Fluid And Electrolytes Flashcards

0
Q

Clinical manifestations of slow hypernatremia versus rapid hypernatremia?

Management?

A

Volume depletion versus confusion, lethargy, coma

D5 1/2NS

versus

D5 1/3NS or even D5W

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1
Q

Estimated water loss based on hypernatremia?

A

Every 3 mEq/L of hypernatremia represents 1 L of water lost

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2
Q

Rule of thumb for treating hypernatremia?

A

Rapidly correct the hypovolemia, but slowly correct the tonicity

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3
Q

Major causes of hyponatremia? Management?

A
  1. Inappropriate ADH secretion (post-Op water intoxication, tumors)
  2. Loss of large amounts of isotonic fluids (from G.I. tract)
#If rapid, hypertonic saline.
#If slow, water restriction
#If from G.I. fluid loss – isotonic fluid
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4
Q

Why does G.I. fluid loss cause hyponatremia?

A
  1. Loss of isotonic fluid

2. Retention of water to maintain correct volume

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5
Q

Hypokalemia – typical causes? Management?

A
  1. G.I. tract losses
  2. Urine losses (direct, aldosterone)

10 mEq per hour

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6
Q

Hyperkalemia – typical causes?

Management options - ultimate? Fastest? Others?

A
  1. Kidney cannot excrete potassium (renal failure, aldosterone antagonist)
  2. Dumping of potassium into blood (acidosis, crush injuries, necrosis)
#Ultimate therapy – hemodialysis
#Fastest - Ca 
#Push potassium into cells – dextrose and insulin, B-2 agonists, Bicarb 
#Suck/neutralize potassium out of G.I. tract – (NG suction, Kayexalate)
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7
Q

Metabolic acidosis – general causes?

A
#Production of fixed acids (DKA, low flow states)
#Loss of buffers (blocks of bicarb)
#Inability to eliminate acids (renal failure)
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8
Q

Metabolic acidosis – in addition to fixing base deficit, be prepared to replace?

A

Potassium

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9
Q

Metabolic alkalosis – most cases will correct with administration of? Rarely need?

A

KCl – 5-10 mEq per hour

Ammonium chloride or .1 N HCL

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