Fluids, electrolytes, Acid-Base disorders Flashcards
Normal urine output in an adult
0.5 to 1 mL/kg/hr
Standard maintenance fluid
D51/2NS with 20 mEq of KCl/L of fluid
When do you not use LR solution
Hyperkalemia b/c it contains potassium
What does a Swan-ganz catheter do
Measure CVP and PCWP
How to measure maintenance fluids amount
100-50-20 rule for 24 hr total, or 4-2-1 rule for per hr
Most common cause of edema
Renal sodium retention
What to do with patients with head trauma and hyponatremia
Keep the sodium higher up so they don’t get cerebral edema
Hypotonic hyponatremia
Hypovolemic: Low urine sodium (20: diuretics, decreased Aldosterone (ACEIs), ATN)
Pseudohyponatremia
More plasma solids decreases Na concentration but the amount is the same. caused by anything that causes elevated protein or lipids.
Glucose and sodium relation in plasma
For ever 100 mg/dL increase in blood glucose above normal, serum sodium decreases 3 Meq/L. sodium content is the same though.
Most common cause of hypercalcemia in O/P
Hyperparathyroidism: 85% parathyroid adenoma 15% hyperplasia»_space;» carcinoma
EKG findings for hyperCa
Short QT, T wave widening, first degree AV block
Bone disease and hyperCa
osteitis fibrosa cystica
PTHrP-SCC secreting cancers
SCC, renal cell cancer, breast, gyn cancers
Calcitriol secreting cancer
Lymphoma
Lithium and Ca effect
HyperCa
Do granulomatous diseases increase Ca
Yes, they increased 1,25 OH vit D (TB< sarcoid, histo, coccidio, lymphoma)
Familial Hypocalciuric Hypercalcemia (FHH)
AD inheritance, benign, hypocalciuria, mild-mod increase in Mg
What thyroid disorder causes hypercalcemia
Thyrotoxicosis
Other causes of HyperCa
Malignancies, medications, immobilization (increased bone resorption), Pagets disease
Osteolytic cancers
Breast, lung, renal