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Fluids And Electrolytes Flashcards

1
Q

What two compartments does water account for?

A
  1. Intracellular
  2. Extracellular
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2
Q

What is fluid status maintained by?

A

Vasopressin

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3
Q

What are the 3 most common causes of hypervolemia?

A
  1. HF
  2. Cirrhosis
  3. Hypoalbuminemia
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4
Q

What are 4 symptoms of hypervolemia?

A
  1. Pitting edema
  2. Muscle weakness
  3. Pulmonary edema
  4. Distended neck veins
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5
Q

What are 2 vital signs that are indicative of hypervolemia?

A
  1. Increased BP
  2. Full peripheral pulses
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6
Q

What are 2 laboratory values used in hypervolemia?

A
  1. Low BUN
  2. Low Hct
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7
Q

How would you clear the fluid for hypervolemia?

A

Loop Diuretics

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8
Q

How much fluid should you restrict for hypervolemia?

A

1-2 L

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9
Q

The most common cause of hypovolemia is renal losses due to _______ or _________.

A

Hyperglycemia; high urea

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10
Q

What are symptoms of hypovolemia? 5

A
  1. Fatigue
  2. Thirst
  3. Orthostasis
  4. Chest pain —> if severe
  5. Confusion —> if severe
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11
Q

A patient presents with symptoms of diminished skin turgor, dry oral mucosa, orthostatic tachycardia or orthostatic hypotension, what do they have?

A

Hypovolemia

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12
Q

An increase in HR of 15-20 bpm when standing

A

Orthostatic tachycardia

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13
Q

> 10-20 mmHg drop in bp when standing

A

Orthostatic hypotension

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14
Q

Laboratory values used for hypovolemia diagnostics?

A
  1. Increased BUN
  2. Increases SCr
  3. Bicarbonate
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15
Q

How would bicarbonate be lost with hypovolemia?

A

Diarrhea

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16
Q

What can you give IV for hypovolemia? 3

A
  1. Normal saline
  2. Colloids
  3. Hypotonic solution
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17
Q

For hypovolemia, what’s the maintenance of fluids?

A

25-30 ml/kg/day

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18
Q

When would you give less fluid in hypovolemia?

A
  1. HF
  2. elderly and frail
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19
Q

What is hypernatremia associated with?

A

High Mortality

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20
Q

What is the most common type of electrolyte abnormality?

A

Hyponatremia

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21
Q

What is the level for hyponatremia?

A

Na <135 mEq/L

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22
Q

What are mild symptoms of hypernatremia? 4

A
  1. Lethargy
  2. Weakness
  3. Restlessness
  4. Twitching
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23
Q

Severe symptoms of hypernatremia include?

A
  1. Seizures, coma, and death
24
Q

What is the level for hypernatremia?

25
Q

In hypovolemic hypernatremia, water loss __ sodium loss

A

> (Greater)

26
Q

In Euvolemic Hypernatremia, what is lost?

A

Water only

27
Q

For hypervolemic hypernatremia, water gain ___ sodium gain

A

&laquo_space;( Less)

28
Q

Drug induced hypo_________ is very common

29
Q

What drugs can induce hyponatremia? 4

A
  1. Thiazide Diuretics
  2. Psychiatric medications
  3. Carbamazepine
  4. Oxcarbamazepine
30
Q

What is the most common type of electrolyte abnormality?

A

Hypervolemia hyponatremia

31
Q

What 3 ways can you treat hyponatremia?

A
  1. treat underlying cause
  2. If drug induced- change therapy
  3. If too much fluid intake, mild fluid restriction
32
Q

What is the level for hyperkalemia?

33
Q

What should you follow with hyperkalemia?

A

Trends, not a single lab

34
Q

What 4 things can cause hyperkalemia?

A
  1. Acute kidney injury
  2. Increased intake
  3. Drug induced
  4. Transient shifts
35
Q

What 6 drug classes can cause hyperkalemia?

A
  1. Trimethoprim
  2. ACEI/ARBs
  3. Aldosterone antagonists
  4. Calcineurin inhibitors
  5. Lithium
  6. Potassium sparing diuretics
36
Q

When is hyperkalemia treated?

A

Chronically, if K is consistently above normal

37
Q

What is the level for hypokalemia?

38
Q

What are symptoms that determine the severity in hyperkalemia when K < 2.5?

A

Palpitations, EKG changes, history of cardiovascular disease

39
Q

What are 3 causes of hypokalemia?

A
  1. Abnormal losses
  2. Lack of absorption (Mg deficiency)
  3. Drug induced
40
Q

What drugs can cause hypokalemia? 3

A
  1. Diuretics
  2. Laxatives
  3. Amphotericin B
41
Q

How would you manage hypokalemia?

A

Replace magnesium first!

42
Q

If hypokalemia is not as severe, how would you treat it?

A

By trying to remove the underlying cause

43
Q

What is the level for hypercalcemia?

44
Q

What is the level for hypocalcemia?

45
Q

What form of calcium is best to give for hypocalcemia?

A

Calcium gluconate

46
Q

What is the most common type of natremia abnormality?

A

Hypervolemic hyponatremia

47
Q

Orthostatic ____ mostly occurs in women.

A

Tachycardia

48
Q

Orthostatic _____ occurs mostly in men.

A

Hypotension

49
Q

If you get a hemolyzed sample for hyperkalemia, what should you do?

A

Recheck another sample

50
Q

What are transient shifts? 2

A
  1. Acidosis
  2. Insulin deficiency
51
Q

When can you consider a bonus of 500 mL with hypovolemia? What should you increase fluids to?

A

If patient is hypotensive; above 30 mL/kg/day

52
Q

You should match the output at ______ for maintenance then what if hypovolemic?

A

Minimum; increase above

53
Q

What is the sodium level for severe hypernatremia?

A

> 180 mEq/L

54
Q

For mild fluid restriction of hyponatremia, how much can you increase by at a time?

A

No more than 12 mEq

55
Q

What is the urine osmolality for hypovolemia?

A

> 450 mOsm/kg

PY3 (24 decks)

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