fluids and electrolytes Flashcards

1
Q

Sodium content determines ?

A

ECF volume status

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2
Q

Sodium concentration determines

A

ICF volume status

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3
Q

when is RAAS activated

A
  • Decreased BP

- Decreased GFR

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4
Q

excretion of water is controlled by

A

ADH

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5
Q

What triggers ADH release

A

Hypernatremia
ECF vol depletion
non-osmotic stimuli

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6
Q

what drugs can trigger ADH release

A

HCTZ, NSAIDs, anti-epileptics, SSRIs

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7
Q

ECF volume expansion means

A

sodium content is increased

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8
Q

RAAS activation results in

A

decreased sodium excretion

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9
Q

in heart failure what happens to sodium

A

more sodium in and less sodium out (less excretion due to RAAS activation)

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10
Q

how is ECF volume expansion treated? as in heart failure?

A
  • increase Na excretion - diuretic
  • decrease intake
  • Block RAAS - improve cardiac function
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11
Q

someone who is very dehydrated should receive what type of solution?

A

ORS - hYPOTONIC solution

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12
Q

when would you need massive amounts of isotonic saline as rehydration therapy?

A
  • cholera with profound hypotension
  • septic shock
  • DKA
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13
Q

Hyponatremia is ALWAYS the result of

A

WATER retention

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14
Q

why would someone retain water

A

ADH is acting
no kidney function - no GFR
- no osmoles to excrete

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15
Q

If hyponatremia presents rapidly, patients can get

A

cerebral swelling - correct rapidly

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16
Q

If hyponatremia is slow onset, patients may be

A

asymptomatic

17
Q

Treating hyponatremia

A
  • reduce water intake
  • remove underlying cause of ADH release
  • rapid correction if acute
  • Treat slowly if chronic and severe
18
Q

common causes of hypernatremia

A
  • failure to drink fluids
  • excess losses - hyperglycemia -
  • or diabetes insipidus - central/nephrogenic
19
Q

Treating hypernatremia

A

give water!

20
Q

treating hyperkalemia 4 principles

A
  • stabilize myocardium
  • shift K into cells
  • excrete potassium
  • hemodialyze