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2.1
Electrolyte Imbalance
Imbalance Electrolytes

Presentation

This presentation was consistent with flacainide cardiotoxicity exacerbated by electrolyte disturbance. The syncopal episodes probably represented life-threatening arrhythmias. [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]

They are present in blood, urine, plasma, and other body fluids and in the tissues. The essential electrolytes present in our body are sodium, potassium, chloride, calcium, magnesium, phosphate, bicarbonate, and sulfate. [tandurust.com]

Entire Body System

  • 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]

    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]

    If stress is unrelenting and becomes chronic, adrenal burnout and fatigue progresses to its more advanced stages. [drlam.com]

    Fatigue Olena Yakobchuk/Shutterstock One of the most common symptoms of electrolyte imbalance is fatigue. Falling short on magnesium can be the culprit. “Magnesium is involved in more than 300 processes in the body,” says Foroutan. [thehealthy.com]

    A man presented with recurrent syncope, weakness and fatigue. His ECG showed marked QRS widening and he had gross hyponatraemia and hypokalaemia. His medications included bendroflumethiazide (long term) and flecainide (started 2 months previously). [ncbi.nlm.nih.gov]

Cardiovascular

  • 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]

    block Atria] asvstole Ventricular tachvcardiaí'fibrillation Asystole,,,diastolic cardiac arrest Neuromuscular Confusion Paraesthesia Muscle weakness Paralysis ECG = electrocardiooratn Table II - Clinical manifestations of hyponatraemia Therapeutics should [medbc.com]

    Block • Polyuria • Kidney Stones • Renal failure • Bone pain • Fracture 166. [slideshare.net]

Workup

QRS Wave

  • Wide QRS Complex

    On an EKG, wide QRS complexes and unusually tall, peaked T waves can be seen. [ems1.com]

    CLINICAL MANIFESTATIONS CARDIOVASCULAR SYSTEM RESPIRATORY GI SYSTEM SYSTEM First tachycardia then bradycardia Slow, weak, irregular heart rate Decreased blood pressure ECG changes- peaked narrow T- waves, wide QRS complex, Depressed ST segment, widened [slideshare.net]

QT, RR, ST Intervals

  • ST Elevation

    Signs and symptoms of hyperkalemia can include ECG & EKG changes including ST elevation, peaked T waves among others. [youtube.com]

    Hyponatremia and long-term mortality in survivors of acute ST-elevation myocardial infarction. Arch Intern Med. 2006;166:781–786. [PubMed] [Google Scholar] 7. Mahowald JM, Himmelstein DU. [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]

PR Interval

  • Prolonged PR 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]

    PR interval : tall T waves : widened QRS 85.  Administration of magnesium  Ventilatory support  IV calcium gluconate  Administration of loop diuretics and sodium chloride  Administration of lactated ringers IV solution 86.  Risk for hypermagnesemia [slideshare.net]

Rhythm

  • Torsades De Pointes

    Ventricular tachycardia, ventricular fibrillation and torsade de pointes. [ecgwaves.com]

T Wave

  • Peaking T Wave

    t waves, tremors twitching (CNS stimulation) Hypokalemia: (too much lasix) tachycardia, hypotension, flacid muscles, flat t waves, u waves. [allnurses.com]

    Signs and symptoms of hyperkalemia can include ECG & EKG changes including ST elevation, peaked T waves among others. [youtube.com]

    Inverted T wave C. Prominent U wave D. Tall peaked T waves 61. A. The client with renal failure B. The client who is taking diuretics C. The client with hyperaldosteronism D. The client who is taking corticosteroids 62. A. Dry skin B. [proprofs.com]

    T waves →widening of the QRS complex →prolongation of the P–R interval →loss of the P wave →loss of R- wave amplitude →ST-segment depression →an ECG that resembles a sine wave, before progression to ventricular fibrillation and asystole.  Hypocalcemia [slideshare.net]

    On an EKG, wide QRS complexes and unusually tall, peaked T waves can be seen. [ems1.com]

  • Flattened T Wave

    In severe cases, changes in the patient's EKG include a shortened QT interval associated with a shortened ST segment, flattened T waves and the presence of Osborn waves. [ems1.com]

    SIGN & SYMPTOMS CARDIOVASCU LAR SYSTEM RESPIRATORY SYSTEM NEUROLOGICSY GI SYSTEM STEM MUSCULO- SKELETAL SYSTEM • Thready, weak, irregular pulse. • Weak peripheral pulses • Orthostatic hypotension • Dysrhythmias • Vertigo • Flattened T wave • Shallow, [slideshare.net]

    Electrocardiographic manifestations of hypokalemia include a flattened T wave, prolongation of the QT interval, or the appearance of U waves. Severe hypokalemia can produce cardiac arrhythmias, ileus, and lethargy. [emedicine.medscape.com]

  • T Wave Inversion

    T-waves become wider with lower amplitude. T-wave inversion may occur in severe hypokalaemia. ST segment depression develops and may, along with T-wave inversions, simulate ischaemia. [ecgwaves.com]

Treatment

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]

However, symptoms can sometimes be severe, and a person may need to be hospitalized and monitored during treatment. [medicalnewstoday.com]

This article was provided by doctor zhengfalei 2013-12-13 10:00 Electrolyte imbalance is one of the major causes for dialysis patients to make diet changes, so a timely and effective treatment is very important. [kidney-treatment.org]

The treatment of hypercalcemia can include intravenous fluid hydration and medications like prednisone, diuretics, and bisphosphonates. [registerednursing.org]

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]

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]

Admission hyponatremia in the elderly: factors influencing prognosis. J Gen Intern Med. 1994;9(2):89–91. Epub 1994/02/01. pmid:8164083. View Article PubMed/NCBI Google Scholar 11. Hawkins RC. [journals.plos.org]

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]

ETIOLOGY  Retention of Potassium- Renal insufficiency, renal failure, decreased urine output, potassium sparing diuretics.  Excessive release of Cellular Potassium - severe traumatic injuries. [slideshare.net]

[…] is likely to be of infectious etiology, particularly when travel, possibly tainted food, or an outbreak with a point-source is involved. [merckmanuals.com]

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]

Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]

Observational retrospective cross sectional and epidemiological surveys have established an association between chronic hyponatremia and osteoporosis and major osteoporotic fracture [106, 107, 108, 109, 110, 111]. [intechopen.com]

Pathophysiology

In McCance KL, Huether SE, Brashers VL et al, editors: Pathophysiology, the biologic basis for disease in adults and children, ed 6, St Louis, 2010, Mosby, pp 96-125; The body fluid compartments: extracellular and intracellular fluids; edema. [musculoskeletalkey.com]

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]

In this video Michael Linares, RN from Simple Nursing helps pinpoint the exact pathophysiology, causes, and treatments of fluid and electrolyte imbalances, which is expected to know for the NCLEX, HESI, ATI, and Kaplan proctor exams. [youtube.com]

PATHOPHYSIOLOGY Fluid shift from interstitial spaceto vascular space Hypervolemia Second Phase 94. [slideshare.net]

Prevention

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]

Early detection of abnormality in serum electrolyte levels allows prompt initiation of measures to prevent further imbalances. [nurseslabs.com]

Aldosterone prevents excessive kidney excretion of sodium. [quizlet.com]

A well-balanced diet including a variety of fruits and vegetables can help prevent electrolyte imbalance. [livestrong.com]

How to replenish potassium to prevent keto flu: Overdosing on potassium can be extremely dangerous. [ketogasm.com]

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