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Clin Phys > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

What are signs of hypervolemia?

A

Increased BP
Low BUN, Hct
Full peripheral pulses

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2
Q

What are symptoms of hypervolemia?

A
  1. Pitting edema (extremities, eyelids, facial)
  2. Muscle weakness
  3. Pulmonary edema (increased respiratory rate, shallow respirations, shortness of breath, moist crackles)
  4. Distended neck veins
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3
Q

How is hypervolemia treated?

A

Loop diuretic (Ethacrynic Acid, Furosemide, Bumetanide, Torsemide)
Fluid restriction (~1-2 L/day)

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4
Q

What is hypovolemia mostly caused by?

A
  1. hyperglycemia
  2. high urea
  3. diuretic induced
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5
Q

What are symptoms of hypovolemia?

A
  1. fatigue
  2. thirst
  3. orthostasis
  4. chest pain
  5. confusion
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6
Q

What are signs of hypovolemia?

A
  1. diminished skin turgor
  2. orthostatic tachycardia (women)/ orthostatic hypotension (men)
  3. Increased BUN, SCr
  4. Bicarbonate loss (diarrhea)
  5. urine osmolality > 450 mOsm/kg
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7
Q

What is the tretment for hypovolemia?

A
  1. normal saline
  2. colloids
  3. hypotonic solution (dextrose in water/ 1/2 NS) if hypernatremia
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8
Q

What is the rate of maintenance fluids?

A

25-30 mL/kg/day

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9
Q

What are the rates of fluids when hypovolemic?

A
  1. above 30mL/kg/day
  2. 500mL bolus if hypotensive
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10
Q

What are symptoms of severe hypernatremia?

A

seizures, coma, death (>180 mEQ/L)

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11
Q

What are symptoms of mild hypernatremia?

A

lethargy, weakness, restlessness, twitching (>145 mEQ/L)

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12
Q

What is the most common type of hypernatremia?

A

hypovolemic hypernatremia

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13
Q

How is hypernatremia treated?

A

free water replacement

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14
Q

What drugs can induce hyponatremia?

A
  1. Thiazide diuretics
  2. Psych meds (SSRI, SNRI, TCA)
  3. carbamazepine and oxcarbazepine
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15
Q

How can the cause of hyper/ hypo natremia be diagnosed?

A

urine osmolality

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16
Q

How much sodium per day should be given to treat hyponatremia?

A

NO MORE THAN 12 mEQ/L/day

17
Q

What could happen if you overcorrect sodium by too much?

A

osmotic demyelination syndrome

18
Q

What is considered hyperkalemia?

A

K> 5mEq/L

19
Q

When should you not react to a hyperkalemia value?

A
  1. no symptoms
  2. single lab value
  3. hemolyzed sample
20
Q

What are causes of hyperkalemia?

A
  1. AKI
  2. drug-induced
  3. supplementation
  4. acidosis, insulin deficeincy
21
Q

What drugs can induce hyperkalemia?

A
  1. ACE/ ARB
  2. aldosterone antagonists
  3. Lithium
  4. calcineurin inhibitors
  5. trimethoprim
  6. potassium-sparing diuretics
22
Q

When does hyperkalemia need to be treated?

A
  1. chronically above normal
  2. EKG changes (peaked T waves)
23
Q

When does hypokalemia become symptomatic?

A

< 2.5 mEQ/L

24
Q

What are symptoms of hypokalemia?

A
  1. palpitations
  2. EKG changes
    Caution in patients with hx of CV disease
25
Q

What are causes of hypokalemia?

A
  1. abnormal GI/renal losses
  2. lack of Mg absorption
  3. drug induced
26
Q

What drugs can cause hypokalemia?

A
  1. diuretics
  2. laxatives
  3. Amphotericin B
27
Q

How is hypokalemia treated with Mg?

A
  1. give 10 mEq for every 0.1 mEq/L
  2. if more than 20mEq needed separate by at least 2 hours
  3. remove underlying cause
  4. prn K+ supplements
28
Q

What are symptoms of mild hypercalcemia?

A
  1. weakened bones
  2. GI issues
29
Q

What are symptoms of severe hypercalcemia?

A
  1. EKG changes
  2. mental status changes
  3. severe sedation
30
Q

What are treatments for hypercalemia?

A
  1. fluids +/- furosemide
  2. IV bisphosphonates/ RANKL inhibitors
  3. Calcitonin
31
Q

What are symptoms of severe hypocalcemia?

A
  1. mental status changes
  2. seizures
  3. coarse hairs
  4. brittle nails
  5. dry skin
32
Q

How do you treat severe hypocalcemia?

A

100-300 mg elemental Ca IV

Clin Phys (15 decks)

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