Fluid/Electrolytes

Question 1

2/3 intracellular, 1/3 extracellular (interstitial, intravascular)

Answer 1

Body fluid distribution

Question 2

“pulling into same space”, creates negative force

Answer 2

Osmotic/oncotic

Question 3

“pushing into another space”

Answer 3

Hydrostatic

Question 4

Urine, sweat, feces, respiration/vomiting, diarrhea

Answer 4

Normal/abnormal excretion mechanisms

Question 5

Vomiting, diarrhea, excessive diuretics, hemorrhage/iatrogenic, heart failure, renal failure
Asymptomatic, tachycardia, orthostatic hypotension, dizziness, syncope, dry mucus membranes, skin tenting, prolonged capillary refill (s/sx of dehydration)

Answer 5

Volume deficit of extracellular fluid

Question 6

Causes: Iatrogenic, heart failure, renal failure
S/Sx: Edema, JVD, dyspnea, orthopnea

Answer 6

Volume excess of extracellular fluid

Question 7

Excess of water = decrease in sodium concentration

Answer 7

Hyponatremia

Question 8

Water deficiency = increase in sodium concentration

Answer 8

Hypernatremia

Question 9

Iatrogenic, water poisoning, Syndrome Inappropriate Anti-Diuretic Hormone, diuretics, replacement of fluids with water but no salt

Answer 9

Causes of hyponatremia

Question 10

Iatrogenic, diabetes insipidus (ADH deficiency), prolonged V/D without volume replacement, diaphoresis

Answer 10

Causes of hypernatremia

Question 11

HA, N/V, confusion, seizures, coma

Answer 11

Clinical manifestations of sodium imbalance (hypo-/hyper-)

Question 12

• Urine, feces, sweat
• Vomiting, diarrhea, wound drainage, NG suction

Answer 12

Normal/abnormal electrolyte excretion mechanisms

Question 13

Diarrhea, vomiting, alkalosis, potassium-wasting diuretics, excess insulin

Answer 13

Causes of hypokalemia

Question 14

Renal failure, iatrogenic (blood transfusions, IV potassium), aldosterone inhibition, insufficient insulin

Answer 14

Causes of hyperkalemia

Question 15

Muscle weakness, cardiac arrhythmia, abdominal distention

Answer 15

Clinical manifestations of hypokalemia

Question 16

Muscle weakness, cardiac dysrhythmias, intestinal cramping/diarrhea

Answer 16

Clinical manifestations of hyperkalemia

Question 17

Dietary insufficiency, Vit. D deficiency, renal failure, fat malabsorption, large blood transfusions

Answer 17

Causes of hypocalcemia

Question 18

Vit. D excess, Milk-Alkali Syndrome (over-ingestion of calcium), bone tumors, multiple myeloma, leukemia, thiazides, Paget disease

Answer 18

Causes of hypercalcemia

Question 19

Increased neuromuscular excitability: parethesias, muscle twitching/cramping, tetany, hyperactive reflexes,Trousseau/Chvostek signs, cardiac arrhythmias

Answer 19

Clinical manifestations of hypocalcemia

Question 20

Decreased neuromuscular excitabillity: personality changes, fatigue, N/V, constipation, muscle weakness, diminished reflexes, cardiac arrhythmias

Answer 20

Clinical manifestations of hypercalcemia

Question 21

Decrease/increase in one level means same directional change in the other level

Answer 21

Compensation

Question 22

Decreased HCO3

Answer 22

Metabolic acidosis

Question 23

Increased HCO3

Answer 23

Metabolic alkalosis

Question 24

Increased CO2

Answer 24

Respiratory acidosis

Question 25

Decreased CO2

Answer 25

Respiratory alkalosis

Question 26

DKA, toxin ingestion, severe infection, burns

Answer 26

Metabolic acidosis

Question 27

Vomiting, intake of bicarbonate, hypokalemia, hyperaldosteronism

Answer 27

Metabolic alkalosis

Question 28

Opioids, COPD, asthma, chest injury

Answer 28

Respiratory acidosis

Question 29

Hyperventilation

Answer 29

Respiratory alkalosis