Fluids Therapeutics

Question 1

normal Na+ concentrations

Answer 1

135-145 mEq/L

Question 2

normal K+ concentrations

Answer 2

3.5-5 mEq/L

Question 3

normal Mg+2 concentrations

Answer 3

1.5-2.5 mg/dL

Question 4

normal Ca+2 concentrations

Answer 4

8.5-10.5 mg/dL

Question 4

normal PO4 concentrations

Answer 4

2.5-4.5 mg/dL

Question 4

most common MIVF

Answer 4

D5W + 1/2 NS + 20 mEq KCl/L

Question 4

Treatment for Hyperkalemia

Answer 4

C A BIG K DROP
1. Antagonize the membrane actions (Calcium)
2. decrease extracellular K+ Concetrations (Albuterol,Bicarb, Insulin + Glucose)
3. Remove K+ from the body (Kayexalate/Lokelma, Diuretics, Renal Unit for dialysis of Patient)

Question 5

acute symptomatic hyponatremia treatment

Answer 5

increase serum Na by 1-2 mEq/L/hr
MAX increase of 8-12 mEq/L in 24 hours
follow rule of 8’s

Question 6

Phoshate Replacement conversions

Answer 6

1 mMol NaPhos = 1.33 mEq Na + 1.33 mEq Phos
1 mMol KPhos = 1.47 mEq K + 1.47 mEq Phos
-infuse IV doses no faster than 7 mMol/hr

Question 7

acute hypocalcemia treatment

Answer 7

1 gram Ca Chloride = 3 grams Ca Gluconate = 270 mg elemental Ca
CaCl IV Push during code
Ca Gluconate for regular IV

Question 8

calcium correction calculation

Answer 8

Measured Ca+2 + [(4-measured albumin) x 0.8]
Ionized Ca+2 =4.6-5.1 mg/dL

Question 9

hypomagnesemia treatment symptomatic

Answer 9

Mg+2 1-2 mg/dL : 0.5 mEq/kg
Mg+2 < 1 mg/dL : 1 mEq/kg
8 mEq = 1 gram; 1 gram per hour

Question 10

intravenous K+ administration infusion rate

Answer 10

infusion rate without cardiac monitoring: 10 mEq/hr
Infusion rate with cardiac monitoring: 20 mEq/hr
40-60 mEq/hr if emergent (cardiac arrest)
NEVER IV PUSH

Question 11

Isotonic solution value

Answer 11

275 to 290 mOsm/L

Question 12

Hypovolemic Hypotonic Hyponatremia treatment

Answer 12

symptomatic: 3% NaCl
asymptomatic: 0.9% NaCl

Question 13

Isovolemic Hypotonic Hyponatremia treatment

Answer 13

symptomatic: 3% NaCl and furosemide
asmyptomatic: 0.9% NaCl and water restriction

Question 14

Hypervolemic Hypotonic Hyponatremia treatment

Answer 14

symptomatic: furosemide and judicious 3% NaCl (rarely need sodium)
asymptomatic: furosemide