0071643192.pdf

SYMPTOMS

■ Weakness

■ Slurred speech

■ Drowsiness →lethargy→coma and respiratory failure.

EXAM

■ Hyporeflexia

■ Cardiovascular

■ Hypotension

■ Prolonged PR and QT

■ ST and T-wave elevation

■ Bradycardia →AV block →asystole.

TREATMENT

■ Diuretics→calcium →dialysis for severe cases.

CHLORIDE

■ Extracellular anion that follows changes of other anions

■ Disorders in chloride are rarely the primary problem, but a reflection of

another process.

■ Chloride functions in water, osmotic, and acid-base balance.

Hypochloremia (Cl-<100 mEq/L)

CAUSES

■ Vomiting or diarrhea

■ Excessive sweating or heat exhaustion

■ Hyokalemic alkalosis

■ Acute infections

TREATMENT

■ Replace chloride with normal saline.

■ Check and correct for other associated electrolyte abnormalities.

Hyperchloremia (Cl->110 mEq/L)

CAUSES

■ Dehydration

■ Cardiac decompensation

■ Gastrointestinal or renal losses of bicarbonate

TREATMENT

■ For gastrointestinal loss administer saline.

■ For renal loss administer oral bicarbonate.

ENDOCRINE, METABOLIC, FLUID, AND

ELECTROLYTE DISORDERS

Always remember to regularly

check the reflexes of any

preeclamptic patient getting

magnesium. Decreased

reflexes indicate toxicity.

Hypochloremic hypokalemic

metabolic alkalosis is the

classic electrolyte disorder

seen with pyloric stenosis.