This document discusses electrolyte disturbances, focusing on sodium, potassium, and calcium. It provides normal levels, causes of hypo- and hyper- conditions, signs and symptoms, diagnostic tests, and treatment approaches for each electrolyte. For sodium, it describes hyponatremia and hypernatremia in detail. For potassium, it addresses hypokalemia and hyperkalemia. For calcium, it discusses hypocalcemia and the key roles of calcium in the body. The document is intended as an educational reference for electrolyte abnormalities.
Post-Cardiac Arrest Syndrome:
Epidemiology, Pathophysiology, Treatment, and Prognostication
A Consensus Statement From the International Liaison Committee on Resuscitation
Circulation. 2008;118:2452-2483
Post-Cardiac Arrest Syndrome:
Epidemiology, Pathophysiology, Treatment, and Prognostication
A Consensus Statement From the International Liaison Committee on Resuscitation
Circulation. 2008;118:2452-2483
The presentation covers definitions, identification, Treatment goals, Special situations, Practice points, and cardinal pharmacotherapy. Session presented in NBE learning session
Short description about awake craniotomy, its indications, contraindications, complications,various techniques of providing awake craniotomy and drugs used.
The presentation covers definitions, identification, Treatment goals, Special situations, Practice points, and cardinal pharmacotherapy. Session presented in NBE learning session
Short description about awake craniotomy, its indications, contraindications, complications,various techniques of providing awake craniotomy and drugs used.
This lecture is based on National guidelines(Sri Lanka) and guidelines by NHS UK. all the materials used to prepare the lecture are trusted and high in quality. also the books referred are internationally recognized. both hyper and hypokalemia management included in the lecture. lecture is free and you can even download. i kept no copy rights. i appreciate your support, comments and suggestions. also i would be grateful if you can make these lectures popular. wishing your success.
THIS SEMINAR GIVES THE BASIC OVERVIEW THAT HOW YOU CAN MANAGE THE PATIENT WHO COMES TO YOU A FLUID AND ELECTROLYTE IMBALANCE . AND BASIC MECHANISM OF HOMEOSTASTIS
Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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2. Sodium
Normal Na level in the blood is 135-145 meq/l.
Hyponatremia :
serum sodium is < 135 meq/l consider hyponatremia.
Results from excess Na loss or water gain
GI losses, diuretic therapy, severe renal dysfunction, severe
diaphoresis, DKA, unregulated production of ADH associated
with cerebral trauma, narcotic use, lung cancer, some drugs
Clinical manifestations
↓ BP, confusion, headache, lethargy, seizures, decreased
muscle tone, muscle twitching and tremors, vomiting, diarrhea,
and cramps
2
3. Diagnosis of hyponatremia
Clinically which depend on underlying causes & serum levels:
Cerebral edema < 120 meq/l
Cardiac symptoms < 100 meq/l
3
4. Labratory tests
we have 3 tests
1.plasma osmolality.
2.urinary osmolality.
3.urinary sodium excretion,(low Na and Cl concentration).
4.The cell is going to swell as water is pulled in from the ECF,
resulting in the increased Hct, and sometimes the increased K.
Decreased Na, Cl, Bicarbonate.
5. Urine specific gravity ↓ 1.010.
6. Generally, urine sodium is decreased EXCEPT in cases of
SIADH. In those cases, the urine Na is greater than 20 mEq/ L,
and the urine specific gravity is high.
4
5. Treatment
Treatment should start when patient have symptoms or whem serum
Sodium < 120 meq/l.
Mild
Water restriction if water retention problem (Euvolemic &
Hypervolemic).
Increase Na in foods if loss of Na
Moderate
IV 0.9% NS, LR (Hypovolemic)
Severe
3% NS – short-term therapy in ICU setting (Hypovolemic)
5
6. Calculation of Na deficit can be obtain from this equation .
Sodium deficit=total body water X (desired Na - present Na)
TBW = body wt x 0.6 males
TBW = body wt x 0.5 females
6
7. Rate of correction depends on absence or presence of neurologic
dysfunction.
In mild to moderate symptomatic patients :
(0.5 to 1 meq/l/hr or 10 to 12 meq/l over first 24 hours).
In Severe symptomatic hyponatremia (<110 meq/l), hypertonic saline
in 1-2meq/l/h in the ist 3-4h.(total not exceed 12meq/l/24h)
Rapid correction can lead to…
1. osmotic demyelination syndrome(central Pontine myelinolysis).
2. chronic hyponatremia.
3. flaccid paralysis,dysarthria,dysphagia.
7
8. Hypernatremia
S.sodium > 145 meq/l
Gain of Na in excess of water or loss of water in excess of Na
The symptoms are generally neuro in origin, and thought to be
related to the cellular shrinking as water goes to the ECF(contracted
ICF volume). Permanent brain damage can occur with prolonged or
severe hypernatremia
8
9. Causes of hypernatremia
Deprivation of water; hypertonic tube feedings without water
supplements, watery diarrhea, greatly increased insensible
water loss, renal failure, use of large doses of adrenal
corticoids, excess sodium intake
Impaired thirst coma.
Diabetic ketoacidosis
Non-ketotic hyperosmolar coma
Excessive water loss diabetes insipidus
Following administration of large quantities of hypertonic
saline solutions
9
10. Signs/Symptoms
Early: Generalized muscle weakness, faintness, muscle
fatigue, desire for water .
Moderate: Confusion, thirst.
Late: Edema, restlessness, thirst, hyperreflexia, muscle
twitching, irritability, seizures, possible coma
Severe: Permanent brain damage, hypertension, tachycardia,
N & V
Patient may prone for intracerebral or subarachnoid
haemorrhage
10
11. Labs:
Increased serum Na above normal level .
Increased serum osmolality
Increased urine specific gravity
11
12. Treatment
Free water to replace ECF volume
Gradual lowering with hypotonic saline
Decrease by no more than 2 mEq/L/hr
Supplement tube feedings with free water
Correction should be done over 48 to 72 hours.
Hypotonic solution like 5% dextrose.
Plasma Na should be lowered by 0.5 meq/l/hr or not more than
12meq/l/ 24 hrs.
13. To calculate water deficit
Water deficit = plasma Na - 140 X TBW
140
Rapid correction can lead to…
Seizures or permanent neurologic damage
13
14. Anaesthetic implications
Enhance uptake of inhalation anaesthtics by decreasing
cardiac output.
Predisposes to hypotension & hypoperfusion of tissues.
Decreases volume of distribution and reduction in dose of
intravenous agents
14
15. Potassium
Normal 3.5-5.5 mEq/L
Major ICF cation.
Potassium is Vital in maintaining:
1. Normal cardiac and neuromuscular function,
2. Influences nerve impulse conduction,
3. Important in CHO metabolism,
4. Helps maintain acid-base balance,
5. Control fluid movement in and out of cells by osmosis
15
16. Hypokalemia
Serum potassium level below 3.5 mEq/L
Causes
1) Loss of GI secretions.
2) Movement of K into the cells (DKA)
3) Prolonged fluid administration without K supplementation
4) Diuretics (some)
5) Metabolic alkalosis.
6) Hormonal( insulin).
7) Drugs : Beta 2 agonist, alpha antagonist.
8) Anabolic state , total parentral nutrition.
9) Renal :Hyperaldosteronism ,Congenital adrenal hyperplasia
10) Cushings syndrome
16
19. ECG Changes of hypokalemia
Appearance of U wave
Flattening or inversion of T wave
ST segment depression
Prolonged QT interval
Prominent U wave
Prolonged PR interval
Widening of QRS complex
Ventricular arrhythmias
19
20. Treatment
Hydrate if low UOP.
Oral replacement through high K diet.
IV supplementation :
No more than 10 mEq/hr; for child 2-4 mEq/kg/24 h.
No more than 40 mEq/L.
20
21. Treatment of hypokalemia
If s.potassium < 3 mq/l needs definitive treatment
Management of severe symptomatic hypokalemia in patient with nil by
mouth:
1)Potassium deficit in mmol is calculated as given below:
Kdeficit (mmol) = (Knormal lower limit - Kmeasured) x kg body weight x 0.4
2) Daily potassium requirement is around 1 mmol/Kg body weight.
3) 13.4 mmol of potassium found in 1 g KCl.
21
22. Example of K replacement
Suppose we get an asymptomatic patient of 70 Kg with a
serum potassium level of 3.0 mmol/L and he is on nil by
mouth but having an adequate diuresis, we proceed this way.
1) Deficit of potassium in mmol = (3.5 - 3.0) x 70 x 0.4 = 14
mmol
2) Daily potassium requirement = 1 x 70 = 70 mmol
3) Total requirement = 14+70 = 84 mmol = (84/13.4) = 6.3 g
KCl
Therefore we can give the patient 1.0 g KCl (around 13 mmol
of K+) in 500 mL Normal Saline (N/S) solution to run 4 hourly
and reassess the serum potassium level after 1 day. So, in
around 24 hours, we have given the patient around (24/4 = 6
pints of N/S solution, total KCl administered = 6.0 g i.e. around
80 mmol K+).
22
24. Hyperkalemia
Serum potassium level above 5.3 mEq/L
Causes:
1. Decreased renal excreation of potassium.
2. Renal failure.
3. Hypoaldosteronism.
4. Drugs: Spironolactone, ACE inhibitors.
5. Excessive K intake (IV or PO) especially in renal failure.
6. Tissue trauma.
7. Acidosis.
24
25. 8. Due to extracellular movement of k+
Acidosis.
Hyperkalemic periodic paralysis.
Succinylcholine.
Rhabdomyolysis.
Cell lysis following chemotherapy.
25
26. Signs/Symptoms
ECG changes – tachycardia to bradycardia to possible
cardiac arrest.
On EKG, tall tented T waves are noted. This is because
changes in cardiac conduction are occuring. Ventricular
dysrhythmias are common. Generally, cardiac changes begin
with a K around (6 – 7meq/l), but are always present with a K
level around 8.
Muscle weakness, paralysis, paresthesia of tongue, face,
hands, and feet, N/V, cramping, diarrhea, metabolic acidosis
26
27. Treatment
1. Calcium gluconate
10ml of 10% calcium gluconate IV over 5 to 10 min. Repeated
if no change in ECG is seen after 5 to 10 min
How it helps……?
protects the myocardium
from toxicity to potassium
27
28. 2. Insulin & glucose:
10 to 20 units of regular insulin in 50 ml of 25 to 50 % dextrose
Initial bolus should be followed by continous infusion of 5%
dextrose , the effect begins in 15 min & peak in 60 Min
3. Sodium bicarbonate:
7.5 % of 50 to 100 ml is given as IV slowly over 10 to 20 min.
4. Beta agonist:
Salbutamol 20 mg in 4 ml saline by nebulisation
28
29. 5. Loop & thiazide diuretics.
6. Cation exchange resins:
Sodium polystyren sulphonate, promote exchange of Na for K
in GIT , 25 to 50g with 100ml of 20% sorbitol 3 to 4 times a
day.
7. Haemodialysis
29
30. Calcium
Ionized calcium is generally accepted as between 4.5 – 5.5.
Ionized calcium is the only form of calcium that is
physiologically relevant. Serum calcium is frequently
reported and must be adjusted for albumin levels and serum
proteins.
Normal plasma calcium 8.5 to 10.5 mg/dl.
50% in ionized form ,40% protein bound,10% complexed
with anions
30
31. Calcium
Required for :
Blood coagulation.
Neuromuscular contraction.
Enzymatic activity.
Strength and durability of bones and teeth
Ca absorption and concentration influenced by Vit D,
calcitriol (active form of Vitamin D), PTH, calcitonin, serum
concentration of Ca and Phosphate.
31
32. Causes of Hypocalcemia
1. Hypoparathyroidism.
2. Vitamin D deficiency.
3. Nutritional malabsorption .
4. Hyperphosphatemia .
5. Pancreatitis.
6. Rhabdomyolysis.
7. Chelation of calcium:(Rapid blood transfusion, rapid infusion
of large amount of albumins).
32
33. Signs/Symptoms
Abdominal and/or extremity cramping
Tingling and numbness
Positive Chvostek (Chvostek sign – abnormal spasm of the facial
muscle elicited by light taps on the facial nerve ),or Trousseau signs
(carpal spasm induced by inflating BP cuff on upper arm to pressure
exceeding systolic BP for 3 minutes ).
Tetany(Tetany is the most common sign of decreased calcium),
hyperactive reflexes
Irritability, reduced cognitive ability, seizures
Prolonged QT on ECG, hypotension, decreased myocardial
contractility
Abnormal clotting
33
34. Treatment
Symptomatic hypocalcemia – emergency 10 ml of 10%
calcium gluconate IV over 10 minutes.
Serial calcium measurements .
Correction of co-existing alkalosis
34
36. Hypercalcemia
Plasma calcium > 10.5 mg/dl.
Severe hyperCa is a very dangerous imbalance, and has greater
than a 50% mortality rate if not treated promptly.
Causes:
Mobilization of Ca from bone
Malignancy
Hyperparathyroidism
Immobilization – causes bone loss
Thiazide diuretics
Thyrotoxicosis
Excessive ingestion of Ca or Vit D
36
37. Signs/Symptoms
Anorexia, constipation
Generalized muscle weakness, lethargy, loss of muscle tone,
ataxia
Depression, fatigue, confusion, coma
Dysrhythmias and heart block
Deep bone pain and demineralization
Polyuria & predisposes to renal calculi
Pathologic bone fractures.
Cardiac standstill can and does occur when the serum Ca
level near 18 mg / dl.
37
39. Magnesium
Normal Mg level: 1.5 to 2.5 mEq/L.
Mg share in :
K and Na transport across cell membrane
Important in CHO and protein metabolism
Plays significant role in nerve cell conduction
Important in transmitting CNS messages and maintaining
neuromuscular activity.
39
40. Magnesium
As Mg plays a role in nerve conduction, Mg affects the
cardiovascular system peripherally by producing vasodilation.
Decreases peripheral vascular resistance
Balance - closely related to K and Ca balance
Intracellular compartment electrolyte
Hypomagnesemia - < 1.5 mEq/L
Hypermagnesemia - > 2.5 mEq/L
40
43. Treatment
Mild:
Diet – Best sources are unprocessed cereal grains, nuts,
legumes, green leafy vegetables, dairy products, dried fruits,
meat, fish. (Diarrhea is a common side effect of increased dietary
Mg.
Magnesium salts
Symptomatic magnesium sulfate 1 - 2 g IV over 10 min.(1 ml of
50% solution contains 4 meq ).
Monitor Mg q 12 hr
Monitor vital signs, knee reflexes
Precautions for seizures/confusion
Check swallow reflex .
43
44. Hypermagnesemia
Plasma mg > 2.5 meq/
Most common cause is renal failure, especially if taking large
amounts of Mg-containing antacids; DKA with severe water loss
Signs and symptoms
Hypotension, drowsiness, respiratory depression, coma, cardiac
arrest
ECG – Bradycardia, CHB, cardiac arrest, tall T waves
Hyporeflexia ,drowsiness & skeletal muscle
Weakness
Hypotension
Prolonged PR interval & widening of QRS complex
Respiratory arrest.
NOTE: Can appear falsely elevated with hemolyzed specimens.
44
45. Treatment
Withhold Mg-containing products
Calcium chloride or gluconate IV for acute symptoms
IV hydration and diuretics
Monitor VS, LOC
Check patellar reflexes.
Do not administer Mg to renal impaired clients.
Ventilatory support and IV Ca is indicated for emergencies.
Dialysis can reduce Mg levels within 2-4 hours.
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