Na disorders

Question 1

what does Na content predict

Answer 1

ECF volume status

Question 2

what does Na conc. predict

Answer 2

ICF volume concentration

-NOT ECF volume status

Question 3

what are 2 main systems, and what regulates them

Answer 3

1. Na balance regulation - RAAS

2. water balance regulation - ADH

Question 4

what is input and 2 sources of Na output

Answer 4

input
- diet
output
1. extrarenal - small and constant
2. renal - controlled by RAAS

Question 5

2 main ways to activate RAAS

Answer 5

1. low BP
   - causes SNS activation
   - RAAS activation
2. low GFR>low Na to macula densa> RAAS activation

Question 6

3 Na “states”

Answer 6

normal - input=output
increased- input>output
decr. - input

Question 7

what are 2 water output sources

Answer 7

1. extrarenal - small and relatively constant

2. renal - regulated by ADH

Question 8

3 things that cause ADH release

Answer 8

1. hypernatremia
2. profound ECF vol. depletion
3. non-osmotic stim.
   - drugs
   - intracranial path
   - N/V
   - pain

Question 9

4 generalized causes of edema

Answer 9

1. CHF
2. liver cirrhosis
3. kidney disease
4. severe hypoalbuminemia

Question 10

2 loacal causes of edema

Answer 10

1. venous or lymph obst.

2. inflamation, allergy, trauma

Question 11

3 ways to treat ECF expansion

Answer 11

lower Na

1. decrease intake
2. promote excretion - diuretics
3. remove RAAS stim

Question 12

findings of ECF depletion

Answer 12

• tachycard.
• hypotension
• wiehgt loss
• low JVP
• poor skin tugor

Question 13

how does diarrhea cause ECF depletion

Answer 13

• poor intake of Na and water

- diarrhea loss of Na and water

Question 14

what is main Tx for diarrhea

Answer 14

oral rehydration fluids

Question 15

what is cause of hyponatremia

Answer 15

ALWAYS relative water retention

Question 16

3 mech. for water retention

Answer 16

1. ADH
2. no GFR - no kideny function
3. no osmoles to excrete in urine

Question 17

what is presentation of hyponatremia

Answer 17

1. if rapid, cell swelling can occur
   - cerebral edema is biggest issue
2. if slow, brain can adapt

Question 18

4 Tx of hyponatremia

Answer 18

1. restrict fluid/water intake
2. remove underlying cause
3. if acute > rapid partial correction to prevent edema
4. if chronic, treat slowly to prevent edema

Question 19

2 main causes of hypernatremia

Answer 19

1. failure to drink fluid - uncommon
   - infacncy
   - dementia
2. excess losses
   - hyperglycemia
   - diabetes insipidus

Question 20

presnetataiotn and Tx of hypernat.

Answer 20

brain cell shrinkage
- confusion, LOC
give water