Lecture Review: Insulins, Electrolytes, and Blood Pressure

A complete set of 60 vocabulary flashcards covering insulin types, electrolyte imbalances (normal ranges, signs, symptoms, and interventions), and blood pressure categories.

Lispro (Humalog)

A rapid-acting insulin with an onset of $10-30$ minutes and a peak of $30$ minutes to $1$ hour.

Aspart (NovoLog)

A rapid-acting insulin used to manage blood glucose with a duration of $3-5$ hours.

Glulisine (Apidra)

A rapid-acting insulin with a peak effect occurring between $30$ minutes and $1$ hour.

Regular Insulin (Humulin R, Novolin R)

A short-acting insulin with an onset of $30$ minutes to $1$ hour and a duration of $5-8$ hours.

NPH (Humulin N, Novolin N)

An intermediate-acting insulin with an onset of $1.5-4$ hours and a peak of $4-12$ hours.

Glargine (Lantus)

A long-acting insulin with an onset of $0.8-4$ hours and no pronounced peak.

Detemir (Levemir)

A long-acting insulin characterized by a flat profile and a duration of $16-24+$ hours.

Degludec (Tresiba)

A long-acting insulin with a duration that can exceed $24$ hours and no pronounced peak.

Rapid-Acting Insulin Onset

The time it takes for rapid-acting insulins like Lispro to begin working, which is $10-30$ minutes.

Short-Acting Insulin Peak

The time range where short-acting insulin reaches its maximum effect, occurring between $2-5$ hours.

Intermediate-Acting Insulin Duration

The length of time intermediate-acting insulin stays in the system, which is $12-18$ hours.

Sodium ($Na^+$) Normal Range

$135-145\,mEq/L$.

Hyponatremia

<135\,mEq/L.

Hypernatremia

>145\,mEq/L.

Osmotic demyelination syndrome

A potential neurological complication resulting from correcting hyponatremia too rapidly with hypertonic saline.

Hypertonic Saline ($3\%\,NaCl$)

An intervention used for severe symptomatic hyponatremia that must be administered slowly.

Potassium ($K^+$) Normal Range

$3.5-5.0\,mEq/L$.

Hypokalemia

<3.5\,mEq/L.

Hyperkalemia

levels exceed $5.0\,mEq/L$.

U-waves

A specific EKG finding associated with hypokalemia.

Tall peaked T-waves

An EKG change that serves as an early sign of hyperkalemia.

Widened QRS

Lead finding on an EKG indicating significant hyperkalemia and decreased cardiac conduction.

Kayexalate (sodium polystyrene sulfonate)

A medication used to treat hyperkalemia by promoting the excretion of potassium.

Calcium Gluconate (in hyperkalemia)

An IV intervention used to stabilize the myocardium to prevent arrhythmias.

Calcium ($Ca^{2+}$) Normal Range

$9.0-10.5\,mg/dL$ .

Hypocalcemia

<9.0\,mg/dL.

Hypercalcemia

>10.5\,mg/dL.

Trousseau’s sign

A clinical indicator of hypocalcemia involving carpal spasms induced by inflating a BP cuff.

Chvostek’s sign

A clinical indicator of hypocalcemia involving facial twitching when the facial nerve is tapped.

Calcium Gluconate (in hypocalcemia)

An IV treatment administered slowly to correct low calcium; monitoring for bradycardia is required.

Magnesium ($Mg^{2+}$) Normal Range

$1.3-2.1\,mEq/L$.

Hypomagnesemia

<1.3\,mEq/L.

Hypermagnesemia

levels exceed $2.1\,mEq/L$.

Torsades de Pointes

A lethal ventricular arrhythmia specifically associated with hypomagnesemia.

IV Magnesium Sulfate

The primary intervention for hypomagnesemia, administered slowly via a pump while monitoring Deep Tendon Reflexes

Calcium Gluconate (in hypermagnesemia)

The antidote used to stabilize the cardiac membrane in the presence of high magnesium.

Phosphate ($PO_4^-$) Normal Range

$3.0-4.5\,mg/dL$.

Hypophosphatemia

<3.0\,mg/dL.

Hyperphosphatemia

>4.5\,mg/dL.

Sevelamer (Renagel)

A phosphate binder taken WITH meals to treat hyperphosphatemia, often seen in renal failure.

Neutra-Phos

An oral supplement used to treat mild cases of hypophosphatemia.

Normal Blood Pressure

A blood pressure reading characterized by a systolic $<120\,mmHg$ AND a diastolic $<80\,mmHg$.

Elevated Blood Pressure

A blood pressure range of $120-129\,mmHg$ systolic AND $<80\,mmHg$ diastolic.

Stage 1 Hypertension

A blood pressure range of $130-139\,mmHg$ systolic OR $80-89\,mmHg$ diastolic.

Stage 2 Hypertension

A blood pressure reading of $\ge 140\,mmHg$ systolic OR $\ge 90\,mmHg$ diastolic.

Hypertensive Crisis

A medical emergency defined by a blood pressure $>180\,mmHg$ systolic OR $>120\,mmHg$ diastolic.

Hypertensive Urgency

A BP $>180/120\,mmHg$ WITHOUT evidence of target organ damage; treated with oral meds.

Hypertensive Emergency

A BP $>180/120\,mmHg$ WITH signs of organ damage like encephalopathy or MI; requires IV vasodilators.

Nitroprusside

An IV vasodilator commonly used in the ICU to manage hypertensive emergencies.

DASH Diet

A dietary approach for hypertension low in sodium and high in potassium and calcium.

Orthostatic hypotension

A potential safety risk to monitor when patients start new antihypertensives like ACE inhibitors.

Stones, moans, and groans

A mnemonic for hypercalcemia symptoms referring to kidney stones, bone pain, and constipation.

Laryngospasm

A life-threatening respiratory complication of hypocalcemia necessitating a tracheostomy tray at the bedside.

Paralytic ileus

A gastrointestinal complication associated with hypokalemia.

Rhabdomyolysis

A condition involving muscle breakdown that can occur as a result of hypophosphatemia.

Osteomalacia

A softening of the bones that can be caused by chronic hypophosphatemia.

Weight-bearing exercise

A non-pharmacological intervention for hypercalcemia that helps shift calcium back into the bone.

Maximum IV K+ Replacement Rate

$10-20\,mEq/hr$.

Hyporeflexia

Decreased or absent deep tendon reflexes (DTRs), a hallmark sign of hypermagnesemia.

Hyperreflexia

Increased deep tendon reflexes (DTRs), a hallmark sign of hypomagnesemia.