |
| Hyperkalemia has a _____ effect on myocardial contractility and conduction | depressant |
| Hyperkalemia = ______ cardiac output | decreased |
| What does hyperkalemia do to GI smooth muscle | makes it hyperactive - nausea, vomiting, diarrhea, hyperactive bowel sounds |
| most important focus in hyperkalemia | treat the underlying cause |
| emergency management of hyperkalemia would include administration of what? | IV glucose bolus (D50 bolus) and IV insulin |
| what would be administered to promote excretion of excess potassium in the urine | Sodium bicarbonate |
| What is given for heart irritability during hyperkalemia | Calcium gluconate or calcium chloride |
| Causes of hypokalemia | vomiting, diarrhea, excess urinary loss, perspiration, stress |
| excess insulin can result in what potassium-related condition? | hypokalemia |
| increase in intracellular potassium occurs in acidosis or alkalosis? | alkalosis |
| most common causes of hypokalemia | vomiting, diarrhea, gastric suctioning |
| fistulas and new ileostomies predispose patients to what electrolyte imbalance | hypokalemia |
| what might you see on an ECG of a patient with hypokalemia | ST-segment depression, T waye inversion with progressive flattening, presence of U waves |
| Would you expect hypertension or hypotension with hypokalemia | hypotension |
| Would you expect hyperventilation or hypoventilation with hypokalemia | hypoventilation |
| True/False: hypoventilation is an early sign of hypokalemia | False: late sign & emergency |
| GI signs of hypokalemia | N & V, anorexia, paralytic illius, abdominal distension due to smooth muscle weakness |
| True/False: Atrial natriuetic peptide (ANP) acts by blocking the production of aldosterone and ADH by causing the kidneys to increase sodium and water excretion. | true |
Created by:
mwillis