Electrolytes (K+, Na+)

Question 0

etiologies of inadequate excretion of K+ (3)

Answer 0

renal failure
medication (spironolactone, triamterene, amiloride)
hypoaldosteronism (Addison’s, ACE inhibitors, renal tubular diseases)

Question 1

causes of hyperkalemia (4)

Answer 1

false elevation
inadequate excretion by kidneys
redistribution of K+ from ICF —> ECF
excess administration

Question 2

etiologies of K+ moving from ICF –> ECF (3)

Answer 2

tissue damage (rhabdo)
acidosis
low insulin

Question 3

tx of hyperkalemia, fast (3) and slow (3)

Answer 3

Fast: Calcium chloride IV, Sodium bicarb IV to raise pH, insulin IV
Slow: diuretics (furosimide), cation resins, dialysis

Question 4

weakness, numbness, tingling, flaccid paralysis, hypoactive DTRs, arrhythmias, cardiac arrest

Answer 4

hyperkalemia

Question 5

tall, peaked T waves (early)

flattened P waves, prolonged PR interval, widened QRS complex (later)

Answer 5

hyperkalemia

Question 6

malaise, weakness, cramps, constipation, paralysis, polyuria, polydipsia, arrhythmias, hypotension

Answer 6

Hypokalemia

Question 7

flattened T waves, ST depression, U waves

Answer 7

hypokalemia

Question 8

hypokalemia causes (4)

Answer 8

inadequate intake, GI loss, renal loss, movement from ECF –> ICF

Question 9

causes of inadequate K+ intake (2)

Answer 9

diuretics, poor diet

Question 10

renal loss of K+ causes (2)

Answer 10

diuretics
osmotic diuresis (hyperglycemia or EtOH)

Question 11

causes of K+ moving ECF —> ICF (3)

Answer 11

metabolic alkalosis
insulin
mineralocorticoid excess (hyperaldosteronism, Cushing’s, steroid use)

Question 12

hypokalemia tx, fast & slow (4)

Answer 12

Fast: KCl IV, checking serum every 2-4h
Slow: oral supplements
- check for hypomagnesia
- correct underlying cause

Question 13

aldosterone actions (2)

Answer 13

1. increase renal sodium reabsorption

2. increase renal potassium secretion

Question 14

thirst, decreased sweating, dry mucous membranes, CNS depression, weakness & muscle cramps, low BP, increased pulse suggest?

Answer 14

hypovolemia

Question 15

edema, hypertension, JVD, hepatojugular reflex, SOB, orthopnea, PND suggest?

Answer 15

hypervolemia

Question 16

what are the body’s priorities for fluid regulation?

Answer 16

volume
pH
electrolytes

Question 17

hypernatremia is defined as?

Answer 17

serum Na+ >145 mEq/L

Question 18

tx for central diabetes insipidus?

Answer 18

dDAVP nasal spray- ADH analogue

Question 19

nephrogenic diabetes insipidus tx? (4)

Answer 19

thiazide diuretics
amiloride (K+ sparing diuretic)
chlorpropamide (oral antidiabetic agent)
NSAIDs- Indomethacin

Question 20

hyponatremia is defined as?

Answer 20

serum Na+ <135 mEq/L

Question 21

what is the most common electrolyte abnormality in hospitalized patients?

Answer 21

hyponatremia due to hypotonic fluid use

Question 22

hyponatremia tx? (3)

Answer 22

restrict fluids if hyper/euvolemic
replace fluid w/ isotonic saline if hypovolemic
vasopressin antagonists for chronic hyponatremia

Question 23

SIADH is a disorder of?

Answer 23

impaired renal free water excretion

Question 24

high serum Na+
dilute urine
associated with?

Answer 24

diabetes insipidus

Question 25

low serum osmolality
high urine osmolality
is characteristic of?

Answer 25

SIADH

Question 26

low Na+ but normal serum osmolality could indicate?

Answer 26

psuedohyponatremia

Question 27

causes of hyponatremia w/ hypervolemia

Answer 27

fluid overload conditions

Question 28

causes of hyponatremia w/ euvolemia (4)

Answer 28

hypothyroidism
SIADH
diuretic use
adrenal insufficiency