Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Spring 15 - GU, Nephro > Hyper/Hyponatremia > Flashcards

Hyper/Hyponatremia Flashcards

1
Q

What causes hypovolemic hypernatremia?

A
  • most common
  • renal losses (osmotic diuresis)
  • insensible losses (sweat, fever, respiration)
  • GI losses (diarrhea)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes euvolemic hypernatremia?

A
  • renal losses (diabetes insipidus)

- variable hypothalamic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes hypervolemic hypernatremia?

A
  • hypertonic saline administration
  • sodium bicarb administration
  • primary hyperaldosteronism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who will almost never present with hypernatremia?

A

alert patient with normal thirst mechanism and access to water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who is at greater risk for hypernatremia?

A

-more common > 60 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 2 defense mechanisms the body has against hypernatremia?

A
  • stimulation of ADH release (causes maximal urine concentration)
  • thirst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Central Diabetes Insipidus

A
  • loosing water freely

- occurs when secretion of ADH is impaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Common Causes of Central DI

A
  • head trauma
  • hypoxic or ischemia encephalopathy
  • idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nephrogenic Diabetes Insipidus

A

-impaired ability to respond to ADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tx of Central DI

A

vasopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx of Nephrogenic DI

A

water PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical Manifestations of Hypernatremia

A
  • neurologic
  • lethargy, weakness, irritability
  • hyperreflexia
  • seizures, coma, death
  • DI pts will c/o polydipsia, polyuria, nocturia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diagnosis of Hypernatremia

A
  • H&P
  • recent fluid losses, altered mental status, thirst
  • assess pt’s volume status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the serum osmolality level in hypernatremia?

A

always > 290 mOsm/kg in hypernatremia

pts with <200 have some form of DI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tx of Hypernatremia

A
  • rapid correction must be avoided b/c of brain’s adaptive response and risk of cerebral edema
  • lower serum sodium concentration by 0.5 mEq/L per hour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx of Hypovolemia Hypernatremia

A
  • normal saline solution initially to correct volume deficit

- then more hypotonic fluids

17
Q

Tx of Hypervolemic Hypernatremia

A
  • remove source of salt excess
  • administer diuretics
  • replace water
18
Q

Tx of Euvolemic Hypernatremia

A

-water replacement alone (water PO or D5W IV)

19
Q

Clinical Manifestations of Hyponatremia

A
  • anorexia, nausea, lethargy
  • more advanced: disoriented, agitated, seizures, depressed reflexes, focal neuro deficits
  • coma and sz with serum sodium concentration <120 mEq/L
20
Q

Physical Exam in Hyponatremia

A
  • orthostatic vital signs
  • check skin turgor, mucous membranes
  • JVD, edema
  • wedge pressure
21
Q

Dx of Hyponatremia

A
  • history
  • meds, esp thiazide diuretics
  • recent V/D or sweating with hypotonic fluid ingestion
  • recent surgery
  • psych illness (psych polydipsia)
  • CHF, cirrhosis, nephrotic syndrome w/ renal failure
22
Q

What causes hypovolemic hyponatremia?

A
  • renal loss: diuretic use, salt wasting nephropathy, hypoaldosteronism
  • GI loss: V/D, tube drainage
  • skin loss: sweating, burns, CF
  • peritonitis
23
Q

What causes hypervolemic hyponatremia?

A
  • CHF
  • cirrhosis
  • nephrotic syndrome
  • acute and chronic renal failure
24
Q

What causes euvolemic hyponatremia?

A
  • ADH excess
  • thiazide diuretics
  • pain
  • post-op state
  • cortisol deficiency
  • hypothyroidism
  • decreased solute intake
25
Q

What can happen with hyponatremia Tx failure?

A
  • can cause central pontine myelinolysis (demyelination of pons)
  • aka osmotic demyelination syndrome
  • encephalopathy, AMS, seizures, weakness, dysarthria, HTN
  • mutism, dysphagia, quadriparesis, delirium, coma, death
26
Q

Tx of Hyponatremia

A
  • eliminate the cause
  • restrict water
  • normal saline, restrict water
27
Q

What will a mental health patient with psychogenic polydipsia have?

A

hyponatremia

28
Q

Which patients may be unable to give a history?

A

hypernatremia

29
Q

Hyperkalemia has peaked T waves. Are there any EKG changes with hyper or hyponatremia?

A

no!

Spring 15 - GU, Nephro (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions