Presentation
This presentation was consistent with flacainide cardiotoxicity exacerbated by electrolyte disturbance. The syncopal episodes probably represented life-threatening arrhythmias. [ncbi.nlm.nih.gov]
Calcium is also present in green leafy vegetables, legumes and nuts. Magnesium is present in whole grains, nuts and green vegetables. Normally, electrolytes are lost during sweating as while doing heavy physical work or travelling in hot weather. [newtimes.co.rw]
Entire Body System
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Fatigue
Dehydration Increased thirst, dry mouth, dry skin, decreased urine output, fatigue, shortness of breath, stomach cramps. Sodium Loss Loss of appetite, stomach cramps, cold arms, and/or legs, fatigue, feeling faint. [zanecohencentre.com]
If stress is unrelenting and becomes chronic, adrenal burnout and fatigue progresses to its more advanced stages. [drlam.com]
breznik 's version from 2012-02-26 05:37 Section Question Answer Lethargy, confusion, apprehension, muscle twitching, abdominal cramps, anorexia, nosia, vomiting, headache, seizures, coma, decreased thirst Hyponatremia Convulsions, disorientation, fatigue [memorize.com]
A man presented with recurrent syncope, weakness and fatigue. His ECG showed marked QRS widening and he had gross hyponatraemia and hypokalaemia. His medications included bendroflumethiazide (long term) and flecainide (started 2 months previously). [ncbi.nlm.nih.gov]
Fatigue Olena Yakobchuk/Shutterstock One of the most common symptoms of electrolyte imbalance is fatigue. Falling short on magnesium can be the culprit. “Magnesium is involved in more than 300 processes in the body,” says Foroutan. [thehealthy.com]
Cardiovascular
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Heart Block
Hypocalcemia Lethargy, weakness, depressed deep tendon reflexes, bone pain, anorexia, nausea, vomiting, constipation, polyuria, hypercalciuria, renal calculy/ flank pain, dysrythmias, heart block. [memorize.com]
Block • Polyuria • Kidney Stones • Renal failure • Bone pain • Fracture 166. [slideshare.net]
block Atria] asvstole Ventricular tachvcardiaí'fibrillation Asystole,,,diastolic cardiac arrest Neuromuscular Confusion Paraesthesia Muscle weakness Paralysis ECG electrocardiooratn Table II - Clinical manifestations of hyponatraemia Therapeutics should [medbc.com]
Workup
QRS Wave
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Wide QRS Complex
On an EKG, wide QRS complexes and unusually tall, peaked T waves can be seen. [ems1.com]
CLINICAL MANIFESTATIONS CARDIOVASCULAR SYSTEM RESPIRATORY GI SYSTEM SYSTEM First tachycardia then bradycardia Slow, weak, irregular heart rate Decreased blood pressure ECG changes- peaked narrow T- waves, wide QRS complex, Depressed ST segment, widened [slideshare.net]
PR Interval
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Prolonged PR Interval
Assessment findings: serum magnesium level is greater than 2.3mg/dl creatinine clearance decreases to less than 3.0ml/min ECG finding: prolonged PR interval : tall T waves : widened QRS 85. Administration of magnesium Ventilatory support IV [slideshare.net]
Prolonged PR interval C. Depressed ST segment D. Widened QRS complexes 69. A. Alcoholism B. Renal insufficiency C. Hypoparathyroidism D. Tumor lysis syndrome 70. [proprofs.com]
QT, RR, ST Intervals
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ST Elevation
Signs and symptoms of hyperkalemia can include ECG & EKG changes including ST elevation, peaked T waves among others. [youtube.com]
Hyponatremia and long-term mortality in survivors of acute ST-elevation myocardial infarction. Arch Intern Med. 2006;166:781–786. [PubMed] [Google Scholar] 7. Mahowald JM, Himmelstein DU. [ncbi.nlm.nih.gov]
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Prolonged QT Interval
Prolonged QT interval D. Shortened ST segment 68. A. Prominent U waves B. Prolonged PR interval C. Depressed ST segment D. Widened QRS complexes 69. A. Alcoholism B. Renal insufficiency C. Hypoparathyroidism D. Tumor lysis syndrome 70. [proprofs.com]
Rhythm
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Torsades De Pointes
Ventricular tachycardia, ventricular fibrillation and torsade de pointes. [ecgwaves.com]
T Wave
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Peaking T Wave
Signs and symptoms of hyperkalemia can include ECG & EKG changes including ST elevation, peaked T waves among others. [youtube.com]
t waves, tremors twitching (CNS stimulation) Hypokalemia: (too much lasix) tachycardia, hypotension, flacid muscles, flat t waves, u waves. [allnurses.com]
ECG changes characteristically progress sequentially from symmetrically peaked T waves widening of the QRS complex prolongation of the P–R interval loss of the P wave loss of R- wave amplitude ST-segment depression an ECG that resembles a sine wave [slideshare.net]
The client in normal sinus rhythm with a peaked T wave. B. The client diagnosed with atrial fibrillation with a rate of 100. C. The client diagnosed with a myocardial infarction who has occasional PVC. D. [proprofs.com]
Clinical signs of hyperkalaemia include muscle weakness, hypotension, bradycardia and loss of cardiac output, and ECG changes may include peaked T waves and flattened P waves. [ausmed.com]
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Flattened T Wave
In severe cases, changes in the patient's EKG include a shortened QT interval associated with a shortened ST segment, flattened T waves and the presence of Osborn waves. [ems1.com]
• Weak peripheral pulses • Orthostatic hypotension • Dysrhythmias • Vertigo • Flattened T wave • Shallow, ineffective respirations • Diminished breath sounds • SOB • Anxiety, confusion, coma • Loss of tactile discrimination • Paresthesias • Deep tendon [slideshare.net]
Electrocardiographic manifestations of hypokalemia include a flattened T wave, prolongation of the QT interval, or the appearance of U waves. Severe hypokalemia can produce cardiac arrhythmias, ileus, and lethargy. [emedicine.medscape.com]
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T Wave Inversion
T-wave inversion may occur in severe hypokalaemia. ST segment depression develops and may, along with T-wave inversions, simulate ischaemia. P-wave amplitude, P-wave duration and PR interval may all increase. Finally, U-waves emerge. [ecgwaves.com]
Treatment
In this case report, the treatment is presented of an elderly patient who was diagnosed with RS and followed-up in the intensive care unit (ICU) due to resistant fluidelectrolyte imbalance. [ncbi.nlm.nih.gov]
Treatment for electrolyte imbalance involves either supplementing low levels or lowering high levels of the affected electrolytes. Treatment may be given by mouth or by injection. [netdoctor.co.uk]
However, symptoms can sometimes be severe, and a person may need to be hospitalized and monitored during treatment. [medicalnewstoday.com]
This article was provided by doctor zhengfalei 2013-12-13 10:00 Electrolyte imbalance is one of the major causes for dialysis patients to make diet changes, so a timely and effective treatment is very important. [kidney-treatment.org]
Prognosis
This study aimed to investigate the etiology, risk factors and short-term prognosis of gastroenteritis with convulsion. [ncbi.nlm.nih.gov]
Admission hyponatremia in the elderly: factors influencing prognosis. J Gen Intern Med. 1994;9(2):89–91. Epub 1994/02/01. pmid:8164083. View Article PubMed/NCBI Google Scholar 11. Hawkins RC. [journals.plos.org]
The prognosis is then poor as irreversible neurological damage and even death may occur. [helpher.org]
Prognosis A patient's long-term prognosis depends upon the root cause of the electrolyte disorder. However, when treated quickly and appropriately, electrolyte imbalances in and of themselves are usually effectively reversed. [medical-dictionary.thefreedictionary.com]
Etiology
The etiologic agent in developed countries is viral in 15-60% of cases, while in developing countries, bacteria and parasites are frequently reported as the etiologic factors. Neurologic signs including convulsion are seen in some cases of diarrhea. [ncbi.nlm.nih.gov]
Calcium Hypercalcaemia Etiology of hypercalcaemia Primary hyperparathyroidism and malignancies cause 90% of all cases of hypercalcaemia. [ecgwaves.com]
ETIOLOGY Retention of Potassium- Renal insufficiency, renal failure, decreased urine output, potassium sparing diuretics. Excessive release of Cellular Potassium - severe traumatic injuries. [slideshare.net]
Epidemiology
The USDA reported in epidemiological studies that 61% of the U.S. population does not ingest adequate magnesium from their diet. Post-operative patients were found to lack adequate magnesium 60% of the time! [metabolichealing.com]
He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]
Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]
Observational retrospective cross sectional and epidemiological surveys have established an association between chronic hyponatremia and osteoporosis and major osteoporotic fracture [106, 107, 108, 109, 110, 111]. [intechopen.com]
Pathophysiology
In McCance KL, Huether SE, Brashers VL et al, editors: Pathophysiology, the biologic basis for disease in adults and children, ed 6, St Louis, 2010, Mosby, pp 96-125; The body fluid compartments: extracellular and intracellular fluids; edema. [musculoskeletalkey.com]
In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills for fluis and electrolyte imbalances in order to: Identify signs and symptoms of client fluid and/or electrolyte imbalance Apply knowledge of pathophysiology [registerednursing.org]
PATHOPHYSIOLOGY Fluid shift from interstitial spaceto vascular space Hypervolemia Second Phase 94. [slideshare.net]
In this video Michael Linares, RN from Simple Nursing helps pinpoint the exact pathophysiology, causes, and treatments of fluid and electrolyte imbalances, which is expected to know for the NCLEX, HESI, ATI, and Kaplan proctor exams. [youtube.com]
Prevention
Advice from the doctor at the Grand Canyon clinic as reported in the Wilderness Medicine Institute regarding the issue: Prevention is a matter of being sensible, which is so often the case. [outdoors.stackexchange.com]
Arrhythmias and cardiac arrest have been reported during amphotericin B administration but no effective technique has been described to prevent them. [ncbi.nlm.nih.gov]
Early detection of abnormality in serum electrolyte levels allows prompt initiation of measures to prevent further imbalances. [nurseslabs.com]