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LECTURE 6 – ELECTROLYTES (#6 time 0:37:40)
RULE: POTASSIUM IMBALANCES DO THE SAME AS THE PREFIX,
EXCEPT FOR HEART RATE & URINE OUTPUT!!
brain:irritability, restlessness, agitation
lungs: tachypnea
heart: low heart rate – bradycardia
urine: oliguria
bowel: diarhhea, borborygmi
muscles: spasticity; increased tone
reflexes: 3+ or 4+ - hyperreflexia
*K rarely affects CNS and seizures doesn’t occur.K greatly affects Cardiovascular and NeuroMuscular systems
brain: lethargy
lungs: bradypnea
heart: tachycardia
urine: polyuria
bowel: adynamic ileus, constipation
muscles: flaccidity / hyporeflexia
reflexes: 1+ or 2+
Hyperkalemia SATA Adynamic ileus low hypoK Obtundedlow hypoK 1+ reflexlow hypoK Clonushigh hyperK uWave hypoK depressed STHypoK polyuriahigh HypoK bradycardialow HyperK This study source was downloaded by 100000857336479 from CourseHero.com on 03-13-2023 20:25:01 GMT -05:00 https://www.coursehero.com/file/65067257/Mark-Klimek-Audio-Lecture-6-Electrolytesdoc/
(#6 time 0:50:20)
RULE: CALCEMIA DO THE OPPOSITE OF THE PREFIX
IF IT IS MUSCULOSKELETAL OR NERVE, BLAME IT ON CALCIUM!!
brain: lethargy, irritability, restlessness
lungs: bradypnea
heart: bradycardia
urine: oliguria
bowel: constipation
muscles: flaccidity
reflexes: 1+ or 2+ hypoactive reflexes
brain: irritability, restlessness, agitation… seizure
lungs: tachypnea
heart: tachycardia
urine: polyuria
bowel: diarhhea, borborygmi
muscles: spasms
reflexes: 3+ or 4+ - hyperreflexia
Chvostek sign: when you touch their CHEEK, they go into a spasm of the face
(neuromuscular irritability associated with a LOW calcium) Trousseau sign: when you put a blood pressure cuff on, blow it up & they go into a spasm of the hand. This study source was downloaded by 100000857336479 from CourseHero.com on 03-13-2023 20:25:01 GMT -05:00 https://www.coursehero.com/file/65067257/Mark-Klimek-Audio-Lecture-6-Electrolytesdoc/
(#6 time 0:55:45)
RULE: MAGNESIUM DO THE OPPOSITE OF THE PREFIX
In a Tie, Don’t Pick Mg - AFFECTS THE BODY VERY MINIMALLY!!
brain: lethargy
lungs: bradypnea
heart: bradycardia
urine: oliguria
bowel: constipation
muscles: flaccidity
reflexes: 1+ or 2+
brain: irritability, restlessness, agitation… seizure
lungs: tachypnea
heart: tachycardia; high BP
urine: polyuria
bowel: diarhhea, borborygmi
muscles: spasms
reflexes: 3+ or 4+, hyperreflexia
(#6 time 1:10:00)
HYPERnatremia: DEHYDRATION
*DKA*
DI
HHNK
HYPOnatremia: OVERLOAD
*Fluid volume excess* SIADH This study source was downloaded by 100000857336479 from CourseHero.com on 03-13-2023 20:25:01 GMT -05:00 https://www.coursehero.com/file/65067257/Mark-Klimek-Audio-Lecture-6-Electrolytesdoc/
(#6 time 1:15:25)
ELECTROLYTE IMBALANCE
Earliest sign of any electrolyte imbalance is numbness/tingling aka PARESTHESIA “circumoral paresthesia” = numbness & tingling lips UNIVERSAL sign of any electrolyte disorder = MUSCLE weakness aka PARESIS TREATMENT: (boards will only test potassium) – the worst electrolyte imbalance HIGH potassium (will stop your heart)
Rules for Potassium :
NEVER push IV!NEVER more than 40 of K per liter of IV fluid If more than 40, question & clarify with PHCP first!The fastest way to treat Hyperkalemia is to give D5W with regular insulin (only hides K) drive the K into the cell and out of the blood K+ in blood will kill you, not K+ in cells [ K – exits – early ] it is the fastest solution, but it is only TEMPORARY Kayexelate (sodium polystyrene sulfonate) chalk full of sodium; given via enema or orally kicks K out of the blood into the gut and eliminate K out of the body Sodium in the body may rise, administer IV fluids to correct the imbalance.Hypoernatremia / Sodium imbalance is less life threatening than Potassium imbalance. [ K – exits – Late ] Takes a long time to take effect but PERMANENT This study source was downloaded by 100000857336479 from CourseHero.com on 03-13-2023 20:25:01 GMT -05:00 https://www.coursehero.com/file/65067257/Mark-Klimek-Audio-Lecture-6-Electrolytesdoc/
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