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2 - CPR (renal) > Disorders of Na and K Regulation > Flashcards

Disorders of Na and K Regulation Flashcards

1
Q

Solute per 1 L of solvent

A

Osmolarity

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2
Q

Solute per 1 Kg of solvent

A

Osmolality

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3
Q

What is the normal serum osmolarity?

A

280-290

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4
Q

If the serum osmolarity is increased, what 2 systems will regulate it?

A

ADH

Thirst

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5
Q

What 2 receptor types can sense increased serum osmolarity and can activate ADH release?

A
  1. Hypothalamus osmoreceptors

2. Arterial baroreceptors

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6
Q

What is the normal serum value for sodium?

A

140

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7
Q

What is the normal serum range for potassium?

A

3.5 - 4.5

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8
Q

What is the normal serum range for chloride?

A

98 - 112

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9
Q

Hyponatremia

A

Na < 135

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10
Q

In what patients is Hyponatremia common and what does it result from?

A

Common in hospitalized patients

= Results from an INCREASE in total body water

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11
Q

Usually Hyponatremia is _____

A

Asymptomatic

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12
Q

If sodium levels drop below 125, what are some possible symptoms?

A

CNS - headache, dizzy, confusion, seizure, coma

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13
Q

When drawing labs, they should be drawn ______

A

Simultaneously

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14
Q

What are 2 steps to assessing Hyponatremia?

A
  1. Measure serum osmolarity

2. Measure urine Na+ and urine osmolarity

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15
Q

If the serum osmolarity is hypotonic hyponatremia, what should then be assessed?

A

Volume status

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16
Q

What is an example of a disease that can cause Hyponatremia and a malignancy associated?

A

SIADH

– Small Cell Lung Cancer can cause ectopic ADH release

17
Q

What is the treatment for Hyponatremia?

A

Hypertonic Saline (3%)

18
Q

What is a potential side effect if Hyponatremia is corrected TOO FAST?

A

Osmotic Demyelination Syndrome

– locked in syndrome and other CNS issues

19
Q

Hypernatremia

A

Na+ > 145

20
Q

Hypernatremia commonly occurs in what patients and is associated with what risk factors?

A

Infants and elderly

– Trauma, burns, dementia and uncontrolled diabetes

21
Q

What 2 things can cause Hypernatremia and which is the most common?

A
  1. Dehydration – most common

2. Sodium overload

22
Q

What are the main symptoms with Hypernatremia?

A

Neurologic

– Intracranial hemorrhage

23
Q

What is the treatment for Hypernatremia?

A

Correct sodium and replace water loss

24
Q

If Sodium levels are corrected too fast with Hypernatremia, what is there a risk for?

A

Cerebral edema

25
Q

What organ primarily controls serum potassium?

A

Kidney

26
Q

The immediate response to changes in K+ levels are controlled by?

A

Transcellular shift – Na/K ATPase

27
Q

The long term control to changes in K+ is controlled by?

A

Renal K+ excretion in distal nephron

28
Q

Hyperkalemia

A

K+ > 5

29
Q

What are the main symptoms with Hyperkalemia?

A

Cardiac arrhythmias
Muscle weakness
Metabolic ACIDOSIS

30
Q

What changes will be seen on ECG with Hyperkalemia?

A

Widened QRS
Peaked T wave
– membrane potential less negative

31
Q

What 2 mechanisms usually cause Hyperkalemia?

A
  1. Transcellular shift

2. Decreased renal K+ excretion

32
Q

What are some transcellular shift causes of Hyperkalemia?

A

Pseudohyperkalemia (RBC hemolysis)
Decreased insulin
Metabolic acidosis

33
Q

What are some decreased renal K+ excretion causes of Hyperkalemia?

A

Decreased Aldosterone

Kidney injury

34
Q

Hypokalemia

A

K+ < 3.5

35
Q

What are the symptoms with Hypokalemia?

A

Cardiac arrhythmias
Muscle weakness
Metabolic ALKALOSIS
Rhabdomyolysis

36
Q

What ECG change is seen with Hypokalemia?

A

U wave

– membrane potential is more negative

37
Q

What are the general causes of Hypokalemia?

A

Transcellular shift
Extrarenal loss
Renal loss

38
Q

What are some causes of a transcellular shift that causes Hypokalemia?

A

Insulin
Beta2 Agonist
Metabolic Alkalosis

39
Q

What are some extrarenal causes of Hypokalemia?

A

GI loss - N/V, diarrhea and sweat

2 - CPR (renal) (27 decks)

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