CEN Solheim Review: Emergency Nursing Certification Course, Study Guide & High-Yield Exam
Prep Overview
Hyperkalemia Causes - correct answer ✔✔Renal Failure
Cell death - rhabdom, crush, burn
Acidosis: DKA, Addisons
Hyperkalemia Early Symptoms - correct answer ✔✔Tall Peaked T Waves
Muscle Excitability
Irritable
Nausea
Vomit
Diarreah
Hyperkalemia Late Symptoms - correct answer ✔✔Weakness - fatigue, distal limb paresthesia,
tetany
Respiratory depression
Ascending paralysis
Hyperkalemia Treatment - correct answer ✔✔Stabilize cardiac:
Calcium Chloride: 10 - 20 ml
or
Calcium Gluconate: 10 - 30 ml IV Push
,Shift K+ into cells:
Insulin 10 units w/ 100 ml 50% dextrose
High dose nebulized albuterol
Remove K+:
Hemodialysis: if severe
Kaexylate
Hypokalemia Causes - correct answer ✔✔K Shifts: Insulin, Beta 2 agonists, aldosterone, alkalosis
Losses: vomiting, diarreah, intestinal obstruction, diuresis/diuretics
Decreased Intake: alcoholism, malnutrition
Hypokalemia symptoms - correct answer ✔✔Prominent U Wave - after T
frequently asymptomatic
K+ 2-3: hyporeflexia, latent tetany, paralysis to lower extremity, respiratory failure, paresthesias
Hypokalemia Treatment - correct answer ✔✔Oral / IV K+ replacement
Correct magnesium: magnesium and potassium are simultaneous
Magnesium Normal Levels - correct answer ✔✔1.7 - 2.2
, Increased Magnesium muscular s/s - correct answer ✔✔decreased muscular irritability and
activity
weakness
Decreased Magnesium muscular s/s - correct answer ✔✔Increased Muscular irritability and
activity
Decreased Magnesium Mild to mod s/s - correct answer ✔✔asymptomatic
Decreased Magnesium Severe s/s - correct answer ✔✔Cramping, palpitations, vertigo, ataxia,
depression, seizures, hyperreflexia
PR / QT prolongation
A Fib, Torsades, V Fib
Chvosteks / Trousseaus Sign
Increased Magnesium s/s - correct answer ✔✔4-5 mg: Decreased deep tendon reflex
5-7 mg: HoTN, QRS widening, QT / PR Prolongation
10 mg: Respiratory Insufficiency
10-15 mg: Heart Block
Prep Overview
Hyperkalemia Causes - correct answer ✔✔Renal Failure
Cell death - rhabdom, crush, burn
Acidosis: DKA, Addisons
Hyperkalemia Early Symptoms - correct answer ✔✔Tall Peaked T Waves
Muscle Excitability
Irritable
Nausea
Vomit
Diarreah
Hyperkalemia Late Symptoms - correct answer ✔✔Weakness - fatigue, distal limb paresthesia,
tetany
Respiratory depression
Ascending paralysis
Hyperkalemia Treatment - correct answer ✔✔Stabilize cardiac:
Calcium Chloride: 10 - 20 ml
or
Calcium Gluconate: 10 - 30 ml IV Push
,Shift K+ into cells:
Insulin 10 units w/ 100 ml 50% dextrose
High dose nebulized albuterol
Remove K+:
Hemodialysis: if severe
Kaexylate
Hypokalemia Causes - correct answer ✔✔K Shifts: Insulin, Beta 2 agonists, aldosterone, alkalosis
Losses: vomiting, diarreah, intestinal obstruction, diuresis/diuretics
Decreased Intake: alcoholism, malnutrition
Hypokalemia symptoms - correct answer ✔✔Prominent U Wave - after T
frequently asymptomatic
K+ 2-3: hyporeflexia, latent tetany, paralysis to lower extremity, respiratory failure, paresthesias
Hypokalemia Treatment - correct answer ✔✔Oral / IV K+ replacement
Correct magnesium: magnesium and potassium are simultaneous
Magnesium Normal Levels - correct answer ✔✔1.7 - 2.2
, Increased Magnesium muscular s/s - correct answer ✔✔decreased muscular irritability and
activity
weakness
Decreased Magnesium muscular s/s - correct answer ✔✔Increased Muscular irritability and
activity
Decreased Magnesium Mild to mod s/s - correct answer ✔✔asymptomatic
Decreased Magnesium Severe s/s - correct answer ✔✔Cramping, palpitations, vertigo, ataxia,
depression, seizures, hyperreflexia
PR / QT prolongation
A Fib, Torsades, V Fib
Chvosteks / Trousseaus Sign
Increased Magnesium s/s - correct answer ✔✔4-5 mg: Decreased deep tendon reflex
5-7 mg: HoTN, QRS widening, QT / PR Prolongation
10 mg: Respiratory Insufficiency
10-15 mg: Heart Block
