Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Erin's Renal > Dr. P's Lytes > Flashcards

Dr. P's Lytes Flashcards

1
Q

D5W

A
  • 5% Dextrose in H2O
  • HYPOTONIC
  • Osmolality = 250
  • 50gm/L of glucose
  • 170cal
  • Used to replace free body water
  • Can be used in tx of hypernatremia
  • Or TKO IVs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Normal Saline

A
  • 154 mEq/l Cl
  • 154 mEq/l Na
  • 0.9%NaCl
  • ISOTONIC
  • Osmolality = 300
  • Used to replace total circulating volume
  • Only fluid you can use with blood products
  • Replaces NaCl deficit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lactated Ringers

A
  • Na, Cl, K (4), Ca (4), Bicarb (in the form of lactate)
  • ISOTONIC
  • Osmolality = 270
  • Used to replace total circulating volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Human Cell Tonicity

A

275-290

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Isotonic Solutions tonicity

A

240-340 mOsm/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypotonic Solutions tonicity

A

<240mOsm/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hypertonic Solutions tonicity

A

> 340mOsm/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ANP mechanism?

A

Increased Na+ secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Increase Aldosterone?

A

Increase Sodium uptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Serum Na+ think…

A

H2O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Extracellular volume think…

A

Na+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acute Hyponatremia

A

massive intake of H2O (drinking contest)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Persistant Hyponatremia due to….(2)

A
  1. Oral or IV intake of water that can’t be excreted
  2. SIADH
  3. Reduced circulating blood volume: diarrhea, vomiting
  4. Renal or heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CNS symptoms with extreme hyponatremia (<120)

A

stupor, seizures, coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Urine Na+ magic number?

A

20meq/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Urine Na+ with depleted circulating blood volume?

A

<20meq/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Urine Na+ with SIADH?

A

Normal at >40meq/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hypotonic Hyponatremia

A

Too much H2O!! Caused by:

  1. IV fluids
  2. Water intox
  3. SIADH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Rapid correction of hyponatremia could result in?

A

Central Pontine Demyelination Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Tx for life threatening hyponatremia?

A

1) Bring pt to 125 with hypertonic saline (3%)

2) then proceed slowly…48-72hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hypertonic Hyponatremia

A 
Increase of another solute --> Increase of H2O --> Decrease serum Na+
Causes:
1. hyperglycemia
2. mannitol
3. serum lipids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hypernatremia symptoms

A

lethargy, irritability, seizures, coma, “dehydration” = water deficit,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Rapid Correction of hypernatremia?

A

cerebral edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diabetes Insipidus

A

peeing out water!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

“Fluid Resusciation”

A

correcting/replacing circulating blood volume

26
Q

Hypovolemic Hypernatremia (5)

A
  1. No access to H2O
  2. GI or nasogastric losses
  3. DI
  4. Diaphoresis
  5. Hyperglycemia
27
Q

Hypervolemic Hyponatremia (3)

A
  1. Heart Failure
  2. Cirrhosis
  3. Renal Failure
28
Q

Hypervolemic Hypernatremia (2)

A
  1. NAHCO3 administration

3. 3% NS

29
Q

Hypotonic Hyponatremia (3)

A
  1. SIADH (euvolemic)
  2. Water Intox
  3. Too much hypotonic IV solution
30
Q

Hypertonic Hyponatremia (3)

A
  1. Hyperglycemia
  2. Hyperproteins (myeloma)
  3. Serum lipids
31
Q

Isotonic Hypovolemia (3)

A
  1. Hemorrhage
  2. Burns, 3rd spacing
  3. GI Losses
32
Q

Causes of Hyperkalemia (4)

A
  1. renal failure
  2. Iatrogenic (K+ sparing diuretics)
  3. Tissue destruction (rhabdo)
  4. Acidosis (H+ and K+ exchange in cells)
33
Q

S and SX of Hyperkalemia

A

EKG changes!

  1. Tall peaked T waves
  2. Wide QRS
  3. Sine wave
  4. asystole :-(
34
Q

Slow tx of Hyperkalemia

A
  1. Discontinue K+ supplements, diuretics, IVs
  2. Hydration with loop diuretics
  3. Kayexalate binds K+ in gut, evacuated in bowel
35
Q

Rapid tx of Hyperkalemia

A

Insulin and Glucose! Drives K+ into cells

36
Q

Psuedo hyperkalemia

A

hemolysis of RBCs during collection of blood

37
Q

Causes of Hypokalemia (K+<3.3meq/l)

A
  1. Diuretics
  2. GI losses
  3. Renal losses
  4. Burns
  5. Intracellular shift (alkolosis/insulin therapy)
38
Q

S and SX of Hypokalemia

A

Moderate = flattening of T Waves, more prominant U WAVES.

Muscle weakness; esp. respiratory muscles

39
Q

Tx of Hypokalemia

A

Oral or IV

*Take much caution with IV! Can damage veins. Is cardiotoxic in central line**

40
Q

Hypokalemia is often accompanied by________?

A

Hypomagnesemia and must be correct to successfully correct K+

41
Q

Serum Ca+ ______%ionized, _____%unionized

A

60%unionized (bound to proteins), 40% ionized (unbound)

42
Q

3 major factors influencing serum Ca+

A
  1. PTH - secreted in response to the smallest of changes in Ca+ –>works on GUT, KIDNEYS, BONE
  2. Vitamin D - need it to absorb Ca+
  3. Calcium ion and phosphate
43
Q

Hypocalcemia (3)

A
  1. Low PTH
  2. Disorder of Vit D and High PTH
  3. Hypoproteinemia (hypoalbuminemia)
    - -acidosis = reduces Ca+/Protein binding = hypercalcemia
    - alkolosis = hypocalcemia
44
Q

Hypocalcemia w/ Low PTH

A

Parathyroid surgery, removal, autoimmune, radiation etc.

45
Q

Hypocalcemia w/ High PTH

A
  1. Vit D deficiency (poor diet)
  2. Hyperphosphatemia = RENAL FAILURE!; too much bound Ca+
  3. Hypomagnesemia, which impairs release of PTH
46
Q

S and SX of Hypocalcemia

A
  1. Tetany
  2. Trousseau’s sign
  3. Chvostek’s sign
  4. Seizures
  5. Myocardial Infarction
47
Q

Tx of Hypocalcemia

A
  1. TX metabolic abnormalities
  2. Vit D supplement
  3. Oral/IV Ca
  4. Correct hypomagesemia
48
Q

Hypercalcemia

A

Ca+ entry into serum exceeds excretion or uptake into bone

49
Q

Causes of hypercalcemia

A
  1. Hyperparathyroidism due to an adenoma that secretes too much PTH
  2. Malignancy; breast cancer that scrounges Ca+ out of bone
  3. High intake milk
50
Q

Sx of Hypercalcemia

A 
Constipation
Polyuria/Polydipsia
Anorexia
Muscles weakness
Renal calculi - reccurent
Renal failure
51
Q

Tx of Hypercalcemia

A

Moderate/Severe:

  1. Aggressive saline
  2. Calcitonin; decreses action of PTH
  3. Bisphosphonates; inhibits Ca+ release from bone
52
Q

Magnesium equilibrium

A

Balance of dietary intake and renal excretion only!

53
Q

Hypermagensemia (3)

A
  1. Renal insuff
  2. Iatrogenic
  3. Excess use of meds (Maalox)
54
Q

Sx of Hypermagnesemia

A

HYPOREFLEXIA, Hypotension, Bradycardia, Arrhythmias

55
Q

Hypomagnesemia

A

Common! Usually associated with hypokalemia and hypocalcemia.

56
Q

Hypomagnesemia usually assoc. with which demographic?

A

Alcoholics, chronic diarrhea, loop diuretics.

57
Q

Sx of hypomagnesemia?

A

Tetany
Chvostek’s sign
Trousseau signs
ECG: prolong PR interval; diminution of T waves, QRS widening

58
Q

Severe hypomagnesemia classically results in ________?

A

Hypocalcemia

59
Q

6 ways we gauge volume status in pts?

A
  1. PE: BP, orthostatics
  2. Urine output (.5-1 ml/kg/hr)
  3. Daily weight
  4. I&O’s
  5. Central Venous Pressure
  6. Labs!
    - Specific Gravity vs. Osmolality
    - Urine NA
    - HcT (rising Hct may indicate hemoconcentration)
    - Changing Cr and BUN
60
Q

What electrolyte does the parathyroid depend on to function?

A

Magnesium! The parathyroid needs magnesium to release PTH.

Erin's Renal (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions