Na and K

Question 1

most of NA is intracellular or extracellular

Answer 1

Extracellular

Question 2

NA is regulated by what 3 hormones

what does each do to NA

Answer 2

aldosterone - conserves or reabsorbs NA

natriuretic peptide - excretes NA

ADH - balances water

Question 3

what lab value is considered hypernatremia

Answer 3

above 140 mEq/L

Question 4

what is hypernatremia caused by

Answer 4

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

Question 5

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

Answer 5

increase leading hypernatremia

Question 6

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

Answer 6

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

Question 7

hypernatremia most often occurs in what people

Answer 7

infants
impaired mental status individuals
elderly

(inability to get water when needed)

Question 8

what are the symptoms of hypernatremia

Answer 8

thirst
dry mucous membranes 
agitation 
restlessness 
weakness 
irritability 
neuromuscular excitability 
edema

Question 9

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

Answer 9

steroids
laxatives 
cough medicine 
cushings syndrome 
hyperaldosteronism 
excessive sweating 
diarrhea 
dehydration

Question 10

what is the lab value that is considered hyponatremia

Answer 10

below 125 mEq/L

Question 11

hyponatremia is due to what

Answer 11

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

Question 12

hyponatremia is often a complication of medial illness such as __

Answer 12

congestive heart failure

syndrome of inappropriate antidiuretic
hormone (SIADH)

polydipsia

exercise associated hyponatremia

Question 13

exercise associated hyponatremia is seen in what people

Answer 13

marathon runners

endurance events

Question 14

hyponatremia below 125 has what symptoms

hyponatermia below 115 has what symptoms

Answer 14

below 125 - weakness

below 115 - confusion and lethargy

Question 15

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

Answer 15

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

Question 16

most of K is intracellular or extracellular

Answer 16

intracellular

Question 17

Na+ and K+ are both considered what

Answer 17

cations

Question 18

what are the normal K serum levels

Answer 18

4 mEq/L

Question 19

what ion is important in maintaining membrane potentials in neuromuscular tissue

Answer 19

K

Question 20

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

Answer 20

K

Question 21

what affect does aldosterone have on K

Answer 21

decreases levels of K by causing excretion

Question 22

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

Answer 22

fatal abnormal arrhythmias

Question 23

what are the symptoms of hyperkalemia

Answer 23

nausea/vomiting 
diarrhea 
malaise 
palpitations 
muscle weakness

Question 24

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

Answer 24

kidney disease and medication use

Question 25

hyperkalemia can be due to what

Answer 25

``` increased dietary intake addisons hypoaldosteronism aldosterone inhibiting diuretics - spironolactone crush syndromes hemolysis infection ```

Question 26

what is hypokalemia

Answer 26

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

Question 27

mild hypokalemia often presents as what

Answer 27

without symptoms or small elevation of blood pressure rarely arrhythmias

Question 28

moderate hypokalemia often presents as what

Answer 28

muscular weakness myalgia muscle cramps constipation disturbs skeletal and smooth muscle

Question 29

moderate hypokalemia is indicated by what lab level

Answer 29

2.5-3 mEq/L

Question 30

what are the symptoms of hypokalemia

Answer 30

weakness paralysis hyporeflexia ileus

Question 31

what causes hypokalemia

Answer 31

hyperaldosteronism dietary deficiency licorice cushings

Question 32

Cl is the major intracellular/extracellular anion/cation

Answer 32

extracellular anion

Question 33

Cl follows __ to support electrical neutrality what follows Cl

Answer 33

Cl follows Na | water follows Cl affects water balance

Question 34

what is primarily associated with acid base balance what also aids in acid base balance how

Answer 34

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

Question 35

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

Answer 35

Na and bicarbonate

Question 36

what do you measure to evaluate CO2

Answer 36

h2c03 dissolved CO2 bicarbonate

Question 37

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

Answer 37

anion gap

Question 38

how is anion gap calculated

Answer 38

(sodium + potassium) - (chloride + bicarbonate) or sodium - (chloride - bicarbonate)

Question 39

what is anion gap used for increased indicates what decreased indicates what

Answer 39

used to determine metabolic acidosis increases with acidosis, diarrhea, and kidney disease decreases from alkalosis, vomiting, and hyperaldosteronism

Question 40

what does osmolality measure

Answer 40

measures the dissolved particles in blood

Question 41

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

Answer 41

decrease decrease

Question 42

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

Answer 42

increase increase

Question 43

low osmolality causes what

Answer 43

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

Question 44

high osmolality causes what

Answer 44

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

Question 45

what are the most important solutes in blood

Answer 45

Na, glucose, BUN

Question 46

how do you calculate osmolality

Answer 46

2Na + glucose/18 + BUN/2.8