acid base and electrolytes Flashcards
(38 cards)
Diuretics cause what acid base disturbance? (except which class?)
Metabolic alkalosis (except CAHs)
Aspirin/salicylate OD will cause what metabolic disturbance?
Respiratory alkalosis and metabolic acidosis
How can you speed excretion of ASA?
Alkalinize the urine with HCO3
Sleep apnea and other chronic lung conditions can cause what kind of heart failure?
right-sided (cor pulmonale)
How low does someone’s pH need to get before you give bicarbonate?
7.0
What kind of hyponatremia is caused by Addison’s disease/hyperaldosteronism?
hypovolemic
What kind of hyponatremia is caused by SIADH?
euvolemic
If water restriction fails, what can you use to treat SIADH?
Demeclocycline
What does demeclocycline induce?
Nephrogenic diabetes insipidus
What happens when hyponatremia is corrected too quickly?
What is the max rate of correction?
Central pontine myelinolysis
0.5-1 mEq/L/hr
what three things can cause false hyponatremia?
hyperglycemia with the glucose level greater than 200 MG/DL
Hyperproteinemia
Hyperlipidemia
what is the relationship between sodium level and glucose?
for each rise and glucose of 100 MG/DL, sodium decreases by 1.6 mEq/L
in adrenal insufficiency what will you see in terms of potassium, sodium, and blood pressure?
Hyponatremia, hyperkalemia, and low blood pressure
how can sickle cell disease affects sodium levels (this is rare).
Hypernatremia
what metabolic Derangements of potassium and calcium can impair the kidneys concentrating ability, thus causing hypernatremia?
hypokalemia and hypercalcemia
what is the classic cause of hyponatremia in pregnant patients about to deliver?
oxytocin
what findings will you see on EKG with hypokalemia?
– Loss of the T-wave or to a flattening
– U waves
– Premature ventricular and atrial complexes
– Ventricular and atrial tachyarrhythmias
what metabolic Derangement causes hypokalemia?
What metabolic derangement. causes hyperkalemia?
hypokalemia – alkalosis
Hyperkalemia – acidosis
what is the max rate of replacement for potassium?
20 mEq/hr
what will you see on EKG with hyperkalemia?
– Tell Peaked T waves – Widened QRS – Prolonged PR interval – Loss of P waves – Sine wave pattern
adrenal insufficiency and hypoaldosteronism will cause what problem with potassium?
Hyperkalemia
what is the treatment for hyperkalemia <6.5?
– Decreased potassium intake and Kayexalate
what is the treatment for hyper kalemia greater than 6.5 or with a parent cardiac toxicity?
– Calcium gluconate thirst, which is cardioprotective but does not change potassium level
– Sodium bicarbonate next, which causes potassium to shift inside cells
– Glucose with insulin, which also forces potassium inside cells
– Beta-2 agonist, which also drive potassium into cells
what do you do for a patient with hyperkalemia who has renal failure?
emergent dialysis