How can Hyperkalemia be treated?
- tx underlying cause
- restrict intake: food, PO meds, IV replacements
- kayexalate (for mild symptoms, this gives pt diarrhea)
- IV (given when K+ is around 6: ca gluconate, sodium bicarbonate, IV insulin (regular only), hypertonic dextrose
- peritoneal dialysis or hemodialysis
- Beta2 agonist (albuterol)
- Other important interventions: check HR/cardiac monitor, re-check K+ labs and EKG, vitals
What are some signs of hypocalcemia?
Chvostek sign (face) and Trousseau’s sign (hand), seizures, muscle spasm, paresthesia
What can cause hypocalcemia?
hypoparathyroidism
hypoalbuminemia
decreased intake
What are the treatments for hypocalcemia?
PO: tums
Symptomatic: IV Ca slowly (given over 30min to 1 hour)
What electrolyte works together and against calcium?
phosphate works opposite and magnesium works with calcium
What are the treatments of hypercalcemia?
- IVF and IV Lasix to prevent FVE
- Neuta-Phos
- Phosphate binders
- Calcitonin
What is so important to monitor for a pt with hypercalcemia?
monitor for digitalis toxicity
What are some causes of hypomagnesemia?
alcoholism
malabsorption
bowel obstruction
Because of the caution between meds for hypomagnesemia and pt with renal impairment what needs to be watched?
urine output
Pt’s taking CNS depressants and hypomagnesemia meds need to be…..
monitored closely
IV infusion meds for treatment of hypomagnesemia can produce what side effects if rate is too fast?
flushing and sweating
What are the treatments of hypermagnesemia?
- decrease intake
- administer diuretics and 0.45% NaCl (only if renal function is adequate)
- IV Ca gluconate
- support respiratory function
- hemodialysis
What is the treatment for mild to moderate hypophosphatemia?
oral supplement
What is the treatment for severe hypophosphatemia?
IV
- do not exceed 10 mEq/hr
- monitor for infiltration
What is the treatment for hyperphosphatemia?
- phosphate binders
- vitamin D preparations
