Fluids/Lytes

Question 1

What is sodium exchanged for in the distal tubules?

Answer 1

Potassium

Question 2

What causes release of ADH?

Answer 2

Posterior pituitary in hypovolemic state

Question 3

Which is used to resuscitate: crystalloids or colloids?

Answer 3

Crystalloids (salt and sugar)

Question 4

Name examples of colloids

Answer 4

Blood, albumin, dextran

Question 5

What organ makes albumin?

Answer 5

Liver

Question 6

What pH is considered acidosis?

Answer 6

Less than 7.2

Question 7

List for things that can occur in acidosis?

Answer 7

Decreased response to catecholamines, cardiac dysfunction, arrhythmias, increased potassium serum level

Question 8

Why do hepatitis C patients have ascites?

Answer 8

The liver makes albumin, so lack of liver function causes reduced oncotic pressure leading to seepage of fluid out of vessels

Question 9

What causes release of aldosterone?

Answer 9

Hypovolemia

Question 10

Describe what can happen as a result of hyponatremia

Answer 10

Seizure, coma, encephalopathy, cramping, twitches, fasciculations

Question 11

Describe what can happen as a result of hyperkalemia

Answer 11

Peaked T waves and prolonged PR, cramping, aches, asystole (lethal injection)

Question 12

Which two drugs lower serum potassium?

Answer 12

Bicarb and insulin

Question 13

List causes of hyperkalemia

Answer 13

Renal dysfunction, hypoaldosteronism, drugs, excessive intake, cell death (rhabdo, tumor lysis, burns, hemolysis)

Question 14

List 4 treatments for hyperkalemia in order of descending strength

Answer 14

CACl2 10%, sodium bicarbonate, D50 and insulin, sodium polystyrene sulfonate (Kayexalate)

Question 15

What is the fastest IV potassium should be run and why?

Answer 15

10 mEq per hour (any faster can cause asystole)

Question 16

What is unique about the treatment of CaCl2 10% for hyperkalemic emergencies?

Answer 16

It antagonizes potassium at the myocardium to protect the heart, but won’t affect serum potassium