clinical: electrolytes Flashcards

1
Q

describe hypotonic fluid

A
  • dilute fluid
  • pushes fluid into a cell
  • e.g. 5% dextrose
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2
Q

describe hypertonic fluid

A
  • pushes fluid out of cells
  • less dilute, stronger concentration
  • only really given in ICU
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3
Q

describe isotonic fluid

A
  • free flow as tonicity is the same as cells

- e.g. 0.9% SodChlr or plasma-lyte

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4
Q

what are ways of assessing volume status

A
  • BP
  • weight (change over time)
  • JVP
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5
Q

why do we give patients IV fluid

A
  1. maintenance (keeping them euvolemic as they cant drink)
  2. replacement of losses
  3. resuscitation (e.g. shock)
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6
Q

describe hyponatraemia

A
  • low Na+

mainly due to excess water

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7
Q

causes of sodium loss

A
  • GI loss (vomiting, diarrhea)
  • hypo-aldosteronism
  • sweat (rare)
  • diuretics
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8
Q

describe pseudohyponatremia

A

Na+ looks low but is due to a lab error

having hypertriglyceridemia or hyperproteinemia can cause Na+ to look low

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9
Q

causes of water excess

A

water overload from:

  • cirrhosis
  • heart failure
  • nephrotic syndrome

SIADH (normal BP)
Polydipsia (over drink water)

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10
Q

steps in identifying the fluid state of patient’s

A
  1. history e.g. GI symptoms, medication, dehydration
  2. examination of fluid status
  3. osmolality (would be low in hyponatremia)
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11
Q

symptoms and causes of water excess with euvolaemia

A
  • no signs of dehydration or edema
  • no elevation of JVP
  • no evidence of fluid overload

causes:

  • SIADH
  • polydipsia
  • diuretics
  • hypotonic fluid overload
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12
Q

describe SIADH and its causes

A
  • ADH release despite not being dry or hypotensive

causes:

  • tumours
  • CNS
  • drugs
  • lung disease
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13
Q

how do we treat patients with hyponatremia

A

dehydrated patients with Na+ loss
= saline

patients with water excess
= fluid restriction (1L daily)

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