cases

Question 1

pt with metabolic acidosis due to diabetic ketoacidosis

Answer 1

-high glucose
-low bicarbonate

-give insulin
-hydrate with saline
-supplement K

Question 2

pt with metabolic acidosis due to infectious diarrhea, cannot tolerate oral consumption

Answer 2

-skin tending
-dehydration
-low K, Cl
-low pH, low bicarbonate, low CO2 (compensating)

-cultures
-antibiotics
-d5 and normal saline -> normal to supplement the Cl
-if the pt was able to eat then you wouldnt really need to supplement Cl -> just D5

Question 3

pt with respiratory acidosis due to asthma attack

Answer 3

-retractions
-low pH, high CO2, bicarbonate normal (without compensation)

-albuterol
-steroids

Question 4

pt with hyponatremia following a urologic procedure that included bladder irrigation with isotonic glycine

Answer 4

-isotonic glycine does not have conduction
-tx- use normal saline

Question 5

pt with hyponatremia following IV mannitol to treat finding of increased ICP

Answer 5

-low Na -> treat slowly 0.5-1 no more than 12
-hypertonic sodium

Question 6

pt with excessive thirst and urination due to DI

Answer 6

-CDI- desmopresson intranasally
-NDI- fluid restriction

Question 7

pt with hyperkalemia following crush injury

Question 8

pt with hypokalemia taking a water pill to lose weight

Answer 8

-replace K fast
-oral
-20-40- cardiac monitoring
-no more than 40

Question 9

hypernatremia

Answer 9

-AMS
-headache
-max over 24 hours 12

Question 10

pt with hypokalemia despite being treated with potassium

Answer 10

-monitor magnesium
-is person on chemo?