Fluid & Electrolyte effects changes in ECG

[bt92019]

Please help me out to remember ECG from fluid & electrolyte deficiency ie; in hyperkalemia-tall paked T waves & in hypokalemia - prominent U wave......is there any easy way to remember for hypo & hyper calcemia,hypo & hyperkalemia and magnesemia? Thanks in advance.

[willdgate]

Not an easy way, but you should check old notes, however, I don't think the n-clex will get specific with types of rhythm changes, but they may have somthing like for hypo calcemia, magnesium pt. needs a cardiac monitor.

[hubbaa3256]

Natremias

D

hypErnatremia

hydration

hypOnatremia

verload

I was taught that kalemias do the same as the prefix except for heart rate and urine output.

EX: HYPERkalemia: bradycardia, oliguria, restlessness,diarrhea, hyperglycemia,hyperreflexia, increased BP, peaked T waves

HYPOkalemia: tachycardia, polyuria, constipation, hypoglycemia

Calcemias do the opposite of the prefix

EX: HYPOcalcemia causes neuromuscular irritability

[MomenTs]

Hi Hubba,

That was very helpful. Thankyou so much.

Does anyone else have a memory tricks like that? If you do please post, it helps so much.

Thank you all.

[texasnursingstudent]

SODIUM:

Hypernatremia (too much Na)

Fever, flushed skin

Restless (irritable)

Increased respirations, BP

Edema-peripheral and pitting

Dehydrated*, decreased urine output**, and dry mouth

*Think about when you eat a bunch of salty FRIED foods....you end up really thirsty!

**Think about the "normal" amount of urine output for an adult patient, which is approx. 30cc/hr. The patient who has too much Na will not be putting out a lot of urine, because his body will be trying to hold on to the fluid it has in order to handle the high amounts of Na floating around in the body.

Causes of hypernatremia:

Medications, meals (too much sodium intake)

Osmotic diuresis (lots of water is moved around out

Diabetes insipidus

Excessive water loss

Low water intake

Hyponatremia- (low Na) --I don't have a mnemonic of this, sorry!

Lots of GI suctioning

Diarrhea

Vomitting

Hypertonic solutions, which cause the fluid to shift from ICF to ECF, leading to dilutional hyponatremia

Diuretics

Vomitting

POTASSIUM:

hyperkalemia (too much K)

Muscle weakness

Urine output changes: oliguria, anuria

Respiratory distress

Decreased cardiac contractility

ECG changes: tall, peaked T waves, wide QRS, no P wave

Reflex changes: hyperreflexia or areflexia (flaccid)

"murder" makes sense because, if you think about it, too much potassium for too long can cause a patient to die. also, without getting into the debates of the morality in lethal injections, potassium is one of the substances that are injected into the inmate (who probably is being put to death for murder, at least here in Texas) to stop his heart.....so he dies. sorry if this offends you, but its the way I remember it....although admittedly cryptic.

causes of hyperkalemia:

Medications: ACE inhibitors, NSAIDS

Acidosis: both metabolic and respiratory acidosis

Cellular destruction: burns, traumatic tissue injury

Hypoaldosteronism and hemolysis

Intake of too much P, such as eating lots of bananas

Nephrons and renal failure

Excretion of K is impaired (K is excreted by kidneys)

Ok, I have to go now...but I hope this helps! I got this from Mosby's Fluid and Electrolyte Memory Note Cards by Zerwekh and Claborn...check it out...there's more stuff in there.

[UM Review RN, ASN, RN]

Hyperkalemia: Tall Tenting Twaves. :) Hope that helps.

[phil03]

Please help me out to remember ECG from fluid & electrolyte deficiency ie; in hyperkalemia-tall paked T waves & in hypokalemia - prominent U wave......is there any easy way to remember for hypo & hyper calcemia,hypo & hyperkalemia and magnesemia? Thanks in advance.

Hypercalcemia/Hypermagnesemia---acts like sedative--think muscle weakness

Hypocalcemia/Hypomagnesemia---No sedative--muscle twitching, rigidity, ---> seizures again... think muscle....