Noel Shared "Noel-Renal" - 54 Picmonics

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Noel-Renal

Normal Electrolyte Lab Values
Potassium (K+)
3.5 to 5.0 mEq/L
Calcium (Ca2+)
8.5 to 10.5 mg/dL
Phosphate (PO43–)
2.5 to 4.5 mg/dL
Magnesium (Mg2+)
1.5 to 2.5 mEq/L
Sodium (Na+)
135 to 145 mEq/L
Chloride (Cl)
95 to 105 mEq/L
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2 mins
Anion Gap Metabolic Acidosis
Pathophysiology
Increased Anion Gap
MUDPILES
Methanol
Uremia
Diabetic Ketoacidosis (DKA)
Propylene Glycol
Isoniazid or Iron
Lactic Acid
Ethylene Glycol
Salicylates
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1 min
Normal Gap Metabolic Acidosis
HARD-ASS
Hyperalimentation
Addison's Disease
Renal Tubular Acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline Infusion
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2 mins
Metabolic Alkalosis
Diuretic use
Vomiting
Antacid
Hyperaldosteronism
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26 secs
Respiratory Acidosis
Hypoventilation
Increased PaCO2 > 45
Barbiturates Depress Central Respiratory Center of Brain
Opioids Depress Central Respiratory Center of the Brain
Airway Obstruction
Respiratory Muscle Weakness/Paralysis
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3 mins
Respiratory Alkalosis
Hyperventilation
High Altitude
Aspirin
Restrictive Lung Disease
Pulmonary Embolism
Pregnancy
Progesterone
Rib Fracture
Anxiety
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1 min
ACE Inhibitor Toxicity
CAPTOPRIL Mnemonic
Cough
Angioedema
Potassium Changes (Hyperkalemia)
Taste Change
Hypotension
Pregnancy Changes
Rash
Increased Renin
Lower Angiotensin II
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2 mins
ACE Inhibitors
-Pril Suffix
Indications
Hypertension
CHF
Diabetic Nephropathy
Mechanism of Action
Inhibits ACE
Decreases GFR
Inhibits Constriction of Efferent Arteriole
Side Effect
Increased Bradykinin
Cough
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1 min
Acetazolamide
Indications
Glaucoma
Altitude Sickness
Pseudotumor Cerebri
CHF
Metabolic Alkalosis
Mechanism of Action
Carbonic Anhydrase Inhibitor
Sodium Bicarbonate (NaHCO3) Diuresis
Side Effects
Metabolic Acidosis
Paresthesias
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1 min
Angiotensin Receptor Blockers (ARBs)
-sartan suffix
Indications
Hypertension
CHF
Diabetic Nephropathy
Mechanism of Action
Angiotensin II Receptor Blockers
Side Effect
Hyperkalemia
Contraindication
Pregnancy
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1 min
K+ Sparing Diuretics
Indications
CHF and Hypertension
Hypokalemia
Hyperaldosteronism
Mechanism of Action
Collecting Tubule
Spironolactone
Competitive Aldosterone Receptor Antagonist
Amiloride and Triamterene
Block Na+ Channels
Side Effects
Hyperkalemia
Gynecomastia
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2 mins
Loop Diuretics
Mechanism of Action
Thick Ascending Limb of Loop of Henle
Inhibits Na+-K+-2Cl- Symporter
Sulfa Drug
Drug Names
Furosemide
Lasix
Side Effects
Gout
Ototoxicity
Hypocalcemia
Hypokalemia
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4 mins
Thiazide Diuretics
Early Distal Tubule
Inhibits NaCl Reabsorption
Sulfa Drug
Hyperglycemia
Hyperlipidemia
Hypercalcemia
Hyperuricemia
Hyponatremia
Hypokalemic Metabolic Alkalosis
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2 mins
Mannitol (Osmitrol)
Indications
Increased Intracranial Pressure (ICP)
Glaucoma
Drug Overdose
Mechanism of Action
Osmotic diuretic
Increased Urine Flow
Side Effects
Dehydration
Contraindications
Anuria
CHF
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2 mins
How to Interpret Acid Base Disorders
pH, pCO2, HCO3 (Bicarbonate)
Step 1
pH
Acidosis
Alkalosis
Step 2
pCO2
Opposite Direction As pH
Respiratory Acidosis
Respiratory Alkalosis
Step 3
HCO3 (Bicarbonate)
Same Direction As pH
Metabolic Acidosis
Metabolic Alkalosis
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3 mins
Hypercalcemia
Assessment
> 10.5 mg/dL Ca2+
Pathologic Fractures
Lethargy
Hypercoagulation
Constipation
ECG Changes
QT Shortening
Interventions
No Calcium Intake
Chelating Drugs
Calcitonin
Bisphosphonates
Loop Diuretics instead of Thiazide Diuretics
Considerations
Increased Risk for Renal Calculi
Increase Fluids
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3 mins
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
IV Calcium
Infusion of Glucose and Insulin
Loop or Thiazide Diuretics
Kayexalate
Dialysis
Prevention Education
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2 mins
Hypernatremia
Assessment
> 145 mEq/L Na+
Change in LOC
Extreme Thirst
Orthostatic Hypotension
Dry Flushed Skin
Muscle Twitching
Seizures
Priority Interventions
Prevent Dehydration
Hypotonic Solutions (0.225% or 0.45% NaCl)
Sodium Restriction
Diuretics
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2 mins
Hypocalcemia
Assessment
< 8.5 mg/dL Ca2+
Decreased Bone Density
Muscle Spasms
Tetany
Chvostek's Sign
Trousseau's Sign
Increased DTR
ECG Changes
QT Prolongation
Considerations
Oral and IV Replacement of Ca2+
Seizure Precautions
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2 mins
Hypokalemia
Assessment
< 3.5 mEq/L
Muscle Weakness
Arrhythmia
U Wave
Ileus
Hyporeflexia
Interventions
IV K+ Infusion at 5-10 mEq/hr
Give Orally with Food
Nursing Considerations
Monitor Respiratory Status
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3 mins

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