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fluid & electrolytes (worksheet/basics) Flashcards

1
Q

weight in oliguric phase of acute tubular necrosis

A

up

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2
Q

total fluid balance in oliguric phase of acute tubular necrosis

A

up

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3
Q

urine output in oliguric phase of acute tubular necrosis

A

down

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4
Q

urine osmolality in oliguric phase of acute tubular necrosis

A

up

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5
Q

serum BUN/creatinine in oliguric phase of acute tubular necrosis

A

up

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6
Q

serum osmolality in oliguric phase of acute tubular necrosis

A

down

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7
Q

how are urine output and osmolality related

A

inverse (if one is up, the other is down)

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8
Q

what should you think of serum osmolality as?

A

amount of salt

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9
Q

potential electrolyte imbalances in oliguric phase of acute tubular necrosis

A

hyperkalemia, hyponatremia, hypocalcemia, hyperphosphatemia

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10
Q

potential complications in oliguric phase of acute tubular necrosis

A

fluid overload!
cardiac arrythmia
CVP/wedge increased

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11
Q

treatment in oliguric phase of acute tubular necrosis

A

stop cause
maintain fluid balance
CRRT

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12
Q

weight in diuretic phase of acute tubular necrosis

A

down

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13
Q

total fluid balance in diuretic phase of acute tubular necrosis

A

down

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14
Q

urine output in diuretic phase of acute tubular necrosis

A

up

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15
Q

urine osmolality in diuretic phase of acute tubular necrosis

A

down

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16
Q

serum BUN/creatinine in diuretic phase of acute tubular necrosis

A

trend down / start normalizing

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17
Q

serum osmolality in diuretic phase of acute tubular necrosis

A

up

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18
Q

potential electrolyte imbalances in diuretic phase of acute tubular necrosis

A

hypernatremia!
hypokalemia

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19
Q

potential complications in diuretic phase of acute tubular necrosis

A

dehydration!
dysrhythmias

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20
Q

treatment in diuretic phase of acute tubular necrosis

A

hydration to replace loss
electrolytes

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21
Q

which F&E problems have the same characteristics?
(in terms of weight, urine output, etc.)

A

SIADH looms the same as oliguric phase of acute tubular necrosis
DI looks the same as diuretic phase of acute tubular necrosis

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22
Q

what to question when looking at phases of third spacing?

A

where is the fluid?

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23
Q

where is the fluid in phase 1 (loss) of third spacing

A

none in vascular spade, all in interstitial

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24
Q

weight in phase 1 (loss) of third spacing

A

up (in wrong place)

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25
total fluid balance in phase 1 (loss) of third spacing
up
26
urine output in phase 1 (loss) of third spacing
down
27
urine osmolality in phase 1 (loss) of third spacing
up
28
serum BUN in phase 1 (loss) of third spacing
up
29
serum osmolality in phase 1 (loss) of third spacing
up
30
potential electrolyte imbalances in phase 1 (loss) of third spacing
hypernatremia hyperkalemia
31
potential complications in phase 1 (loss) of third spacing
renal hypoperfusion, no fluid
32
treatment in phase 1 (loss) of third spacing
IV fluids **albumin! same as colloids**
33
how does albumin help in phase 1 (loss) of third spacing
pulls from interstitial to vascular
34
weight in phase 2 (reabsorption) of third spacing
down (start urinating)
35
total fluid balance in phase 2 (reabsorption) of third spacing
down
36
urine output in phase 2 (reabsorption) of third spacing
up
36
urine osmolality in phase 2 (reabsorption) of third spacing
down
37
serum BUN in phase 2 (reabsorption) of third spacing
back to normal
38
serum osmolality in phase 2 (reabsorption) of third spacing
low or normal
39
potential electrolyte imbalances in phase 2 (reabsorption) of third spacing
hypokalemia sodium returning to normal or slightly low
40
potential complications in phase 2 (reabsorption) of third spacing
vascular fluid overload! pulmonary status concern
41
treatment in phase 2 (reabsorption) of third spacing
assess for overload (dec. fluids/diuretics if so) look at net balance to determine intake
42
weight in SIADH
up
43
total fluid balance in SIADH
up
44
urine output in SIADH
down
45
urine osmolality in SIADH
up
46
serum osmolality in SIADH
down (only holding water, dilutes sodium)
47
ADH relationship to salt and water
ADH only deals with water NOT SALT
48
SIADH = ?
soaked inside too much ADH
49
potential electrolyte inbalances in SIADH
hyponatremia!!
50
potential complications in SIADH
Sodium = Seizures!!! Stop urinating coma/death
51
treatment in SIADH
fluid restriction sodium replacement (hypertonic saline!) demeclocycline (side effect interferes with ADH) Stop fluids, give Salt
52
what med has a side effect that interferes with ADH to help SIADH
demeclocycline
53
DI = ?
dry inside nothign to do with blood sugar!
54
weight in diabetes insipidus (DI)
down
55
total fluid balance in diabetes insipidus (DI)
down (peeing lots)
56
urine output in diabetes insipidus (DI)
up
57
urine osmolality in diabetes insipidus (DI)
down
58
serum osmolality in diabetes insipidus (DI)
up
59
potential electrolyte imbalances in diabetes insipidus (DI)
hypernatremia
60
potential complications in diabetes insipidus (DI)
seizures, coma, death (sodium)
61
treatment in diabetes insipidus (DI)
hypotonic fluids vasopressin (same as ADH) hydrochlorothiazide (only is caused by kidneys)
62
what is a "quick fix" to maintain stability
CRRT
63
heparin use in CRRT and probs
can be used in the circuit to prevent clots, can cause HIT -> watch platelets
64
functions of the kidneys
1) eleimination of metabolic waste 2) BP regulation 3) erythrocyte production 4) vitamin D activation 5) acid/base balance
65
what is GFR dependen on?
blood flow
66
normal GFR?
125
67
GFR levels of dec. kidney fxn and kidney failure
< 100 = dec. fxn < 15 = failure
68
which fluid compartment is accessed IV
extracellular fluid
69
describe isotonic, hypertonic, and hypotonic fluids in relation to plasma
isotonic = same concentration as plasma hypertonic = > plasma concentration hypotonic = < plasma concentration
70
isotonic crystalloids
0.9% NaCl LR
71
hypertonic crystalloids
3% NaCl (monitor close) D5 NaCl (D5 normal) D5 in LR (D5LR) D5 0.45% NaCl (D5 half normal)
72
hypotonic crystalloids
0.25% NaCl 0.45% NaCl
73
examples of colloids
25% albumin hetastarch blood prodicts
74
what do colloids do to fluid
pull fluid into intravascualr space
75
Condition defined by: decline in GFR retention of products normally excreted electrolyte imbalance acid/base abnormality fluid volume disruption
AKI
76
normal BUN
10-20
77
which AKI is any renal hypoperfusion from dec. cardiac output, hemorrhage, vasodilation, thrombosis, etc.
pre-renal AKI
78
which AKI is any condition that produces ischemic or toxic insult directly at site of nephron
intra-renal AKI
79
which AKI is any obstruction that hinders flow of urine after the kidney
post-renal AKI
80
potential causes of post-renal AKI
kidney stones, catheter blockage, tumor
81
which kind of acute tubular necrosis (ATN) results from prolonged hypoperfusion?
ischemic ATN
82
which ATN results when concentration of nephrotoxin causes necrosis of tubular cells
nephrotoxic ATN
83
potential causes of nephrotoxic ATN
vancomycin aminoglycosides zosyn contrast dye
84
what is important to prevent nephrooxic ATN?
monior peaks and troughs of risk meds
85
which phase of ATN is period from initial insult until cell injury occurs, ischemia injury is evolving
onset phase
86
which ATN phase results from necrotic cellular debris blocking formation of urine and removal of wastes
oliguric/anuric phase
87
which phase of ATN is characterized by increase in GFR
diuretic phase
88
main goal of AKI treatment
restore and maintain electrolye imbalance
89
contraindications for hemodialysis
hemodynamic instability inability to coagulate lack of access
90
what is used if dialysis is contraindicated?
CRRT
91
why is CRRT better if hemodialysis is contraindicated?
filters smaller amount of blood over longer times
92
what is the end result of the loss phase of third spacing?
fluid moves into interstitial space
93
which DI is when posterior pituitary fails to release ADH?
central DI
94
which DI is inability of kidney to respond to ADH
nephrogenic

critical care (23 decks)

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