Fluid, Electrolyte, Acid Base Flashcards
Serum sodium level indicative of hypernatremia
> 145
Serum sodium level of 200 requires
dialysis
Rapid correction of hypernatremia can cause
pulmonary or cerebral edema - esp in patients w DM
Serum sodium level indicative of hyponatremia
< 135
**signs and symptoms may not be present until 125
Most common electrolyte disorder seen in general hospital population secondary to fluid administration
Hyponatremia
Hyponatremia w HYPERvolemia
occurs in setting of
CHF
nephrotic syndrome
renal failure
hepatic cirrhosis
Hyponatremia and EUvolemia occurs with
hypothyroidism
glucocorticoid excess
SIADH
Hypotonic hyponatremia, Urine Osmo > 100, absence go extracellular fluid volume deficit
SIADH
Plasma osmo 280-295
Isotonic hyponatremia (paraproteinemia, hypertriglyceridemia)
Plasma osmo > 295
Hypertonic hyponatremia (hyperglycemia)
Plasma osmo < 280
Hypotonic hyponatremia, measure urine osmo
URINE osmo < 100
Excessive water intake (primary polydipsia)
URINE osmo > 100
impaired renal diluting ability (SIADH, diuretics)
Neurologic symptoms of hyperkalemia
numbness, tingling, weakness, flaccid paralysis
IV administration for hyperkalemia
Sodium bicarbonate
Glucose
Insulin (10 units)
Med used to remove potassium from the body when levels are extremely high
Sodium polystyrene sulfonate (Kayexalate)
Hypokalemia defined as
Serum potassium < 3.5
Hyperkalemia defined as
Serum potassium > 5.0
Most common causes of hypokalemia
Diuretics
Renal tubular acidosis
GI loss
Cardiovascular manifestations of hypokalemia
Ventricular arrhythmias
Hypotension
Cardiac arrest
Neuromuscular manifestations of hypokalemia
Malaise
Skeletal muscle weakness
Cramps
Smooth muscle involvement
Tx for hypercalcemia
Isotonic saline
Loop diuretics (if hypervolemic after iv fluids)
Bisphosphonates
Tx for hypermagnesemia
IV calcium gluconate
Diuresis
Dialysis if severe
Tx hypomagnesemia
oral magnesium oxide
if severe, IV magnesium sulfate
Primary CO2 changes bring
Secondary HCO3 changes
Primary HCO3 changes bring
Secondary HCO3 changes
Anion gap
(Na - (Cl + HCO3))
Tells us how many unmeasured anions are present in blood
(accumulating acids in ECF)
For differentiating cause of metabolic academia
- HCO3 loss has normal anion gap
- acid production or accumulation has wide anion gap
