Fluid and electrolytes Flashcards
normal NA+ values
133-146mmol/L
Symptoms of hypernatramia
convulsions, dehydration, thirst, oliguria, postural hypo, tachycardia , hypovolameia (volume depletion)
drug causes of hypernatramia
lithium , sodium content in IV antibiotics, oral corticosteroids, sodium bicarbonation, contraceptives
how to treat hypernatraemia causes by diabetes insipidus
IV glucose
symptoms hyponatraemia
convulsions, drowsy ,confusion, n/v, nausea cramps
drug cause hyponatreamia
loop and thiazide diuretics
desmopressin
carbamazepine
antidepressants
treat mild to mod hyponatraemia
oral sodium chloride/ sodium bicarb (add glucose if volume depletion)
treat mod to severe hyponatraemia
IV saline (via peripheral vein= isotonic but central vein= concentrated)
why must you give IV saline slowly in a hypo
risk of osmotic demyelination- CNS effect
Rehydration therapy (loss of electrolyte) tx and how long it is given over
electrolyte imbalance : Ort (K+, na+ glucose)
- given over 3 to 4 hrs in diarrhoea
given over 12 when due to hyponatraemia ie. insipidus
replacing water deficit in electrolyte imbalance?
IV glucose, should not be given alone unless no significant loss of electrolytes . i.e insipidus or hyper calcemaim
metabolic acidosis (hypercholamia) what is it
Cl- ions in blood increase beyond normal val 103 mol/l, makes blood more acidic
tx metabolic acidosis
sodium bicarb (alkaline)
if k+low then give potassium bicarb
normal calcium value
2.10-2.58 mol/l
tx of hypercalcaemia
bisphosphonates and corticosteroid reduce serum calcium
tx of hypercalcaemia of malignancy
calcitonin
tx of hypercalcaemia of hyperparathyroidism and in renal failure
cinacalcet reduces parathyroid hormone therefore calcium
and to tx in renal failure is paracalcitol
how to treat hypercalciuria
Bendroflumetiazide increase fluid intake and increase dietary calcium
what can hypocalcaemia cause
osteoporosis
tx mild mod hypocalcaemia
vit d and calcium supplement
severe acute hypocalcaeima
iv calcium gluconate (down give too fast = arrhythmia)
normal phosphate range
0.85-1.45 mol/l
hyperphosphatemia tx and hypo
calcium containing preparation (phosphate binding agents) for hyper
hypo= iv phosphate
Magnesium normal range
0.7-1.05mmol/l
where is hypomagnaemsia common and what happens
common in alcoholics,
hypomagnesiua, mean low k+,ca2+, and NA+ all linked
potassium normal range
3.5-5.3 mol/l
symptoms hyperkalemia
ventricular tachycardia and cardiac arrest
drug causes of hyprkalameia “had beans”
H= heparin
a=acei/arb
d=digoxin
beta blockers
e=eplerenone
amiloride
nsaids
spironolactone
mild mod hyperkalemia tx no ecg change
calcium resonium
acute severe hyperkalemia >6.5mmol
IV slow calcium gluconate
can give insulin salbutamol and glucose in addition
add sodium bicarb to prevent compounding acidosis
should u give calcium gluconate and sodium bicarb the same line
no same line = thrombosis
symptoms hypokalaemia
muscle hypotonia, arrhythmia
drug causes hypokalemaia
dare insult Bettys tough carpet
diurectic, insulin, beta 2 agonist, theophylline corticosteroids
mild hypokalemia tx
oral slow potassium chloride
- nausea and vomiting cause poor compliance
- reduce dose in renal impairment
-if caused by diuretic = k+ sparing instead
