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Electrolyte Imbalance


Presentation

  • Abstract A man presented with recurrent syncope, weakness and fatigue. His ECG showed marked QRS widening and he had gross hyponatraemia and hypokalaemia.[ncbi.nlm.nih.gov]
  • The accurate characterization of these disturbances, however, may be considerably more difficult when more than one metabolic abnormality is present in the same individual.[ncbi.nlm.nih.gov]
  • The 17-day-old boy presented with a salt-losing episode simulating adrenal insufficiency. An initial diagnosis of CAH was made.[ncbi.nlm.nih.gov]
  • Here, we present a case of a heart donor with severe electrolyte imbalance, specifically severe hypokalemia, and severe hypernatremia.[ncbi.nlm.nih.gov]
  • Calcium is also present in green leafy vegetables, legumes and nuts. Magnesium is present in whole grains, nuts and green vegetables. Normally, electrolytes are lost during sweating as while doing heavy physical work or travelling in hot weather.[newtimes.co.rw]
Fatigue
  • Dehydration Increased thirst, dry mouth, dry skin, decreased urine output, fatigue, shortness of breath, stomach cramps. Sodium Loss Loss of appetite, stomach cramps, cold arms, and/or legs, fatigue, feeling faint.[zanecohencentre.com]
  • Abstract A man presented with recurrent syncope, weakness and fatigue. His ECG showed marked QRS widening and he had gross hyponatraemia and hypokalaemia.[ncbi.nlm.nih.gov]
  • If stress is unrelenting and becomes chronic, adrenal burnout and fatigue progresses to its more advanced stages.[drlam.com]
  • ) breznik 's version from 2012-02-26 05:37 Section Question Answer Lethargy, confusion, apprehension, muscle twitching, abdominal cramps, anorexia, nosia, vomiting, headache, seizures, coma, decreased thirst Hyponatremia Convulsions, disorientation, fatigue[memorize.com]
  • The symptoms of an electrolyte imbalance can include: fatigue dizziness nausea weakness Chemotherapy can cause your electrolyte levels to become too low or too high.[breastcancer.org]
Heart Block
  • Hypocalcemia Lethargy, weakness, depressed deep tendon reflexes, bone pain, anorexia, nausea, vomiting, constipation, polyuria, hypercalciuria, renal calculy/ flank pain, dysrythmias, heart block.[memorize.com]
Febrile Convulsions
  • No significant electrolyte imbalance was observed in patients with gastroenteritis experiencing febrile convulsion.[ncbi.nlm.nih.gov]

Workup

Seizure Activity
  • activity followed by coma - 4.5 - Causes: decreased kidney excretion resulting from kidney disease, tumor lysis syndrome, increased intake of phosphorus, hypoparathyroidism - Critical for skeletal muscle contraction, carbohydrate metabolism, ATP formation[quizlet.com]
Prolonged PR Interval
  • .  Assessment findings: serum magnesium level is greater than 2.3mg/dl creatinine clearance decreases to less than 3.0ml/min ECG finding: prolonged PR interval : tall T waves : widened QRS 85.  Administration of magnesium  Ventilatory support  IV[slideshare.net]
  • Prolonged PR interval C. Depressed ST segment D. Widened QRS complexes 69. A. Alcoholism B. Renal insufficiency C. Hypoparathyroidism D. Tumor lysis syndrome 70.[proprofs.com]
ST Elevation
  • Prognostic importance of hyponatremia in acute ST-elevation myocardial infarction. Am J Med. 2004; 117 :242–248. [ PubMed ] 6. Goldberg A, Hammerman H, Petcherski S, Nassar M, Zdorovyak A, Yalonetsky S, et al.[ncbi.nlm.nih.gov]
Prolonged QT Interval
  • Prolonged QT interval D. Shortened ST segment 68. A. Prominent U waves B. Prolonged PR interval C. Depressed ST segment D. Widened QRS complexes 69. A. Alcoholism B. Renal insufficiency C. Hypoparathyroidism D. Tumor lysis syndrome 70.[proprofs.com]
Torsades De Pointes
  • Ventricular tachycardia, ventricular fibrillation and torsade de pointes.[ecgwaves.com]
Peaking T Wave
  • t waves, tremors twitching (CNS stimulation) Hypokalemia: (too much lasix) tachycardia, hypotension, flacid muscles, flat t waves, u waves.[allnurses.com]
  • Clinical signs of hyperkalaemia include muscle weakness, hypotension , bradycardia and loss of cardiac output, and ECG changes may include peaked T waves and flattened P waves.[ausmed.com]
  • The client in normal sinus rhythm with a peaked T wave. B. The client diagnosed with atrial fibrillation with a rate of 100. C. The client diagnosed with a myocardial infarction who has occasional PVC. D.[proprofs.com]
T Wave Inversion
  • T-wave inversion may occur in severe hypokalaemia. ST segment depression develops and may, along with T-wave inversions, simulate ischaemia. P-wave amplitude, P-wave duration and PR interval may all increase. Finally, U-waves emerge.[ecgwaves.com]
Prominent A-Wave
  • We report a case of hyperkalemia, with concurrent hypocalcemia and hypomagnesemia resulting in (1) peaking of the T wave, (2) a prominent U wave, and (3) prolongation of the descending limb of the T wave such that it overlapped with the next P wave.[ncbi.nlm.nih.gov]
  • Prominent U wave C. Prolonged QT interval D. Shortened ST segment 68. A. Prominent U waves B. Prolonged PR interval C. Depressed ST segment D. Widened QRS complexes 69. A. Alcoholism B. Renal insufficiency C. Hypoparathyroidism D.[proprofs.com]

Treatment

  • In this case report, the treatment is presented of an elderly patient who was diagnosed with RS and followed-up in the intensive care unit (ICU) due to resistant fluidelectrolyte imbalance.[ncbi.nlm.nih.gov]
  • Treatment for electrolyte imbalance involves either supplementing low levels or lowering high levels of the affected electrolytes. Treatment may be given by mouth or by injection.[netdoctor.co.uk]
  • After these were corrected the amphotericin B was restarted and the course of treatment completed successfully. I suggest that prior to giving amphotericin B to patients with resistant kala-azar their electrolyte imbalance should be corrected.[ncbi.nlm.nih.gov]
  • Early diagnosis is essential because both conditions are potentially fatal and treatment differs significantly. Differential diagnosis may be achieved by urinalysis and abdominal ultrasound scan.[ncbi.nlm.nih.gov]

Prognosis

  • This study aimed to investigate the etiology, risk factors and short-term prognosis of gastroenteritis with convulsion.[ncbi.nlm.nih.gov]
  • The prognosis is then poor as irreversible neurological damage and even death may occur.[helpher.org]
  • Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2010; 36 :304–311. [ PubMed ] 16. Bilezikian JP. Etiologies and therapy of hypercalcemia. Endocrinol Metab Clin North Am. 1989; 18 :389–414. [ PubMed ] 17.[ncbi.nlm.nih.gov]
  • Prognosis A patient's long-term prognosis depends upon the root cause of the electrolyte disorder. However, when treated quickly and appropriately, electrolyte imbalances in and of themselves are usually effectively reversed.[medical-dictionary.thefreedictionary.com]

Etiology

  • The etiologic agent in developed countries is viral in 15-60% of cases, while in developing countries, bacteria and parasites are frequently reported as the etiologic factors. Neurologic signs including convulsion are seen in some cases of diarrhea.[ncbi.nlm.nih.gov]
  • Calcium Hypercalcaemia Etiology of hypercalcaemia Primary hyperparathyroidism and malignancies cause 90% of all cases of hypercalcaemia.[ecgwaves.com]
  • All patients had electrolyte imbalance, with various etiologies other than traumatic origin. Demographic and clinical parameters were collected after obtaining informed consent from the patients.[ncbi.nlm.nih.gov]
  • […] is likely to be of infectious etiology, particularly when travel, possibly tainted food, or an outbreak with a point-source is involved.[merckmanuals.com]
  • Applying a Knowledge of Pathophysiology When Caring for the Client with Fluid and Electrolyte Imbalances The pathological etiology, risk factors and the signs and symptoms related to fluid and electrolyte imbalances were fully discussed immediately above[registerednursing.org]

Epidemiology

  • The USDA reported in epidemiological studies that 61% of the U.S. population does not ingest adequate magnesium from their diet. Post-operative patients were found to lack adequate magnesium 60% of the time![metabolichealing.com]
  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.com]
Sex distribution
Age distribution

Pathophysiology

  • In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills for fluis and electrolyte imbalances in order to: Identify signs and symptoms of client fluid and/or electrolyte imbalance Apply knowledge of pathophysiology[registerednursing.org]
  • OUTPUT FLUID IMBALANCEFLUID IMBALANCE • Changes in ECF volume alterations in sodium balance • Change in sodium/water ratio either hypoosmolarity or hyperosmolarity • Fluid excess or deficit loss of fluid balance • As with all clinical problems, the same pathophysiologic[slideshare.net]

Prevention

  • Abstract Arrhythmias and cardiac arrest have been reported during amphotericin B administration but no effective technique has been described to prevent them.[ncbi.nlm.nih.gov]
  • Advice from the doctor at the Grand Canyon clinic as reported in the Wilderness Medicine Institute regarding the issue: Prevention is a matter of being sensible, which is so often the case.[outdoors.stackexchange.com]
  • In addition, cisplatin-based chemotherapy is sometimes accompanied by marked serum electrolyte fluctuation because it needs massive hydration to prevent renal damage.[ncbi.nlm.nih.gov]
  • CONCLUSION: In patients with malnutrition, thiamin replacement should be given before starting nutrition to prevent RS. Energy intake should be 10kcal/kg/day at the start, and be gradually increased between days 4-10.[ncbi.nlm.nih.gov]
  • Abstract Identification of populations susceptible to heat effects is critical for targeted prevention and more accurate risk assessment. Fluid and electrolyte imbalance (FEI) may provide an objective indicator of heat morbidity.[ncbi.nlm.nih.gov]

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