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Paige: Renal Module! > Fluid and electrolytes > Flashcards

Fluid and electrolytes Flashcards

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1
Q

What three fluid issues can you have?

A

volume overload

volume depletion

dehydration

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2
Q

What is the MC cause of volume overload?

A

HF

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3
Q

What is the MC cause of volume depletion?

A

vom/diarrhea

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4
Q

What is the MC cause of dehydration?

A

diarrhea

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5
Q

What is HCO3 actually a measure of?

A

total venous CO2 volume

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6
Q

Which two lab results do we look at for renal function (glomerular filtration)?

A

Cr

BUN

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7
Q

What is Cr a breakdown product of?

A

muscle energy metabolism

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8
Q

What is BUN an end-product of?

A

protein metabolism

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9
Q

Which one gets secreted by the kidney, BUN or Cr?

A

BUN

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10
Q

What symptoms would a person be experiencing that you would want to order these labs? (one general word)

A

neuromuscular

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11
Q

Which electrolyte abnormality might cause weakness, delerium, and seizures?

A

hyponatremia

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12
Q

Which electrolyte abnormality might cause arrhythmias, weakness, and cramping?

A

hypokalemia

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13
Q

Which electrolyte abnormality might cause weakness and diarrhea?

A

hyperkalemia

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14
Q

Which electrolyte abnormality might cause cramping, arrhythmias, and seizues?

A

hypocalcemia

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15
Q

Which electrolyte abnormality might cause polyuria, constipation, and lethargy/confusion?

A

hypercalcemia

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16
Q

SO REVIEW.

Which three electrolyte issues cause muscle weakness?

A

high K, low K

low Na

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17
Q

Sooo which two electrolyte issues cause seizures?

A

low Na, low Ca

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18
Q

Sooo which two electrolyte issues cause cramping?

A

low K, low Ca

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19
Q

Anddd which two electrolyte issues cause arrhythmias?

A

low K, low Ca

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20
Q

What MC causes hyponatremia, a water imbalance or a sodium imbalance?

What causes this?

A

water imbalance

from increased ADH secretion

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21
Q

What gets secreted when there is an increased in the [Na]

( [] = concentration of )

A

ADH

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22
Q

What type of hyponatremia do you have if you have low Na with low ECF volume, and the total body Na/H20 is low?

A

hypovolemic hypotonic hypoNa

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23
Q

If you have hypovolemic hypotonic hypoNa, how will your body respond? Will it

a) excrete more water to maintain [Na]
b) increase ADH to maintain blood volume
c) decrease ADH to maintain [Na]
d) your body doesn’t respond because it can’t fix both at the same time

A

b - increases ADH to maintain blood volume, because this drive is greater than the drive to maintain [Na]

(this is the kind of bitch question we would get on the exam lol)

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24
Q

How do you treat hypotonic hypovolemic hypoNa

A

isotonic fluids + KCL

or gatorade + KCL (mild)

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25
What type of hypoNa is it is you have low Na, high ECF volume, and the total body Na/H20 is increased?
hypervolemic **hypo**tonic hypoNa | (see next slide)
26
If a pt has low na, high ECF volume, and **high** body na/h20, then why is he **hypo**tonic?
Because **both** body H20 and Na are high (so it's high but kind of diluted), so it actually turns out to be that the Na is still low overall
27
How do you tx hypervolemic hypotonic hypoNa?
tx underlying restrict water diuretics
28
What kind of hypoNa do you have with low Na, low serum [Na], and increased urine [Na]?
euvolemic hypotonic hyponatremia
29
Which type of hypoNa is caused by inappropriate ADH secretion from tumors, lesions, drugs, etc?
euvolemic hypotonic hyponatremia
30
Which type of hypoNa is caused by diuretics or vomiting/diarrhea?
hypovolemic hypotonic hypoNa
31
Which type of hypoNa is caused by edema-related disorders?
hypervolemic hypotonic hypoNa
32
What is it called when psychological meds cause patients to take \>10L/day of water?
psychogenic polydipsia
33
What imbalance can happen to patients postop?
increased ADH secretion (from pain) --\> hyponatremia
34
What are the s/s of postop hyponatremia?
pt was most likely on hypotonic fluids nausea, HA, seizures
35
How do you treat postop hyponatremia?
pain control with **iso**tonic fluids
36
Which type of Na imbalance is seen in diabetics?
hypertonic hyponatremia
37
What's the cause/patho of this diabetic hypertonic hyponatremia?
a significant rise in hyperglycemia causes increased [glucose] so H20 goes from cells into the ECF and causes a dilution of Na
38
Why is hyponatremia common in HIV/Aids (patho)
combination of GI fluid, electrolyte loss, inappropriate ADH secretion
39
what imbalance are you going to get if you're stranded in a desert/lost at sea?
hypernatremia and concentrated urine
40
What imbalance causes orthostatic hypotension, dehydration, and oliguria?
hypernatremia and concentrated urine
41
If you have hypernatremia with concentrated urine, will ADH be high or low?
High
42
What's the treatment of someone who is lost in the desert?
replace volume, h20, electrolytes
43
For someone who is dehydrated, you should replace water quickly or slowly? Why?
SLOWLY over 48-72 hours. to avoid cerebral edema
44
what disease is associated with hypernatremia and diluted urine?
diabetes insipidus
45
Which of the following is not a type of diabetes insipidus? a) central b) nephrogenic c) congenital d) peripheral
peripheral DI is not a thing.
46
How is K regulated?
by cells and the kidneys | (Oral K in = renal K out)
47
remember those symptoms of hypokalemia I told you about earlier? Well handler changed his mind about the symptoms. So this says s/s = weakness, cramps, fatigue, constipation.
school is awesome.
48
What will you see on EKG for someone with hypokalemia? (2 changes, 1 condition)
NSST-T changes\* U waves PVCs
49
How does one become hypokalemic?
vom/diarrhea increased aldosterone +/or diuretics
50
How do you treat hypokalemia?
mild: KCL oral severe: KCL IV dietary supplement
51
What might coexist with mild hyperkalemia?
metabolic acidosis | (due to H/K exchange)
52
What will a hyperkalemic EKG look like?
peaked T waves\* wide QRS increased intervals no p waves
53
Whats the treatment of hyperkalemia?
infusion of glucose + insulin
54
Why does glucose + insulin help with hyperkalemia?
insulin drives glucose into cells and K follows
55
If you think someone has hyperkalemia, what should you assess?
renal function\*
56
What arrhythmia are people at risk for with K \>7, and especially with K \> 8.1?
vfib
57
What's the MC cause of hypocalcemia?
chronic renal failure
58
what 2 signs will be + if a person has hypocalcemia?
trosseau's sign chvostek's sign
59
What will an EKG look like with hypocalcemia?
prolonged QT interval\* arrhythmias
60
How do you treat a symptomatic patient with hypocalcemia?
IV Ca gluconate via bolus and infusion
61
How do you treat an asx patient with hypocalcemia?
oral Ca and Vit D
62
What are the MC causes of hypercalcemia?
hyperparathyroidism malignancy
63
What will you see on EKG in someone with hypercalcemia?
shortened QT interval PVCs
64
How do you treat hypercalcemia?
tx underlying infuse 0.9% saline and IV furosemide
65
What drug should you avoid in hypercalcemia?
thiazides!
66
So other than postop hyponatremia, what imbalance is super common in hospitalized patients on IVF?
hypomagnesemia
67
What imbalance does hypomagnesemia mimic?
hypocalcemia
68
Can hypomagnesemia be associated with hypokalemia?
Yes and this is dangerous (increased risk of vfib)
69
How do you treat hypomagnesemia?
IV or oral MgSO4

Paige: Renal Module! (4 decks)

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