Fluids & Electrolytes

Question 0

What determines osmotic pressures?

Answer 0

Proteins

Question 1

Amount of total body weight composed of water

Answer 1

2/3
More in men
Infants have more

Question 2

.9% NaCl composed of…

Answer 2

Na 154

Cl 154

Question 3

LR composed of….

Answer 3

Na 130
K 4
Cl 109
Ca 2.7
Bicarbonate 28

Question 4

Volume replacement…

Answer 4

4cc/kg/hr for first 10kg
2cc/kg/hr for 2nd 10kg
1cc/kg/hr for each kg after

Best indicator: urine output

Question 5

Hyperkalemia treatment

Answer 5

Calcium gluconate… Cardiac membrane stabilizer
10U insulin
1Amp 50% dextrose
Sodium bicarbonate(K enters cell in exchange forH)
Kayexalate
Dialysis

Question 6

To correct hypokalemia this also needs to be replaced

Answer 6

Mg

Question 7

EKG changes in Hyperkalemia

Answer 7

Peaked T waves

Question 8

Hypernatremia symptoms

Answer 8

Restless, irritable, ataxia, seizures

Correct with D5 water SLOW- avoid brain swelling

Question 9

Hyponatremia symptoms

Answer 9

Headache, N/V, seizures

Correct no more than 1mEq/hr— avoid central pontine myelinosis

Question 10

Side effect with too fast correction of Hyponatremia

Answer 10

Central pontine myelinosis

Do not correct more than 1mEq/ hour

Question 11

Pseudohyponatremia cause….

Answer 11

Due to hyperglycemia

For each 100 glucose over normal add 2 to Na value

Question 12

Hypercalcemia- most common malignant cause

Answer 12

Breast cancer

No LR
No thiazide diuretics

Tx: NS @200-300/hr, LASIK
Mal dz: mithramycin, calcitonin, dialysis

Question 13

Signs of hypocalcemia

Answer 13

Hyperreflexive
Chvosteks sign
Perioral numbness and tingling
Trousseau sign
Prolonged QT interval

Question 14

Protein adjustment for calcium

Answer 14

For every 1g decrease in protein add 0.8 to Ca

Question 15

Anion gap calculation

Answer 15

Na- (HCO3 + Cl)

Normal < 10-15