Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
78 Cards in this Set
- Front
- Back
t/f
renal failure can cause hyperkalemia |
true
|
|
t/f
aldosterone is effected by hyperkalemia |
true
impaired tubular responsiveness to aldosterone |
|
___ is the clenching and unclenching of fists during venipuncture
|
pseudohyperkalemia
|
|
t/f
hyperkalemia frequently has no symptoms |
true blue with a side of ew
green mean with a taste of cream |
|
Palpitations and other arrhythmias occur in hyper or hypo kalemia?
|
hyperkalemia
|
|
*** key
in hyperkalemia, emergent treatment occurs when K>___mEq/L or >___mEq/L with symptoms / EKG changes |
in hyperkalemia, emergent treatment occurs when K>7 mEq/L or > 6.1 mEq/L with symptoms / EKG changes
|
|
what do you give (2 things) or do (1 thing) in hyperkalemia, emergent treatment occurs when K>7 mEq/L or > 6.1 mEq/L with symptoms / EKG changes ?
|
Give :
1) CaCl or gluconate IV -MOA antagonizes membrane actions of K and restores normal Cardiac function 2) promotion of intracellular shift -insulin/glucose, albuterol, NaI ICO3 3. Hemodialysis |
|
t/f
B-blockers causes hyperkalemia |
true
|
|
t/f
hypokalemia causes impaired tubular responsiveness to aldosterone |
false, hyperkalemia
|
|
true/false
insulin/glucose, albuterol, and NaI ICO3 antagonize membrane actions of K to treat hyperkalemia |
false,
insulin/glucose, albuterol, and NaI ICO3 promote intracellular shift to treat hyperkalemia |
|
what are the two nonemergent treatments of hyperkalemia?
|
Loop diuretics
-MOA increase renal K excreation -onset - minutes; duration - 4 to 6 hrs -starting dose + furosemide (20-40 mg PO) and sodium polystyrene sulfonate -MOA - ion exchange resin (1 Gm exchanges 1 meq Na for 1 meq K) -onset - 1 to 2 hrs; repeat every 4 hrs prn -usual dose 15-60 Gm po q 4-6 hr |
|
what is the MOA of Sodium polystyrene?
|
ion exchange resin (1 gm exchanges 1 meq NA for 1 meq K)
|
|
what is the dose of sodium polystyrene sulfonate?
|
15-60 gm po q 4 to 6 hr
|
|
what is the onset of sodium polystyrene sulfonate
|
1 to 2 hrs
|
|
what is the 2nd most abundant intracellular cation
|
Mg
|
|
what is considered "natures physiologic calcium channel blocker"
|
Mg
|
|
what are normal serum Mg levels?
|
1.4 - 1.8 mEq/L
|
|
what are the three therapeutic uses of Mg?
1.diabetes 2.preeclampsia 3.depression 4.delerium tremens 5.cardia arrhythmias 6. diuretic 7.brain tumor |
cardiac arrhythmias
preeclampsia delerium tremens |
|
hypomagnesium is commonly seen in conjunction with ____ and _____
a-hypocalcemia b-hyponatremia c-hypophoshoremia d-hypokalemia |
hypokalemia and hypocalcemia
|
|
t/f
alcoholism causes hyperkalemia |
false ,
alcoholism causes hypomagnesium |
|
a cause of hypomagnesemia is digoxin which causes? causes renal loss
|
causes renal loss
|
|
t/f
a decrease in phosphate causes an increase in magnesium |
false
a decrease in phosphate causes a decrease in magnesium |
|
at what level are symptoms seen in hypomagnesemia?
|
<1 mEq/L
|
|
if Mg serum levels are <1 mEq/L or symptomatic
what two treatment methods are used? |
MgSO4 via IV route
Dilute in NS |
|
if Mg serum levels are >1 mEq/L and w/o symptoms, what three methods of treatment are used?
|
milk of magnesia
-5 ml QID PO Mg-containing antacids -15mL TID PO magnesium oxide tablets -400 - 800 mg QID |
|
what is the dosing for magnesium oxide tablets?
|
400- 800 mg QID
|
|
what is the dosing of Milk of magnesia?
|
5ml QID PO
|
|
what is the dosing of Mg-containing antacids?
|
15mL TID
|
|
When treating hypermagnesemia you give what type of IV?
|
Ca, it antagonizes the effects of Mg....
do the same thing in Hyper k and hypo Ca |
|
t/f
hemodialysis is a form of treatment in hypermagnesemia in ESRD |
true
|
|
what is the total body content of Ca?
|
1200g
|
|
where is 99% of Ca found in the body?
|
bones
|
|
where is <0.5% of Ca found in the body?
extracellular or intracellular |
extracellular
|
|
what are normal Serum Ca levels?
|
8.5 - 10.5 mg/dL
|
|
t/f
serum levels represent bound and unbound Ca |
true
|
|
what is Ca closely regulated by?
|
parathyroid
|
|
Vitamin D deficit diets can cause hypocalcemia?
|
true
|
|
t/f
hypoparathyroidism cause hypercalcemia |
false, hypoparathyroidism causes hypocalcemia
|
|
a cause of hypocalcemia is hypomagnesium
|
true
Mg~Ca~K |
|
t/f
calcitonin causes hypo or hyper calcemia? |
hypocalcemia
|
|
loop diuretics cause hypo or hyper calcemia?
|
hypocalcemia
|
|
t/f
bisphosphonates, phenobarbital, phenytoin all cause hypocalcemia? |
true
|
|
what type of IV is used to treat hypocalemia?
|
IV calcium chloride or Gluconate
do not exceed 60mg/min |
|
what is the max Mg/min of IV calcium chloride or gluconate when treating hypocalemia?
|
60 mg/min
|
|
t/f
use oral calcium +/- Vit D when a patient is symptomatic hypocalcemia |
false
t/f use oral calcium +/- Vit D when a patient is ASYMPTOMATIC hypocalcemia |
|
what is the starting dose of Oral calcium when treating hypocalcemia?
|
1-3 g/dayof elemental Ca
|
|
what type of dietary modifications should a patient with hypocalcemia make? (two things decrease Ca levels, what are they?)
|
caffeine and phosphorus decrease Ca levels
|
|
Paraneoplastic syndromes are associated with what electrolyte imbalance?
|
hypercalcemia
|
|
Vitamin D toxicity can cause Hyper or hypo calcemia?
|
hypercalcemia
|
|
deposits of Ca in multiple organs and blood vessels contributes to ___disease
|
cardiac disease
|
|
when do symptoms appear in hypercalcemia?
|
when levels >13 mg/dL
|
|
t/f
you want to increase blood volume in hypercalcemia treatment? |
true (increases Ca excretion)
|
|
do you give a loop or thiazide diuretic to a pt with hypercalcemia?
|
loop diuretic after rehydration is complete
|
|
What is calcitonin used for?
|
treating hypercalcemia
|
|
what is calcitonin usually comboed with?
|
bisphosphonates which decrease bone resorption, Ca levels begin to decline after 2 days of taking bisphosphonates
|
|
what do you use Gallium nitrate for?
|
hypercalcemia
|
|
what is the most useful situation for gallium nitrate?
|
malignancy, symptoms and no response to hydration
|
|
how does gallium nitrate work ?
|
it inhibits bone reabsorption in hypercalcemia like bisphosphonates (zoledronate, etidronate, pamidronate, and ibandronate)
|
|
t/f
Gallium nitrate is the first choice when treating hypercalcemia |
false
but i don't know what is :/ |
|
who is the most beautiful princess in the world?
|
cinderella
wait..real world..eee...umm...o yeah..BRITTTANNNNYYY |
|
what is mithramycin used for?
|
hypercalcemia
nephrotoxic and hepatotoxic though |
|
what is the onset of mithramycin used in hypercalcemia?
|
12hrs and peak effects are 48-96 hrs
|
|
corticosteroids are commonly used in what electrolyte imbalance?
|
purple drank?
hypercalcemia, most useful with multiple myeloma, leukemia, and sarcoid decrease GI Ca absorption, increase urinary Ca excretion, and decrease bone reabsorption |
|
what is the "principle intracellular anion"
|
phosphorus
|
|
what is the primary source of ATP
|
phosphorus
|
|
what are the normal serum levels or phosphorus?
|
2.5 -4.5 mg/dL
|
|
would you like some grape juice?
|
JUICE! W....T......F...... IS JUICE!??!?!?!?
|
|
Vitamin D deficiency can cause hypo or hyper phosphatemia?
|
hypophosphatemia
|
|
sevelamer can cause hypo or hyperphosphatemia?
|
hypophosphatemia
along with Sucalfate, Ca or Al or Mg antacids, and lanthanum |
|
we've got soda, water, ahh ALRighT! SUNNY-D!
|
..i want sum uv that purple stuff
|
|
does dextrose/insulin, glucagon, epinephrine, respiratory alkalosis, and re-feeding syndrome cause and intra or extracellular shift of phosphorus leading to hypophoshatemia.
|
intracellular shift of phosphorus
|
|
what is considered severe hypophosphatemia?
|
<1 mg/dL or symptomatic
normal range - 2.5-4.5 |
|
how do you treat severe hypophosphatemia?
|
IV supplementation
|
|
how much and how fast do you run a phosphorus IV?
|
9 to 15 mmol over 4-12 hrs
|
|
t/f
Phosphorus IV will cause in increase risk of Hypocalemia, hypomagnesemia, metastatic soft tissue, CaPO4 deposition |
true
Phosphorus IV will cause in increase risk of Hypocalemia, hypomagnesemia, metastatic soft tissue, CaPO4 deposition |
|
what is the oral dose of phosphorus?
|
1-2 Gm daily
|
|
t/f
Ca, Ma, or Al antacids increase effect of a K oral supplement |
false,
Ca, Ma, or Al antacids DECREASE effect of a K oral supplement |
|
t/f
you commonly see hyperphosphatemia with hypocalcemia? |
true
|