Fluid And Electrolytes Flashcards
What is the normal range for sodium?
133-146mmol/L
What are the symptoms of hypernatraemia?
Convulsions Hypovolaemia Thirst Dehydration Oliguria Postural hypotension Tachycardia
What drugs cause hypernatraemia?
Oral contraceptives Corticosteroids Sodium bicarbonate Sodium content in IV antibiotics Lithium
What do you use to treat hypernatraemia caused by volume depletion?
IV glucose
What are the symptoms of hyponatraemia?
Drowsiness Confusion Convulsions Nausea Vomiting
What drugs cause hyponatraemia?
Antidepressants
Loop and thiazide diuretics
Carbamazepine
Desmopressin
What is used to treat mild to moderate hyponatraemia?
Oral sodium chloride / sodium bicarbonate
Add glucose if water depletion
What is used to treat severe hyponatraemia?
IV saline
Isotonic via peripheral vein
Concentrated via central vein
Give slowly as risk of osmotic demyelination syndrome
What electrolytes are within ORT?
Potassium
Sodium
Glucose
Give over 3-4 hours in diarrhoea
Give over 12 hours in hypernatraemic dehydration
How do you replace water deficit?
IV glucose
What is metabolic acidosis?
Hyperchloraemia
What is the normal level of Cl-?
103 mmol/L
What is used to treat metabolic acidosis?
Sodium bicarbonate
If caused by low potassium - potassium bicarbonate
What is the normal range for calcium?
2.1-2.58 mmol/L
What do you use to treat hypercalcaemia?
Bisphosphonates
Corticosteroids
What is used to treat hypercalcaemia of malignancy?
Calcitonin
What is used to treat hypercalcaemia caused by hyperparathyroidism?
Cinacalcet
Paracalcitol in chronic renal failure
What is used to treat hypercalciuria?
Bendroflumethiazide
Increase fluid intake and reduce dietary calcium
What does hypocalcaemia cause?
Osteoporosis
What is used to treat mild to moderate hypocalcaemia?
Vitamin D and calcium supplements
What is used to treat severe acute hypocalcaemia?
Slow IV calcium gluconate
Too fast causes arrhythmias
What is the normal range for magnesium?
0.7-1.05 mmol/L
When is hypomagnesaemia common?
In alcoholics
What can hypomagnesaemia lead to?
Hypo Ca2+, K+, Na+
How do you treat hypomagnesaemia?
IV/IM magnesium sulphate
What is the normal range of phosphate?
0.85-1.45 mmol/L
What is used to treat hyperphosphataemia?
Calcium containing preparations as it is phosphate binding
What is used to treat hypophosphataemia?
Phosphate
Give IV if moderate-severe
What is the normal range of potassium?
3.5-5.3 mmol/L
What are the symptoms of hyperkalaemia?
Ventricular fibrillation
Cardiac arrest
What are the drug causes of hyperkalaemia?
HADBEANS
Heparin ACEi/ARB Digoxin Beta blockers Eplerenone Amiloride NSAIDS Spironolactone
How do you treat mild to moderate hyperkalaemia with no ECG changes?
Calcium resonium
How do you treat acute, severe hyperkalaemia > 6.5 mmol/L?
Slow IV calcium gluconate
IV insulin, glucose and salbutamol in addition
Add sodium bicarbonate to correct compounding acidosis, but not through same line as causes precipitation
What are the symptoms of hypokalaemia?
Muscle hypotonia
Arrhythmias
What are the drugs that cause hypokalaemia?
Dare insult bettys tough carpet
Diuretics Insulin B2 agonist Theophylline Corticosteroid
What is used to treat mild hypokalaemia?
Oral slow potassium chloride
Smaller doses in renal impairment
If caused by diuretics then a potassium sparing diuretic is preferred
How do you treat severe hypokalaemia?
IV potassium chloride
KCl injection overdose is fatal
