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83 Cards in this Set
- Front
- Back
Name 6 major electrolytes/minerals
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Sodium, Chloride, Potassium, Calcium, Phosphate, Magnesium
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What are 3 functions of Sodium
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maintains osmotic pressure,
balances acid/base, transmits nerve impulses |
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What is the most abundant cation
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Sodium
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What is the normal range for Na
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135-145 mEq/L
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Etiologies of Hyponatremia
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gain of more water than salt:excess water,
loss of more salt than water, diuretic usage, vomiting/diarrhea/burns, excessive sweating, renal dz, excess ADH, excessive IV infusion, tap water enemas, replacement of water after v/d/burns, but not salt |
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Neurological Clinical Manifestations of Hyponatremia
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neuronal swelling, H/A, confusion, behavioral change, seizures, hallucinations
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Cardiovascular manifestations of Hyponatremia
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orthostatic hypotension, weak and/or thready pulse
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Respiratory manifestations of hyponatremia
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crackles, tachypnea, dyspnea, orthopnea
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GI manifestations of hyponatremia
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N/V, hyperactive bowel sounds, abdominal cramping, diarrhea
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How to assess for hyponatremia
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CNS sx, BP, HR (tachy), dry mucous membranes, fluid i/o, sodium below 135, cl below 97
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Tx Goals for hyponatremia
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correct body water osmolality,
restore cell volume, raising ratio of na/h2o |
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Interventions for hyponatremia
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reduce na loss in high risk patients,
restore sodium imbalance, |
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Etiologies of Hypernatremia
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gain of more salt than water
loss of more water than salt: excess water loss, dehydration, overuse of IV saline solutions, cushing's syndrome, uncontrolled dm, tube feeding IV hypertonic solution, inability to respond to thirst, decreased ADH (diabetes insipidus), diarrhea or sweating without water replacement, difficulty swallowing fluids |
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neuro sx of hypernatremia
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increased osmolality of ECF causes neurons to shrivel because water moves from cells to interstitial fluid causing confusion, seizures, coma and death
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gi sx of hypernatremia
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polyuria, nausea, vomiting
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CV 6 sx of hypernatremia
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HTN, jugular venous distention, S3 gallop, generalized weight gain and edema, dysrythmias
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3 respiratory sx of hypernatremia
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crackles, dyspnea, fluid effusion
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tx goals for hypernatremia
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correct body water osmolality,
restore cell volume, decrease ratio of na/water |
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interventions for hypernatremia
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monitor i/o,
oral care |
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name elements in extracellular fluid
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sodium, bicarb HCO3, chloride, calcium
low in K, Mg, Phosphate |
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name elements in intracellular fluid
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K, Mg, Phosphate, Protein
low in Cl and Na |
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what is major anion found predominantly in extracellular spaces
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chloride
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which mineral follows sodium
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chloride
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what is the function of chloride
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maintains cellular integrity
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What is the normal range for chloride
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98-107 mEq/L
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hypochloremia etiologies
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loss via gi tract,
diuretics |
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clinical manifestations of hypochloremia
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weakness, muscle cramps, hyperactive reflexes
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hyperchloremia etiologies
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increased in na serum levels,
deficit of bicarb |
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clinical manifestations
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metabolic acidosis
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what is the principle cation of intracellular fluid and the primary buffer of the cell
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k
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what are 5 functions of potassium
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nerve conduction,
muscle function, acid/base balance, osmotic pressure, controls rate/force of contraction of heart and cardiac output |
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what is the normal range for potassium
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3.5 - 5 mEq/L
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hypokalemia: etiologies
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decreased K intake (anorexia, fasting, NPO),
increased K loss (renal, fecal, sweating), K redistribution from ECF into cells (excess insulin tx for DM), hyperaldosteronism, debilitated patients, medications, hypernatremia, vomiting/diarrhea |
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gi sx of hypokalemia
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anorexia, n/v, abdominal distention, decreased bowel sounds
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cv sx of hypokalemia
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r/t decreased conduction,
ECG/EKG changes, dysrhythmias, hypotension, weak pulse, slightly peaked p wave, prominent u wave |
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neuro sx of hypokalemia
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postural hypotension,
weakness, fatigue, irritability, confusion, a/v premature beats, v fib |
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respiratory sx of hypokalemia
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shallow respirations, SOB, apnea
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interventions for hypokalemia
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cardiac monitor,
oral or iv potassium, potassium rich foods, |
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hyperkalemia: etiologies
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increased K intake (excessive or too rapid IV infusion),
impaired excretion of K (renal dz), shift of K out of cells into ECF (24-72 hours after trauma, crushing injury, cytotoxic drugs, lack of insulin from untreated DM) |
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gi sx of hyperkalemia
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abdominal cramps, diarrhea
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cv sx of hyperkalemia
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r/t increased conduction,
ecg/ekg changes, dysrythmias, hypotension, tachycardia, arrythmia, death by asystole or V fib, cardiac arrest |
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respiratory sx of hyperkalemia
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muscle paralysis
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neuro sx of hyperkalemia
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nerve and muscle irritability,
paresthesia, convulsions, agitation, weakness |
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renal sx of hyperkalemia
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oliguria, anuria
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hyperkalemia ecg changes
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decreased r wave amplitude (not as high),
widened QRS, narrow and peaked T wave |
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What is normal range for Calcium
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4.5 - 5.5 mEq/L
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what other lab values are affected by calcium
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decreased albumin = decreased calcium
increased phosphorus = decreased calcium |
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3 types of calcium in the body
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protein bound 50%,
citrate/salt form, free/ionized (most active)50% |
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functions of ionized calcium
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muscular contraction, cardiac function, nerve impulse transmission, blood clotting
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hypocalcemia: etiologies
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decreased ca intake or absorption (chronic diarrhea from laxative abuse or pancreatitis),
decreased physiologic availability of ca (hypoparathyroidism, hypomagnesmia), increased ca excretion via renal or fecal routes, inadequate vitamin D intake (lactose intolerance, gi disease, liver disease), NPO status, medications, parathyroid disease |
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neuro sx of hypocalcemia
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paresthesias in hands/feet/toes/lips,
chvostek's sign, trousseau's sign, muscular irritability, muscle twitching, seizures |
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cv sx of hypocalcemia
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r/t abnormal conduction,
hypotension, dysrhythmia, prolonged QT interval |
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hematological sx of hypocalcemia
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prolonged bleeding times
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musculoskeletal sx of hypocalcemia
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tetany, laryngospasm, muscle twitching and cramping, pathological fractures
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interventions for hypocalcemia
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cardiac monitor and
monitor for bleeding |
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hypercalcemia: etiologies
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increased ca intake or absorption (antacids, vit. D overdose from shark cartilage),
mobilization of ca from bone into blood (hyperparathyroidism, malignant tumor, leukemia), decreased ca excretion (thiazide diuretics) |
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gi sx of hypercalcemia
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n/v, constipation, anorexia
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neuro sx of hypercalcemia
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r/t abnormal conduction,
fatigue, muscle weakness, decreased reflexes, h/a, confusion, lethargy, personality change, coma |
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renal sx of hypercalcemia
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kidney stones
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cv sx of hypercalcemia
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r/t abnormal conduction,
shortened QT interval, Widened T wave, dysrhythmias, cardiac arrest |
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interventions for hypercalcemia
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cardiac monitoring,
increase fluid intake, safety precautions |
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functions of phosphate
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generation of bony tissue,
metabolism of glucose and lipids, maintanance of acid/base balance, storage and transfer of energy |
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what is normal serum range for phosphate
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2.7 - 4.5 mg/dL
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hypophosphatemia: etiologies
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decreased intake or absorption (alcoholism, chronic diarrhea, malabsorption),
shift from ECF into cells (insulin), increased excretion through normal renal route (diabetes, ETOH withdrawal), loss through abnormal route (excessive vomiting), excessive antacid use, lead poisoning |
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clinical findings in hypophosphatemia
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r/t decreased energy source,
anorexia, malaise, paresthesias, hemolysis, decreased reflexes, muscle aches/weakness, confusion, stupor, seizures, coma, respiratory failure, impaired cardiac function |
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interventions for hypophosphatemia
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mild: treat with diet,
severe: treat with TPN |
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hyperphosphatemia: etiologies
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increased intake or absorption (iatrogenic),
redistribution from cells into ECF (tumor lysis, crushing injury), decreased excretion (renal failure with oliguria), excessive vitamin D, hypoparathyroidism, addison's disease |
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gi sx of hyperphosphatemia
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anorexia, n/v
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neuro sx of hyperphosphatemia
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restlessness
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cv sx of hyperphosphatemia
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tachycardia, palpitations, dysrhythmia
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renal sx of hyperphosphatemia
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kidney obstruction
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interventions for hyperphosphatemia
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mild or asymptomatic: diet modification - limit high phosphate foods,
administer calcium or aluminum products |
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what is normal serum magnesium range
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1.5 - 2.5 mEq/L
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How is magnesium distributed in body
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40-60% in bone,
20% in muscle, 30% in cells |
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Functions of magnesium
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regulates neuromuscular irritability and clotting mechanism,
linked with calcium |
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hypomagnesemia: etiologies
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decreased intake or absorption (alcoholics, malnutrition),
decreased availability of mg, increased loss through normal routes, loss thru abnormal routes |
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cv sx of hypomagnesemia
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r/t increased neuromuscular activity,
premature ventricular contraction, atrial or ventricular fibrillation, ecg changes |
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neuro sx of hypomagnesemia
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increased neuromuscular excitability,
insomnia, increased reflexes, muscle cramping/twitching, chvostek sign, trousseau sign, tetany, convulsions, dysphagia |
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gi sx of hypomagnesemia
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anorexia, nausea, abdominal distention
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psychological sx of hypomagnesemia
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depression, psychosis, confusion
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hypermagnesemia: etiologies
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increased intake or absorption (antacid tx, near drowning in salt water),
decreased excretion (renal failure with oliguria, decreased urine output), severe dehydration, iv administration, |
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cv sx of hypermagnesemia
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r/t decreased neuromuscular activity,
ECG changes, heart block, premature ventricular contractions, hypotension, arrythmias/bradycardia |
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neuro sx of hypermagnesemia
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decreased reflexes, lethargy, loss of deep tendon reflexes, respiratory paralysis, loss of consciousness, drowsiness
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