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MI Clinical Diagnosis > Na and K > Flashcards

Na and K Flashcards

1
Q

most of NA is intracellular or extracellular

A

Extracellular

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2
Q

NA is regulated by what 3 hormones

what does each do to NA

A

aldosterone - conserves or reabsorbs NA

natriuretic peptide - excretes NA

ADH - balances water

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3
Q

what lab value is considered hypernatremia

A

above 140 mEq/L

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4
Q

what is hypernatremia caused by

A

rarely NOT caused by excess sodium intake - drinking seawater or salty liquids like soy sauce

but RATHER caused by decrease in free water in the body aka DEHYDRATION

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5
Q

if the amount of water ingested consistently is below the amount of water lost, the serum sodium levels will __

A

increase leading hypernatremia

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6
Q

even a small rise in serum sodium concentration above normal ranges results in what

A

strong sensation of thirst,
increase in free water intake,
results in correction of abnormality

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7
Q

hypernatremia most often occurs in what people

A

infants
impaired mental status individuals
elderly

(inability to get water when needed)

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8
Q

what are the symptoms of hypernatremia

A 
thirst
dry mucous membranes 
agitation 
restlessness 
weakness 
irritability 
neuromuscular excitability 
edema
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9
Q

hypernatremia is seen in increased intake or decreased loss due to what diseases or conditions

A 
steroids
laxatives 
cough medicine 
cushings syndrome 
hyperaldosteronism 
excessive sweating 
diarrhea 
dehydration
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10
Q

what is the lab value that is considered hyponatremia

A

below 125 mEq/L

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11
Q

hyponatremia is due to what

A

excess body water or intake (OVERHYDRATION) which dilutes the serum sodium

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12
Q

hyponatremia is often a complication of medial illness such as __

A

congestive heart failure

syndrome of inappropriate antidiuretic
hormone (SIADH)

polydipsia

exercise associated hyponatremia

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13
Q

exercise associated hyponatremia is seen in what people

A

marathon runners

endurance events

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14
Q

hyponatremia below 125 has what symptoms

hyponatermia below 115 has what symptoms

A

below 125 - weakness

below 115 - confusion and lethargy

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15
Q

hyponatremia is seen in decreased intake or increased loss of Na which is seen in what conditions

A 
diuretics 
carbamazepine 
ACEI 
NSAIDs 
vomiting/diarrhea 
chronic renal insufficiency 
addisons disease 
excessive water intake 
hyperglycemia 
CHF 
peripheral edema 
SIADH
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16
Q

most of K is intracellular or extracellular

A

intracellular

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17
Q

Na+ and K+ are both considered what

A

cations

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18
Q

what are the normal K serum levels

A

4 mEq/L

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19
Q

what ion is important in maintaining membrane potentials in neuromuscular tissue

A

K

20
Q

which ion is said to have minor changes that cause major effects

A

K

21
Q

what affect does aldosterone have on K

A

decreases levels of K by causing excretion

22
Q

extreme hyperkalemia is a medical emergency due to the risk of what

A

fatal abnormal arrhythmias

23
Q

what are the symptoms of hyperkalemia

A 
nausea/vomiting 
diarrhea 
malaise 
palpitations 
muscle weakness
24
Q

during the medical history intake for a patient with hyperkalemia, what should one focus on

A

kidney disease and medication use

25
Q

hyperkalemia can be due to what

A 
increased dietary intake 
addisons 
hypoaldosteronism 
aldosterone inhibiting diuretics - spironolactone 
crush syndromes 
hemolysis 
infection
26
Q

what is hypokalemia

A

condition in which the concentration of K in the blood is low

27
Q

mild hypokalemia often presents as what

A

without symptoms or small elevation of blood pressure

rarely arrhythmias

28
Q

moderate hypokalemia often presents as what

A

muscular weakness
myalgia
muscle cramps
constipation

disturbs skeletal and smooth muscle

29
Q

moderate hypokalemia is indicated by what lab level

A

2.5-3 mEq/L

30
Q

what are the symptoms of hypokalemia

A

weakness
paralysis
hyporeflexia
ileus

31
Q

what causes hypokalemia

A

hyperaldosteronism
dietary deficiency
licorice
cushings

32
Q

Cl is the major intracellular/extracellular anion/cation

A

extracellular anion

33
Q

Cl follows __ to support electrical neutrality

what follows Cl

A

Cl follows Na

water follows Cl
affects water balance

34
Q

what is primarily associated with acid base balance

what also aids in acid base balance

how

A

CO2

Cl

if CO2 and H elevate, then biocarbonate moves out of cells and Cl moves into cells

35
Q

hypo or hyperchloremia does not occur alone, but only with shifts of __ and __

A

Na and bicarbonate

36
Q

what do you measure to evaluate CO2

A

h2c03
dissolved CO2
bicarbonate

37
Q

what is the difference between cations and anions in the extracellular space

A

anion gap

38
Q

how is anion gap calculated

A

(sodium + potassium) - (chloride + bicarbonate)

or

sodium - (chloride - bicarbonate)

39
Q

what is anion gap used for

increased indicates what
decreased indicates what

A

used to determine metabolic acidosis

increases with acidosis, diarrhea, and kidney disease

decreases from alkalosis, vomiting, and hyperaldosteronism

40
Q

what does osmolality measure

A

measures the dissolved particles in blood

41
Q

as free water in the blood increases, particles __, and osmolality __

A

decrease

decrease

42
Q

as free water in the blood decreases, particles ___, and osmolality __

A

increase

increase

43
Q

low osmolality causes what

A

decrease secretion of ADH, which increases urine output, which raises osmolality

44
Q

high osmolality causes what

A

increase secretion of ADH, which decreases urine output, which decreases osmolality

45
Q

what are the most important solutes in blood

A

Na, glucose, BUN

46
Q

how do you calculate osmolality

A

2Na + glucose/18 + BUN/2.8

MI Clinical Diagnosis (12 decks)

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