Fluid/Electrolytes

Question 1

Patient with asthma, CHF, on Lasix and Albuterol. EKG changes and muscle weakness. What electrolytes suspecting?

Answer 1

Potassium (hypokalemia)

(and Magnesium? Hypomagnesemia)

Question 2

Emerging from a parathyroidectomy. Striderous. Electrolyte abnormality?

Answer 2

Hypocalcemia

Question 3

18% body surface burn. Restless, irritability, muscle twitching, lethargy. Lab value/electrolyte issues?

Answer 3

*** Hypernatremia (Na+ > 145 mEq/L, > 325 mOsm/kg)

*** Hypomagnesmia (Mg+ <1.5 mEq/L)

Hypokalemia

Hypocalcemia

Question 4

Hyponatremic, hypervolemic status. Electrolyte responsible for compensating to prevent brain swelling

Answer 4

Potassium

Question 5

Muscle twitching, Chvostek’s sign. What electrolyte abnormality?

Answer 5

Hypocalcemia

Question 6

Preeclamptic, lethargic, weak, decreased deep tendon reflexes. Electrolyte? What direction?

Answer 6

Hypermagnesemia (Mg2+ > 2.5 mEq/L)

Question 7

Assuming non-pathologic state, what electrolyte responsible for serum osmo?

Answer 7

Sodium (Na+)

Question 8

We primarily affect what part of TBW?

Answer 8

ECF, specifically the intravascular plasma volume

Question 9

Trauma patient. 6 units blood. Electrolyte abnormality most prominent (can be a couple of electrolytes)

Answer 9

** Hypocalcemia
** Hyperkalemia
Hypomagnesmia (sometimes)

Question 10

Normal levels for electrolytes

Sodium (Na+)

Answer 10

136-145 mEq/L

Question 11

Normal levels for electrolytes

Potassium (K+)

Answer 11

3.5-5.0 mEq/L

Question 12

Normal levels for electrolytes

Calcium (total)
Ionized

Answer 12

Total: 8.5-10.5 mg/dL
Ionized: 1.1-1.3 mmol/L
4.4-5.2 mg/dL

Question 13

Normal levels for electrolytes

Magnesium (Mg2+)

Answer 13

1.5-2.5 mEq/L
0.7-1.1 mmol/L

Question 14

Normal levels for electrolytes

Chloride (Cl-)

Answer 14

95-105 mEq/L

Question 15

Normal levels for electrolytes

Bicarbonate (HCO3-)

Answer 15

22-26 mEq/L

Question 16

Normal levels for electrolytes

Phosphate

Answer 16

2.5-4.5 mg/dL

Question 17

QT, ST segments. Shortened with increased BP. Electrolyte abnormality?

Answer 17

Hypercalcemia

Question 18

What calcium disorder is associated with Milk-alkali syndrome?

Answer 18

Hypercalcemia

Question 19

Elderly inpatient. Most common electrolyte abnormality in that population?

Answer 19

Hyponatremia

Question 20

Tissue hypoxemia. What want to avoid?

Answer 20

Sodium bicarbonate administration

Question 21

Electrolyte abnormality associated with nasogastric suctioning. Acid/base disorder?

Answer 21

Hypokalemia
Metabolic alkalosis (d/t decrease in
chloride)