Electrolytes Flashcards
Where is most of our water?
in our cells
ECF and ICF are determined by what?
ECF= sodium
ICF=potassium
What does ADH do?
water resorb because sensed low volume
True or false sodium goes up if ADH?
FALSE-low because dilutional
What does aldosterone do?
increase sodium+ water
What does ANP do?
get rid of water
What is normal amount of water a day?
1400ml
How does volume depletion usually happen?
due to sodium loss
Signs of hypovolemia?
hypotension standing, thirst, tired, mental changes
How to restore mild hypovolemia? what if needing quickly?
isotonic fluids, NS,
need wuick= 1-2 bolus
signs of hypervolemia?
dyspnea, leg swelling, weight gain
How to fix hypervolemia?
restrict sodium, diuretics
How do thiazide effect electrolytes?
decrease sodium, decrease K, decrease Mg, INCREASE Ca
How do loop effect electrolytes?
decrease K,Mg,CA
How do K sparing diuretics effect electrolytes?
Increase K
If you drink too much water what happens?
hyponatremia
What is hyperosmolar hyponatremia?
Na is normal but high glucose= dilution hyponatremia
What causes hypovolemic hyponatremia?
drugs causing sodium loss with water such as diuretics
What causes hypervolemic hyponatremia?
heart failure retaining fluid and causing dilution hyponatremia
What causes euvolmeic hyponatremia?
ADH or SIADH
What drugs can cause SIADH?
SSRI, AP, NSAID
How long is chronic hyponatremia?
> 3 days
How can we know if hyponatremia is due to glucose and not salt?
if osmolality is high
What test tells us if hyponatremia is due to ADH?
if urine osmolality that is normal and NOT low
Why do we have to correct hyponatremia slowly?
rapid cell swelling if done fast
Limit of Na a day?
8mEq per day
If ADH is the issue in hyponatremia how does NS help?
restores vascular volume which turns off ADH receptors
How to fix evolemic hyponatremia?
treat underlying
water restriction, salt tablets, loop diuretics
Is hypernatremia due to salt intake or water loss?
usually water loss
How does our body attempt to minimize hypernatremia?
become thirsty, concentrate urine
How does the body lose water?
diarrhea, sweat, diabetes, diuretics
What is the difference between central diabetes insipidus and nephrogenic?
central= not secreting ADH
nephrogenic= kidney not listening to ADH
How to fix central insipidus?
desmopressin (ADH)
How to fix nephrogenic insipidus?
sodium restriction and thiazide
How to treat hypernatremia?
D5W, loop diuretic
What is the most abundant cation in the body?
potassium
WHat hormone excretes K?
aldosterone
What hormone drive K into cells?
insulin and epinephrine
What can cause low K?
vomit, diarrhea, diuretics
What other low electrolyte contributes to low K?
hypomagnesium
HOW much K fixes K levels by 0.1?
10mmol
Why don’t you want to fix low K too fast?
cardiac issues
What is the main contributor to high K?
ESRD
How to fix high K?
Calcium gluconate- protect heart
insulin, sodium bicarbonate
diuretics
kayexalate
Where is most magnesium found?
bone-most
muscle
What can cause low Mg?
diuretics, PPI, diarrhea, colitis
Side effect of too much Mg?
diarrhea
When do you get severe sx of magnesium?
> 2 mmol
How to fix hyper magnesium?
calcium to protect heart
loop diuretics
Normal pH?
7.4
If issue with lungs what fixes it?
kidney
If kidneys are having issues what fixes?
Lungs
If pCO2 is high what does this mean?
resp acidic and kidneys will try to excrete H and retain bicarb
How to fix metabolic acidosis?
bicarb
What drugs can cause metabolic acidosis?
metformin, lithium, topiramate
What can cause metabolic alkalosis?
vomit, diuretics
How to treat metabolic alkalosis?
correct underlying and volume repletion
How long will it take for bicarbonate to go down in resp alkalosis?
> 24 hours
WHo get resp alkalosis?
pregnant, high altitude
What can cause resp acidosis?
anything that slows breathing or restricts breathing
