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36 Cards in this Set
- Front
- Back
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What is the normal range for potassium level?
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3.5–5.0 mEq/L
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What are the surgical causes of hyperkalemia?
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Iatrogenic overdose, blood transfusion, renal failure, diuretics, acidosis, tissue destruction (injury/hemolysis)
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What are the signs/symptoms of hyperkalemia?
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Decreased deep tendon reflex (DTR) or areflexia, weakness, paraesthesia, paralysis, respiratory failure
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What are the EKG findings of hyperkalemia?
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Peaked T waves, depressed ST segment, prolonged PR, wide QRS, bradycardia, ventricular fibrillation
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What are the critical values of hyperkalemia?
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K+ > 6.5
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What is the urgent treatment of hyperkalemia?
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IV calcium (cardioprotective), EKG monitoring
Sodium bicarbonate IV (alkalosis drives K+ intracellularly) Glucose and insulin Albuterol Sodium polystyrene sulfonate (Kayexalate) and furosemide (Lasix) Dialysis |
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What is the nonacute treatment of hyperkalemia?
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Furosemide (Lasix), sodium polystyrene sulfonate (Kayexalate)
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What is the acronym for the treatment of acute symptomatic hyperkalemia?
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"CB DIAL K+":
Calcium Bicarbonate Dialysis Insulin/dextrose Albuterol Lasix Kayexalate |
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What is "pseudohyperkalemia"?
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Spurious hyperkalemia as a result of falsely elevated K+ in sample from sample hemolysis
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What acid-base change lowers the serum potassium?
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Alkalosis (thus, give bicarbonate for hyperkalemia)
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What nebulizer treatment can help lower K+ level?
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Albuterol
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What are the surgical causes of hypokalemia?
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Diuretics, certain antibiotics, steroids, alkalosis, diarrhea, intestinal fistulae, NG aspiration, vomiting, insulin, insufficient supplementation, amphotericin
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What are the signs/symptoms of hypokalemia?
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Weakness, tetany, nausea, vomiting, ileus, paraesthesia
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What are the EKG findings of hypokalemia?
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Flattening of T waves, U waves, ST segment depression, PAC, PVC, atrial fibrillation
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What is a U wave?
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U wave
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What is the rapid treatment for hypokalemia?
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KCl IV
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What is the maximum amount of potassium that can be given through a peripheral IV?
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10 mEq/hour
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What is the maximum amount of potassium that can be given through a central line?
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20 mEq/hour
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What is the chronic treatment for hypokalemia?
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KCl PO
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What is the most common electrolyte-mediated ileus in the surgical patient?
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Hypokalemia
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What electrolyte condition exacerbates digitalis toxicity?
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Hypokalemia
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What is the normal range for sodium level?
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135–145 mEq/L
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What are the surgical causes of hypernatremia?
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Inadequate hydration, diabetes insipidus, diuresis, vomiting, diarrhea, diaphoresis, tachypnea, iatrogenic (e.g., TPN)
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What are the signs/symptoms of hypernatremia?
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Seizures, confusion, stupor, pulmonary or peripheral edema, tremors, respiratory paralysis
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What is the usual treatment supplementation slowly over days for hypernatremia?
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1/4 NS or 1/2 NS
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What are the surgical causes of hypovolemic hyponatremia?
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Diuretic excess, hypoaldosteronism, vomiting, NG suction, burns, pancreatitis, diaphoresis
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What are the surgical causes of euvolemic hyponatremia?
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SIADH, CNS abnormalities, drugs
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What are the surgical causes of hypervolemic hyponatremia?
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Renal failure, CHF, liver failure (cirrhosis), iatrogenic fluid overload (dilutional)
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What are the signs/symptoms of hyponatremia?
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Seizures, coma, nausea, vomiting, ileus, lethargy, confusion, weakness
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What is the treatment for hypovolemic hyponatremia?
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NS IV, correct underlying cause
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What is the treatment for euvolemic hyponatremia?
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SIADH: furosemide and NS acutely, fluid restriction
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What is the treatment for hypervolemic hyponatremia?
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Dilutional: fluid restriction and diuretics
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What may occur if you correct hyponatremia too quickly?
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Central pontine myelinolysis!
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What is the most common cause of mild postoperative hyponatremia?
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Fluid overload
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How do you remember the sodium level in S.I.A.D.H.?
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S.I.A.D.H. = Sodium Is Always Down Here.
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What is pseudohyponatremia?
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Spurious lab value of hyponatremia as a result of hyperglycemia, hyperlipidemia, or hyperproteinemia
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