Category: Electrolytes

Hypomagnesaemia

The UK Medicines Information group have provided excellent guidance on how to replace magnesium.

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Nutrition

Nutrition is an important aspect of a patient’s health and is overlooked during medical school as you are learning exciting pathophysiology of weird and wonderful diseases. One never thinks about nutrition until you are placed on a ward where you need to manage patients in need of nutritional support. Various studies show that doctors and

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Fluid Balance

Almost every patient admitted to hospital receives IV fluids at some point in their journey. However, the body manages this, without the need for careful medical assessment and adjustment, as fluid balance is one of its core functions. Despite this, there are many situations where we need careful and controlled management. These include: Electrolyte disturbance

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Hyperkalaemia

Hyperkalaemia can cause life-threatening emergencies particularly cardiac arrhythmias. A widely used definition is extracellular [K+] ion concentration ≥ 5.5 mmol/L. Complications increase with severity and hyperkalaemia may be classified as: Mild 5.5-5.9 mmol/l Moderate 6.0-6.4 mmol/l Severe ≥ 6.5 mmol/l Causes Always consider the cause of hyperkalaemia. Emergency treatments only temporarily lower potassium levels to

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Hypernatraemia

Hypernatraemia is defined as a sodium above 145 mmol/L with severe being more than 150 mmol/L.

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Hypokalaemia

As an FY1 you will frequently see hypokalaemia and most trusts have guidelines that should be used in the first instance. The advice below is informal & based on broad day to day practice. It should never replace clinical judgement and escalation for senior support if indicated. The UK Medicines Information group have provided information

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Hyponatraemia

Hyponatraemia (serum Sodium <135 mmol/L) is one of the most common electrolyte abnormalities you will see and so a systematic approach to identifying the underlying cause and management is vital. We will use the algorithm below from ESE which is far easier to use than the antiquated system of first assessing their volume status. Do check

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Refeeding Syndrome

Defined as a collection of electrolyte abnormalities associated with a massive intracellular shift of electrolytes. Associated with aggressive nutritional rehabilitation of malnourished patients in e.g. malignancy, chronic organ dysfunction, inflammatory conditions (e.g. pancreatitis, colitis), the perioperative period as well as anorexia nervosa. Clinical features Sequelae of hypophosphataemia, hypokalaemia, hypocalcaemia, hypomagnesaemia, e.g.Congestive heart failure, peripheral oedema,

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Hypocalcaemia

Acute hypocalcaemia that is severe (<1.9 mmol/L) or symptomatic can be life-threatening and necessitates urgent treatment. It is often initially picked up when a patient has low ionised calcium on the blood gas as bone profiles are not routinely measured for every admission. Symptoms & Signs Perioral & digital paraesthesia Positive Trousseu’s and Chvostek’s signs

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