Fluid And Electrolytes

Question 1

Normal Sodium level

Answer 1

135-145

Question 2

What is a normal urine sodium level? What is indicated if it is elevated vs low

Answer 2

Normal: 20
Low: Renal retention of sodium
Elevated: renal salt wasting

Question 3

What is the normal serum osmo and what does it mean when its high vs low

Answer 3

Normal is x2 serum sodium (275-285)
High: concentrated urine
Low: diluted urine

Question 4

Causes of isotonic hyponatremia and tx

Answer 4

Occurs with hyperlipidemia or hyperproteinemia
Tx Cut down on fats

Question 5

Causes of hypertonic hyponatremia and tx

Answer 5

Elevated glucose, HHNK
Treat underlying cause

Question 6

Causes of hypotonic hypervolemic hyponatremia and treatment

Answer 6

RF, CHF, cirrhosis, nephrotic syndrome
Tx: Water restriction, lasix

Question 7

Causes and treatment of hypotonic hypovolemic hyponatremia

Answer 7

Dehydration, salt wasting, vomiting/diarrhea, diuretics
Tx: IVF

Question 8

Hypotonic euvolemic hyponatremia Causes

Answer 8

SIADH, hypothyroidism, glucocorticoid insufficiency

Question 9

Hypernatremia causes

Answer 9

Typically excessive water loss

Question 10

Tx of hypovolemic hypernatremia

Answer 10

NSS followed by 1/2 NSS IV

Question 11

Tx of Euvolemic hypernatremia

Answer 11

D5W

Question 12

Treatment of hypervolemia hypernatremia

Answer 12

Free water and lasix

Question 13

Normal CA level and iCal level

Answer 13

Ca: 8-10
iCal 1.2-1.3

Question 14

Causes of hypercalcemia and treatment

Answer 14

Causes: Hyperthyroidism, hyperparathyroidism, vitamin D toxicity, thiazide diuretic use, immobility, malignancies
Tx: Calcitonin, NSS, diuretic, phosphate

Question 15

Hypocalcemia causes, s/s, and treatment

Answer 15

Causes: Pancreatitis, blood transfusions, hypothyroidism, hypomagnesium, low albumin, alkalemia, post Parathyroidectomy, hungry bone syndrome, rhabdo
S/S: hyperactive symptoms, Trop sauces, chvoteks sign, prolonged t interval
Tx: Phoslo, calcium replacement, vitamin D

Question 16

Normal potassium level

Answer 16

3.5-4.5

Question 17

Causes of hypokalemia, s/s, ekg changes, and tx

Answer 17

Causes: Excessive diuretic use, GI loss, alkalosis, DKA, cooling/hypothermia, albuterol, epinephrine
S/S: Weakness, fatigue, muscle cramps, constipaiton, ileus, polydipsea, polyuria, paralysis, restless leg
EKG: Short QRS, decreased amplitutde, broad T and U waves, and PVCs
Treatment: KCL raises serum levels 0.2 for 10meq

Question 18

Hyperkalemia causes, s/s, EKG changes, and treatment

Answer 18

Causes: Too much dietary intake, Rhabdo, digoxin, succinylcholine, RF, hemolysis, NSAIDS, acidosis
S/S: Flaccid paralysis
EKG: Peaked t waves and prolonged QRS, sine wave
TX: 10units of insulin with 1 amp of D5 and 1 amp of calcium gluconate, can also give albuterol neb

Question 19

Causes of hypomagnesemia

Answer 19

Malnutrition, chronic ETOH, CHF, PPOs, celiacs, diuretics

Question 20

Hypermagnesemia causes and treatment

Answer 20

Causes: primary hyperparathyroidism
Tx: CaGL

Question 21

Complications of over correction of hypernatremia

Answer 21

Risk of osmotic demlyination syndrome

Question 22

What does a urine sodium >20 and <10 indicate

Answer 22

> 20 indicates a kidney problem
<10 indicates a problem elsewhere

Question 23

Causes of hypotonic hypovolemic hyponatremic hypnatremia with a U Na<10

Answer 23

Dehydration
Diarrhea
Vomiting

Question 24

Causes of Hypotonic Hypovolemic Hyponatremia with U Na >20

Answer 24

Diuretics
ACE
Mineralcorticoids deficiency

Question 25

What is the effect of pancreatitis on calcium

Answer 25

Hypocalcemia

Question 26

What is the effect of renal failure on calcium

Answer 26

Hypocalcemia

Question 27

What medications cause hyperkalemia

Answer 27

Any drugs that impair renal function
Heparin
Succs