Electrolytes

Hyponatremia cause

water excess (NA is diluted) , direct sodium loss, water inside cells gets pulled to blood

Hyponatremia manifestations/management

swelling, delerium, seizures, coma, can be carefully treated with sodium replacement,

Hypernatremia cause

water loss, sodium gain, cells shrink, vomiting, diarrhea

Hypernatremia manifestations

neurological changes, agitation, coma, seizures, increased thirst, muscle twitching, encourage fluid intake

Hypokalemia cause

diuretic therapy, shifts of potassium into cells from blood, alcohol/malnutrition

Hypokalemia manifestations

slows GI tracts, kidneys lose ability to concentrate urine, paralysis of respiratory muscles, deep tendon reflexes decrease, dysrythmias

Hypokalemia treatment

usually given orally, only IV if severe, potassium rich foods (bananas, avocados, spinach)

potassium chloride

used to treat hypokalemia and replaces potassium, moniter IV sight and the EKG (arythmias)

potassium chloride should never be given

push, directly into vein, it stops the heart,

potassium chloride needs to moniter urine since if there is none it can lead to

a toxic build of of potassium

check mg because if low

the body cant hold on to potassium, fix Mg first

hyperkalemia cause

too much K, decreased renal excretion (kidney disease) or hypoperfusion (vomiting/heart failure), metabolic acidosis

hyperkalemia manifestations

muscle paralysis, heart block, cardiac arrest, respiratory paralysis

hyperkalemia management

calcium gluconate (stabilizes heart), insulin (moves k into cells), glucose, sodium bicarbonate (metabolic acidosis), loop diuretics (pee it out), GI binders (k moves out in stool)

hypocalcemia causes

hypoparathyroidism, vitamin d deficiency, Mg deficiency, acute pancreatitis

Hypocalcemia manifestations

trousseau/ckvosteks signs, tetany, laryngeal spasm,torsades de points (heart rhythm)

hypocalcemia treatment

calcium gluconate

hypercalcemia causes

hyperparathyroidism, malignancy, prolonged immobilization

Hypercalcemia manifestations

muscle weakness, slowed reflexes, kidney stones, bone pain/calcium loss

Hypercalcemia management

IV fluids and calcitonin (blocks osteoclasts) together, bisphosphate

hypomagnesemia causes

diarrhea (mg lost in stool), malabsorption, chronic alcohol use (triple threat: increased urine output, poor diet intake, malabsorption), insulin pushes it into the cells causing drop in blood level.

hypomagnesium manifestations

hyper active, hyperreflexia, tremors, hypertension, torsades de pointes

what follows Mg (if Mg drops so do these)

K and Ca

Hypomagnesemia treatment

mag sulfate

hypermagnesemia causes

renal failure, excessive intake, DKA, lithium

hypermagnesemia manifestations

diminished or absent DTR's, muscle paralysis, seems like sedation, drowsiness, slows down the muscles, heart and nerves. hypotension

if phosphorus goes up calcium

goes down

hypophosphatemia cuases

malnurishment, alcohol withdrawl, chronic antiacid use, hyperparathyroidism

hypophosphatemia does what to the body

ATP deficit so cells are starved of energy and decreases oxygen in tissues

hypophosphate manifestations

chest pain, hemolysis, heart failure, muscle weakness

hyperphosphatemia causes

renal failure, excessive laxative intake, hypoparathyroidism

hyperphosphatemia does what to the body

causes damage to soft tissues becasue it binds to calcium

hyperphosphatemia manifestations

tetany, pruritus (itching)

normal ph

7.35-7.45

normal CO2

35-45

normal bicarbonate HC)3

22-28

pH effects

organ function

the two systems that regulare ph are

renal (slow) and respiratory (fast)

the kidneys moniter

bicarb

the lungs moniter

CO2

low ph means….. and high ph means …..

acidic, alkaline (basic)

CO2 is

acidic

bicarb is

basic

faster breathing makes pH ….. because

rise, it helps get rid of acid

slower breathing makes pH….. because

drop, it holds on to acid