Study 1 Emergency Assessment of Severe Electrolyte Disorders with 12 free online flashcards. Review key terms, definitions, and concepts with this interactive flashcard deck.
What comes first when a patient with a severe electrolyte disorder is unstable?
Prioritize airway, breathing, circulation, cardiac monitoring, and immediate treatment of the suspected cause. Obtain an ECG and urgent tests, but do not delay stabilization.
What is the immediate electrolyte treatment for hyponatremia with a seizure?
Give monitored boluses of 3% hypertonic saline. Avoid overly rapid sodium correction, which can cause osmotic demyelination.
What is the initial sodium-rise goal in severe symptomatic hyponatremia?
Aim initially for a modest sodium rise of about 4–6 mmol/L to reduce cerebral edema and improve symptoms, not immediate normalization. Check sodium frequently and avoid overcorrection.
What should be given promptly for hyperkalemia with ECG changes?
Give IV calcium promptly to stabilize the cardiac membrane. ECG changes indicate hyperkalemic cardiotoxicity and require urgent treatment.
Does IV calcium remove potassium from the body?
No. IV calcium stabilizes the myocardium but does not lower serum potassium. Potassium-shifting treatment and definitive potassium removal are also needed.
What is a key safety rule for potassium replacement in severe hypokalemia?
Replace potassium with controlled, monitored dosing according to protocol; never give a routine IV potassium push. Assess renal function and magnesium.
Why assess magnesium and renal function in severe hypokalemia?
Low magnesium can make hypokalemia difficult to correct and increase arrhythmia risk. Renal function also informs safe potassium replacement.
What is an initial treatment for severe symptomatic hypocalcemia?
Give IV calcium gluconate with ECG monitoring. Stridor, tetany, and QT prolongation are emergency findings in suspected acute hypocalcemia.
Why check magnesium in severe symptomatic hypocalcemia?
Magnesium deficiency can contribute to hypocalcemia and make it refractory to treatment, so check magnesium and correct it as indicated.
What is a typical initial approach to severe hypercalcemia with dehydration?
Assess volume status and cardiac and renal function; begin IV isotonic saline when appropriate. Individualize fluid therapy, then arrange cause-directed treatment.
What is a key treatment for torsades de pointes associated with low magnesium?
Give IV magnesium and manage the rhythm urgently. Correct contributing potassium deficiency, review QT-prolonging drugs, and provide resuscitation or defibrillation if indicated.
How is immediate severe hypermagnesemia toxicity addressed?
Stop magnesium sources, support airway and circulation, and give IV calcium to temporarily counteract magnesium’s effects. Severe toxicity with renal impairment may require hemodialysis.
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