Brainscape's Knowledge GenomeTM

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


See full index

Therapeutics P2 > Exam 1 lecture 2 > Flashcards

Exam 1 lecture 2 Flashcards

1
Q

normal range of sodium

A

135-145

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

most common disturbance in hospital patients

A

hyponatermia

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

too rapid of a correction of sodium leads to

A

demyelination

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

hyponatremia sodium levels

A

less than 135

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

serum osmolarity calculation

A

(2xNa) + (BUN/2.8)+(glucose/18)

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

what is the use in calculating serum osmolarity in hyponatremic patients

A

Lets us know if patient is isotonic, hypotonic or hypertonic hyponatremic

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

Hypertonic hyponatremic is almost always due to

A

hyperglycemia (elevated blood glucose)

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

how to correct hypertonic hyponatremia

A

Calculate corrected Na using (Na serum +1.6 ((BG-100)/100)

if Na is still hyponatremic after calculating corrected Na, use insulin.

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

3 types of hypotonic hyponatremia

A

hypovolemic hypotonic hyponatremia
hypervolemic hypotonic hyponatremia
isotonic hypotonic hyponatremia

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

Effect of hypovolemic, hypotonic hyponatremia on TBW and Na levels

A

decreases TBW
Decreases Na drastically

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

effect of hypervolemic hypotonic hyponatremia on TBW and Na levels

A

increases TBW drastically,
increases na

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

Isovolemic hypotonic hyponatremia effect on TBW and Na levels

A

High TBW and same Na

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

most common hyponatremia

A

hypotonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

2 causes of hypovolemic hypotonic hyponatremia

A

renal
non-renal

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

renal cause of hypovolemic hypotonic hyponatremia

A

Excessive diuresis

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

Na levels in urine for renal cause of hypovolemic hypotonic hyponatremia

A

Na> 20 mEq/L

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

Na levels of non renal cause of hypovolemic hypotonic hyponatremia

A

Na<20 meq/L

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

non renal cause of hypovolemic hypotonic hyponatremia

A

Hemorrhage/blood loss
burns, sweats, wounds
GI losses(vomiting, diarrhea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

effect of isovolemic hypotonic hyponatremia on TBW and Na

A

increase in TBW and same Na

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

Most common cause of isovolemic hypotonic hyponatremia

A

SIADH

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

What does SIADH stand for

A

Syndrome of inappropriate ADH release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Most common drugs that case SIADH

A

Antipsychotics, carbamazapine, SSRIs

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

1st line of treatment for SIADH induced isovolemic hypotonic hyponatremia

A

Free h20 restriction

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

Hypervolemic hypotonic hyponatremia effect on TBW and Na

A

Increase in Na and Drastic increase of TBW

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

clinical presentation of hypovolemic, hypotonic, hyponatremia

A

Dehydration (decreased skin turgor, orthostatic hypotension, tachycardia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Clinical presentation of isovolemic, hypotonic hyponatremia

A

malaise, psychosis, seizure, coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

cllinical presentation of hypervolemic hypotonic hyponatremia

A

edema and weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Avoid rise in serum sodium of no more than

A

8-12 mEQ/L/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

how to treat hypovolemic hypotonic hyponatremia

A

Give fluid

hypertonic Nacl (3%) if symptomatic
Isotonic NaCl (0.9%) if asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How to treat isovolemic hypotonic hyponatremia

A

-Stop SIADH
-furosemide and 3% nacl if symptomatic
0.9% nacl if asymptomatic and water restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how to treat hypervolemic hypotonic hyponatremia

A

Furosemide and 3% NaCl in symptomatic patients
furosemide in asymptomatic patoents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Difference in how we treat acute vs chronic hyponatremia

A

In chronic hyponatremia, our body is already acclimated to the low sodium levels. However, in acute hyponatremia we need to treat it expeditiously because it could kill us.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What time frame do we consider hyponatremia to be acute

A

Less than 48 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What could acute hyponatremia lead to?

A

Cerebral edema, brain herneation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

By how much should we increase Na+ every hour for acute hyponatremia

A

Increase by 1-2 meq every hour (keep in mid we can only increase up to 8-12 meq per day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the short term goal for acute hyponatremia

A

Na concentration of 120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

If sodium is corrected too quickly, it could lead to

A

demyelination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are some risk factors for demyelination

A

Serum Na<105
hypokalemia
alcohol use/malnutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How do we treat acute symptomatic hyponatremia

A

3% NaCl with rule of 8s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the rule of 8s

A

Replace half the deficit in 1st 8 hours, the remaining over 8-16 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

TBW (total body water) calculations in males vs females

A

Males- 0.6 x wt
females- 0.5 x wt

42
Q

Na deficit calculation

A

TBW x (Na goal-current Na serum)

43
Q

Review lecture 2 patient cases and calculations for fluid/lytes

44
Q

Hypernatremia is always associated with what tonicity

A

Hypertonicity

45
Q

What are the 3 types of hypernatermia

A

Hypovolemic hypernatremia
Isovolemic hypernatremia
Hypervolemic hypernatremia

46
Q

Effect of hypervolemic hypernatremia on TBW and Na levels

A

increase in h20 but drastic increase in Na

47
Q

Effect of hypovolemic hypernatremia on TBW and Na levels

A

Drastic decrease in H20 but a little decrease in Na

48
Q

Effect of isovolemic hypernatremia on TBW and Na levels

A

losing water but not h20

49
Q

How to treat hypovolemic hypernatremia

A

Lecture 2 slide 119

50
Q

how to treat hypovolemic hypernatremia

A

Restore hemodynamic status first if needed, use 0.9 NaCl. Then calculate the free water deficit and give D%W or free water using rule of 8s

51
Q

How to calculate free water deficit

A

TBW x [(Na serum/140)-1]

52
Q

What is the goal rate of decrease in hypovolemic hypenatremic pts

A

0.5 meq/hr

53
Q

isovolemic hypernatremia is usually due to

A

Diabetes insipidus

54
Q

How to treat isovolemic hypernatremia

A

Vasopressin or desmopressin

55
Q

WHat is hypervolemic hypernatremia caused by

A

Too much saline. This makes us hold on to to much sodium, leading to holding too much fluid

56
Q

How to treat hypervolemic hypernatremia

A

Stop the fluid/cause
Diuretic

57
Q

Potassium range

A

3.5-5
usually found intracellularly

58
Q

Use of potassium in body

A

Helps maintain the action potential across cardiac cell membrane, so people with potassium issues have cardiac issues

59
Q

Most common cause of hypokalemia

A

Diuretics

(another cause is albuterol)

60
Q

Why is magnesium depletion a cause of hypokalemia

A

Mag is a cofactor for that sodium-potassium ATP-ase. No mag= no transport

61
Q

Treatment of hypokalemia

A

Give potassium

62
Q

K levels of 3.5-4 treatment

A

No therapy

63
Q

3-3.4 K levels treatment

A

Debatable
Po potassium for Pts with cardiac conditions

64
Q

less than 3 K level treatment

A

Always treat
PO for asymptomatic pts
IV for symptomatic pts

correct Mag deficiency aswell

65
Q

When to use IV Potassium

A

Severe hypokalemis (2.5-3)
exhibiting symptoms (ECG changes, muscle spasms)
unable to tolerate PO

66
Q

warnings or precautions of IV potassium

A

Could cause arrythmias or cardiac arrest if given too quickly

67
Q

Administration rate of K IV

A

Without cardiac monitors- 10 mEQ/hr
with contionous monitoring- 20 meq.hr

40-60 during cardiac arrest

68
Q

Rank hyperkalemia interms of severity

A

Mild- 5.5-6
moderate- 6.1-6.9
severe > or equal to 7

69
Q

clinical presentation of hyperkalemia

A

Peaked T wave

70
Q

Steps to treat severe hyperkalemia

A

C ABIG KDROP

  1. Calcium (antagonizes cardiac membrane)
  2. Albuterol, Bicarb, Insulin+glucose
  3. Kayexelate (lokelma) [diuretics that excrete K]
    Diuretics (furosemide)
    Renal unit for dialysis
71
Q

WHat is the only case insluin is give IV push

A

Hyperkalemia

72
Q

Magnesium normal range

73
Q

Use of Magnesium

A

Co factor for many enzymes
Related to Ca & K metabolism

74
Q

If someone has hypomagnesemia they usually have what kind of disturbance

A

GI tract or kidney

75
Q

Drugs that cause you to lose mag

76
Q

How to treat hypomagnesemia

A

asymptomatic pts with mg>1 mg/dl- Milk of mag or mag ox

symptomatic ots

mg- 1-2- IV at 0.5 meq/kg
mg<1- IV at 1 meq/hr

77
Q

How many Meq of Magnesium is 1 gram

A

8 meq=1 gram

78
Q

Calcium normal range

79
Q

hypocalcemia causes

A

Mag deficiency
large volume of blood products (Ca is used in clotting)
hypoalbuminemia

80
Q

Why does hypoalbuminemia cause hypocalcemia

A

Calcium binds to albumin, low albumin levels might show low calcium levels even if Ca kevels are normal

81
Q

How to tell if low calcium is caused by actually low ca or low albumin levels?

A

Corrected Ca

82
Q

Formula for corrected Ca

A

Measured Ca + [(4-measured albumin x 0.8)]

83
Q

Ionized vs serum calcium accuracy

A

Ionized is more accurate

84
Q

how to treat hypocalcemia

A

100-300 mg of calcium IV over 5-10 min

85
Q

What are the two different forms of Calcium treatment

A

1 gm of CaCl or 3 Gm of Ca gluconate

86
Q

What are the calcium levels of the two calcium treatments

A

1gm CaCl= 3gm of Ca gluconate = 270 gms

87
Q

How do we decide to gove CaCl or Ca gluconate

A

Symptomatic- CaCl
Asymptomatic- Ca gluconate

88
Q

What are the pros and cons of Ca gluconate

A

Pros- Lower% of Ca, less risk of necrosis

con- less predictable ris ein Ca

89
Q

Which Ca is preferred for PIV (Push IV)

A

Ca gluconate

90
Q

Usual administration rate for acute hypocalcemia

91
Q

What other element should be corrected for hypocalcemia

92
Q

How to treat chroncic hypocalcemia

A

1-3 gm of Ca PO per day
Tums 650 mg po QID

93
Q

Phosphorous range

94
Q

Mild to moderate hypo PO4 concentration

95
Q

Severe hypophosphotemia range

A

LESS THAN 1

96
Q

Treatment of mild-moderate hypophosphatemia

A

Oral phosphate (phos-nak)

97
Q

Treatment of severe hypophosphatemia

A

IV PO4 either Naphos or Kphos

98
Q

When to use NaPhos and K phos

A

Use KPhos when K is less than 4

If 4 or above use Naphos

99
Q

Rate of Phos infusion

100
Q

Lets just make it 100

Therapeutics P2 (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions