Med-Surg: Electrolytes Made Easy (Part 1) | Picmonic Nursing Webinar

welcome to our pick monic webinar series pick monic is a powerful multi-sensory study tool to help you remember all the information you need to know in nursing school fast this pre-recorded live webinar will be a three part series on electrolytes made easy but before we get into it make sure you head to pick Monaco comm to sign up for a free account that way you can reference the pic monix that are talked about in the lecture and continue to use pick monic to memorize all the topics through to the NCLEX so without further ado here's Kendall to teach you about electrolytes my name is Kendall Wyatt so I am started out as a paramedic then I went to nursing school and I'm actually in my third year of medical school now so I'm broadcasting today from Phoenix in our pick monic sound booth so this is where our pick monix are actually recorded and whatnot so if you've never used pick monic just a quick little intro what are what else pick mic so pick mark means picture mnemonic and what we actually do is we take text and things like text and things you need to memorize and we turn them into phonetic characters that you need that you need to know an easy way to remember them so like penicillin which is when we use all the time we use the pencil villain so you see this pencil villain and amoxicillin another antibiotic we would show this armorer ox and we would you know show you an interactive way like a phonetic character we show you this phone and we would show you that those are those fight bacteria by actually showing you a picture of them fighting this bacterial character so that you know that their antibiotics and we use images to help you associate all the things you need to know so you really recall them very fast on when it comes to exam time so we have we cover over 700 topics than they're saying each one has I'm at least 10 facts that going with it for everything you need to know in nursing school save lots of these images that you can learn almost remember anything you need to know as far as medicine so what are we going to go over today so we're doing electrolytes we're going to go over some imagery and things of how we're going to show you some pictures and what we're using and everything we're doing here today we're gonna go over the normal values because you got into the normals before you can really know the abnormals we're gonna go over trends and some abnormalities and then we're gonna do a quick review now one of the things that I really stress all the time is that you really have to understand a general concept of everything you're doing in nursing school so you guys as you're out there in nursing school whether you're you know first semester second semester second year third year whatever wherever you are or if you're planning to take the NCLEX right now next week is you should understand the concept of everything because if you don't understand this big picture concept you're not gonna be able to critically think and really get the answers correct and that's where you really have to um you really have to it's really where a lot of your knowledge is gonna come in to help you always get the answers correct so one of the things I just like to mention is that inside of your GoToWebinar control panel I'm aside from seeing my beautiful face you will see a question box where you can go in and type questions and shoot anything out so we have Steve and Matt on the background they're helping me out today but if they can't immediately answer your question or it's something that's relevant to what I'm doing out I'll definitely address it and I ask lots of questions so you can just type in your answer right there and and we'll go from there so just get all that stuff by the way in case any of you guys have a minute so let's go ahead and jump right in to really like just some things we're gonna go over and the first thing I really want to touch on is cellular exchange and this is like physiology pain points right pain this is awful stuff that no one likes to know but I want to just go over this general concept here and I just got a cardiac myocyte and what I've done is I've stripped out all of these other Meccans all these are the channels and ion channels that are in here and I want you to understand that so what happens with all of these is that ions go in and out of cells all the time these electrolytes they go out of a cell like let's say cardiac myocyte potassium okay here freely moves out of a cell but as it freely moves out of a cell then something like sodium will freely move into the cell but at the same time there are lots of other mechanisms but so intracellular x' is inside the cell this ICF means intracellular volume here inside the cell and this ez-up is outside the cell so inside of the tissues itself this is maybe inside of a cardiac tissue and outside the cell maybe the actual blood that's going past those tissues and that's kind of the big picture of the concept of how you need how you need to see this like how you need to really understand what's going on so you can see those like this this ion goes out potassium and sodium goes in so there's always a balance and I'm not gonna go into Physiology you know math calculations because there's potentials and whatnot lots of advanced things with this you can really go in depth but the thing I really just want you to understand is that these work with gradients and they work with so if there's if there's a lot of potassium outside the cell so let's say I put lots of potassium on here outside the cell hey potassium now there's a bunch outside the cell do you think that it's more likely or less likely that this potassium that's inside the cell is going to go out I'm a little secret if there's a ton outside the cell it's going to then the potassium isn't going to freely keep leaving the cell it's going to of course back up inside the cell so then you end up with a whole bunch of potassium and hyperkalemia and we're going to get to this concept again and at the very end I'm going to tie this exactly thing back this whole thing back together again and show you another mechanism of how this works hopefully and you just pull it all together you get Y oh my god it makes so much sense I really understand it now and I can memorize it all with pictures and keep it all together and I'm gonna do amazing that's what we're gonna go for today so we're gonna we're gonna add on to this at the end I'm just as a quick review to pull it all together and that's a really important point so if you have a situation like hyperkalemia we're gonna show you how it's going to cause these cardiac myocytes to be crazy excited they're gonna go nuts because they're building up all this intracellular calcium and with lots of other mechanisms so inside a pic monic and a lot of everything you need to know to follow along with this webinar today so pick monic product as well as this webinar policy we use I use the exact same images inside of our product and or similar images and this is anything that's hypo or low you're gonna see a hippo a hippo so like hypocalcemia this is a hippo head calcified cow hip hypocalcemia a hippo so anything that's a hyper inside of our product is a hiker so you're gonna see whatever it is is a hiker so you're gonna see this hiker calcified cow for Hyper Cal see Mia and that's how you can always see which character is and what we do is we associate these images they're really just ties in together so if you see a high bow then you think a low whatever the character is low calcium hypo Kalsi MIA low calcium hippo cow and you're gonna see more even if you've never seen pic Manik you're really mastered by the time we get to the end and you're going to just be like your mind just gonna be blown should be well hopefully maybe it's just my mind I'm not sure I forgot to mention that tons of times throughout this is I absolutely loved it throughout corny jokes not just like corneas and corny bacteria but really corny jokes I hope you enjoy those and if not you can just like plug your ears or something so one of the most important things is you have to know the normal ranges of all these lab bayous and I would I've hit five of them right here that I just want to touch on it really show you how you can use pictures to help you remember them and an important thing here is that I've organized these from smallest to largest as far as the volume in the extracellular space so if you know the normal ranges magnesium phosphorus potassium calcium chloride calcium chloride sodium then you know if you memorize the normals then you can then memorize what's abnormal so if you know what's normal then you know immediately whether it's abnormal you know that it's high or low rather because it's really important as you go through you don't want to get a question and you don't want to not really know because you didn't have the lab you down especially as you go to NCLEX or you going to your exam especially if you're going to like Hesse or a final exam you really want to have these lab by is down so we have 32 lab buddies and total in our product but we're gonna go over these just really quick to show you what they are so first we're gonna just I'm just gonna show you these images so magnesium 1.5 to 2.5 phosphorus potassium calcium chloride sodium I'm not gonna mention all these numbers right now but what you can see here is that I have normal ordered them from the smallest number to the largest number what's important to know here is if we're measuring these if I have a 1.5 to 2.5 that means it's a really small amount right but that's a small amount in the serum in in the extracellular space because we cannot measure intracellular lab values I mean we can't take a sample of the blood from the blood and measure inside the cell lab we can get some indirect estimations but there's nothing that actually do that direct that's not how we get lab buddies we measure the extracellular volume because we know then that's how it what those are going to affect the intracellular levels and then we know what to expect signs and symptoms wise so I get really excited as I go through these and you'll see me always taking a dream from my wonderful pic Monica which Steve so gracefully will fill up for me every now and then but as I have said before is you know they give me 35 cents every time I take a drink so it's like a plug for the company that's how I get paid but you know I believe I'm gonna demand a raise to 37 cents just because of inflation so let's look at these lab values so what what we actually have a pic monic for every single one of these so I'm gonna go over each one of these in depth sync as we go through but when every time you're gonna see these images and we're gonna go magnesium phosphorus we're gonna go through each one but you'll see this 1.5 to 2.5 so you see this 1 1 1.5 to 2.5 on this magnesium magazine and you'll see these kind of images that we help you actually use pictures to help you remember the lab values and we tie it all in for you so that you can really just pull it together so let's just jump down down here to chloride so you see this chloride on this chlorine dispenser and you see 95 to 105 pools that's how you can kind of remember cuz we use this pool because it's hot right 95 to i-95 I mean it's a hundred and thirteen here in Arizona right now but if you think it's really hot you probably want to be at the pool and so we use these images to help you get this and it inside the pic monic today we're gonna share you on a playlist that's gonna go over these and we're gonna actually just touch on each one of these as we go in through just a save time so we have over 32 lab values you'll need to know inside of an entire story to help you go through these and we're going to go through it each one of these really quick as we go through but most important here's what I actually want to touch on each one of these when you think of the electrolytes and you're going through and you're learning what you need to know is you have to think about generalized or I want you to think of a generalized theme for each one you can't really memorize everything that goes with everything I mean you could but you don't have time and what I most of the nursing style questions is they're geared towards a generalized theme or the signs and symptoms and in general so we've kind of kind of put these in here for you as a generalized rule yes they're I mean if you were a super nerd or you know that there are some extra things in here in some of these and that's absolutely true but I'm not not to answer 99% of the questions so magnesium muscle relaxation phosphorus muscle contraction and potassium intracellular excitation that's except you know the cells getting excited from inside the cell calcium we know foot bones and muscle excitation again chlorides cellular cellular excitation and sodium's extracellular excitation so we're going to hit every hippies individually and show you how you need to think about it and then with the highs and the lows and that's really important so you know that if you have lots and lots and lots of magnesium so if the core focus of magnesium here is muscle relaxation you've lots of magnesium are you gonna be really relaxed reading me really excited your muscles which one is it anybody no no the answer is exploded right so if you have lots and lots and lots of magnesium will you be very relaxed right and we can give magnesium as a medication so it's actually just look we look at these individually to show you how they go through we think of each one of these we're gonna think about the normal values we want to know that normal value range we're going to hit on it again we want to make sure we know the basic function of how it works this magnesium muscle relaxation we want to think about the body's systems how they go and then fluid volume compartments specifically with sodium as we go and that's how you can really just tie it in together so here's magnesium magnesium itself we just we just talked about it and now we're gonna hit it hit it right on ahead magnesium a normal range 1.5 to 2.5 so that means it has a relatively small extracellular volume right I mean if compared to sodium in 130s 1.5 to 2.5 very small oh I think I've got the hiccups excuse me so the main function when I think about is muscle relaxation so I want you to think about this little image here what we draw on here soon since magnesium magazine he's just chillin just relaxing out relaxing out that's what magnesium is for and we think about the normal range is 1.5 so we got this one wand and that's point five hand to two point five so I always think about this - two - it's a ballerina - to here and her point five hand so 1.5 to 2.5 now it's a really important point I hear this a lot is and my book says it's one point seven to two point two okay listen every lab in America has a little bit different guidelines on what they use for a normal range so we use them the Lewis book as far as our normal ranges but just as a reference but that doesn't mean that in a different book it's not a little bit different or in a different lab or a different region that it's not just a smidge different on on the lab values and that's exactly how you need to think so if you have a small ECF amount do you think we're gonna be giving large doses of magnesium or very small doses of magnesium if we were give it as a you know in a medication form anybody know oh you guys that's right Andy right away set a small amount because if we give a very large amount we're gonna we're gonna overload the body we're gonna see lots and lots of problems we're gonna talk about that right here in just a second so let's look at this next slide as we go through the highs and lows so if you think about we're gonna start at the top of your hypomagnesemia so a low magnesium levels so if you think of first what you think about magnesium itself magnesium itself is causes muscle relaxation as a general theme okay make sense magnesium magazine I'm chilling out I'm having a good time well but I'm gonna take all the way magnesium away I would have a low magnesium level are you gonna be muscles gonna be excited are they gonna be relaxed we're gonna be excited really excited and they're gonna be like on the edge of their seat they're gonna be like crazy like me and they'll be ready to go into me jump into them oh my god crazy what are gonna see well if you jumped or epic monic we have this hippo magnus emia and he's angry I mean he's right he's ready to charge up and just go at it right he's excited and that's how we teach you in these pictures and the themes that we integrate all the images so what are you going to see for deep tendon reflexes if you hit somebody on the knee is that reflex gonna be all relaxed out or is it just gonna be boom increased deep tendon reflexes it's gonna be increased increased deep tendon reflexes seizures and tachycardia everything is going to be up up up up with a low magnesium level because if you don't magnesium itself works with ATP to calm as a it creates a calming and we're not going to go into this cellular level stuff because the actual mechanism of action of magnesium itself is actually unknown we're gonna mention that again in the review at the end but hypomagnesemia so you know that what level below magnesium is low Wow it's less than one point five so we memorized our normal levels of 1.5 so less than 1.5 is low and we're gonna see increased deep tendon reflexes possible seizures tachycardia and some other things you know you're gonna see irritation you see you know you see lots of things and those are all included we're hitting on the general themes here to really just solidify how things are different because what I've learned and as I teach me you know tons and tons of students if you know the general theme of how everything is different you can probably figure out most of it if everything's excited because there's no magnesium then you know that we can then give magnesium to calm everything down right so the treatment for low magnesium would be to give magnesium that makes pretty much sense to me so what about hyper Magnus emia all right this is one of my favorite big monic images and I someone wrote in and they said Kendall what isn't your favorite pic monic image and that I have some unfavorite s-- and our artist team can tell you I definitely have some non favorite images but this one is one of my favorites because it portrays hyper Magna see me in the best way possible so we got this hiker he's got his magnesium magazine and this guy is chillaxed I mean he's relaxing here right and his muscles are relaxed his hairy chest his hairy legs awkward he's relaxing out there with his magnet magazine and that's what you really have to think about this high magnesium level magnesium's basic function is to muscle relaxation is a general theme so what are you going to see him all the muscles are relaxed well neuronal excitability is also gonna be relaxed so what do you think those deep tendon reflexes are gonna be they gonna be up up up or down down down that's right the deep tendon reflexes are gonna be decreased and if we can way too much magnesium it's gonna cause respiratory arrest because what is the muscle that controls breathing that is a muscle right and it's automatic you don't have to think to breathe well maybe somebody out there has to think to breathe you have a friend that you always think you have to think to breathe right so is one of my favorite jokes I bet they have to think to breathe but you could end up with the diaphragm being depressed as well because it's a muscle and end up with respiratory arrest so let's think about this really quick as I adjust my seat so I don't fall if we have I have to fix my posture I got really bad posture today so um if we think about what situation would we give magnesium in what what treatment scenario mm-hmm I need to give somebody magnesium to relax their muscles I would probably give it in aa benita and to meet both of you guys right away I would give it in Maternity with preterm labor right I have contractions contractions contractions of that uterus right I need to calm the uterus down calm that muscle downs I'm gonna give magnesium and the way I tell that I gave too much magnesium is I'm measuring deep tendon reflexes if they disappear I stopped giving magnesium but also when we see tour saws at a point as Benita pointed out if you have torsades that's v-tach right that's a polymorphic v-tach so to calm that heart muscle down we're gonna give magnesium chill calm down slow down we also give it and preeclampsia and some other things but you know those are not as you know they're always more answers in a couple of you pointed those out that's correct so mmm I just wanted to spend a little extra time on this just one really go over how we're gonna think about themes so think about the themes as we go through these and that's what I really want you to think about so here are hypomagnesemia and hyper magazine epic Manik so we've tied in all the stuff you need to know all those nitty-gritty details in here like hypomagnesemia and everything you need to see everything you need to worry about along with this hypomagnesemia pick Manik so when anything you're learning let's say you're out there you learning the concept you you know you've learned and you're good you need to tie it all together with memorization of everything that's where we really come in to to help you keep it all together so phosphorous phosphorous is another one to remember and I just just this one's actually a 1 I'm gonna skip really quick through but it's it's not really as high yield but um you need another normal lab value of 2.5 to 4.5 so we've got the 2.5 to 4.5 here but it's for muscle contraction so it's kind of them what is the term anyway I'll get to it I think of it later but as a small you see if amount and it's really you know it's for like a muscle contraction as a general rule and so that means of course it is going to be if you have a low amount the muscles are relaxed and a high amount the muscles are excited you see like tetany you'll see tetiny which is you know full muscle rigidity if you have hyper phosphate amia now what patients are going to have hyper phosphate amia what type of patient if you think of a type of patient which patient out there you were gonna see a high phosphate emia in ah that's right away renal patient several you said right away in renal failure renal failure patients you're gonna see a high phosphate emia because they can't get rid of that phosphate they can't get rid of it and that's a really important really important concept you know I'm you see that right away so here's one of the highest yield ones and I spent an extra couple minutes on this one is is potassium so potassium a normal lab by you amounts three point five to five so I think about this three point five this three tree with this five hand three point five to five and it's intracellular excitability so as we if you think back to that original image so I had the you know the action potentials there and you have intracellular excitability as potassium job so if you get a lot of potassium inside or backed up inside the cell you've got a serious problem saying if we'll get to the other one but there's you know sodium which is outside the cell so a small ECF amount means very small amounts make very big differences and a very important thing you need to think about as soon as you think of potassium is arrhythmias and heart differences because there's some very high yield points you need to know about high potassium and low potassium very very high points so let's let's actually look at him so hypokalemia a low potassium level if you have a low potassium level do you think your intracellular cells are going to be excited we're not excited they're not going to be as excited right they're going to be deep decreased excitement and when you have decreased excitement then you end up with numbness or paresthesias and I always this is one of our Paris t-shirt paresthesias you may end up with a decreased excitement of the cardiac tissue so if you think about this and we think about how it all goes together you have potassium and potassium helps with cardiac contractility so if you have a decreased potassium then the T wave what is a T wave represent in the EKG the t-wave rep see the P wave which is atrial contraction the the QRS which is ventricular contraction and then you have the QRS which is ventricle repolarization or a relaxation right essentially electrically and then physically yes there are differences so repolarization and relaxation of that tissue so if it's not relaxing it's just kind of doing whatever right just me not really do anything then the T wave which is what represents it is going to be flattened you're gonna see this flattening of the T wave and you might even see this you wave at the end just a little extra wave pqrst you you little bump at the end and it just kind of relaxes everything it doesn't really get that excited but contrast that with hyperkalemia hyperkalemia itself high potassium level what do you see you could see paralysis and problems with you know neuronal excitement whatnot but most importantly high-yield you're gonna see these toe peaked t-waves very tall and peaked in this very high yield point and we have that on our question of the day and as a very important point to know is because a tall peak T wave it causes this crazy relaxation is crazy repolarization and it can very commonly cause arrhythmias very commonly it's more commonly that hyperkalemia causes arrhythmias then hypokalemia and that's an important point to note because you have this very high potassium level this is an important point does anybody know digoxin which one of these hypokalemia or hyperkalemia is important with digoxin to know about really high your point relatively just kind of one of those tidbits in the back your mind so hypokalemia hypo a low potassium level inhibit it causes digoxin toxicity it causes it to happen a lot more often because if you don't have any potassium this relaxation is kind of like me but then digoxin causes what crazy contraction so it's like this extreme opposite and then you end up with this really bad toxicity that's kind of the general way to think about it yes there's an eye on change and you know sodium-potassium ATPase transporters and it's all true but trying to memorize and wrap your head around all of those membrane potassium ion transporters is not as important as understanding the concept of it and that's that's really that's how you're going to get the most answers right as well so I understand the general concept and you will do the best at most of your questions especially in nursing so hypokalemia so a low potassium oh this is our low potassium pick not pick monic and a hypokalemia less than 3.5 you see all these different characters which represent everything you need to know so you see you weigh which is this arrhythmia drum with this EKG you weigh right here for the hypokalemia and then over in the hyperkalemia one you see this tall peaked T character here that completes part one of electrolytes made easy before we go to part two make sure you go review the ten pick monix that we just learned about which were magnesium hypomagnesemia hypermagnesemia magnesium sulfate phosphorus potassium hypokalemia hyperkalemia parts of an ECG and digoxin toxicity to find these ten pick monix in the learning system just click on browse on the Left navigation bar and search for what you're looking for by course body system book or board exam easy and after you learn each one don't forget to use the quiz feature to make sure you really have them down there's also a playlist link in the description below so after you've memorized those come meet us back for part two of electrolytes made easy and learn more electrolytes and imbalances like hypo and hyper kelsey Nia see you there you

Channel: PicmonicVideo

Views: 125,490

Rating: 4.7993031 out of 5

Keywords: Electrolytes, Nurse, Nursing, Nursing student, Nursing school, mneumonics, study guide, study plan, student, student nurse, NCLEX, HESI, ATI, magnesium, sodium, potassium, phosphorus, chloride, test, test taking, webinar, nursing webinar, pharmacology, RN, RN student, LPN, healthcare student, nursing school study tips, nursing school tips, nursing school videos, mnemonics memory tricks to remember anything for tests

Id: YrgRN7Eq6ts

Length: 27min 54sec (1674 seconds)

Published: Tue Apr 24 2018