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Q3 Clin LAB Test 1 (UA, Na, K, CMP) > Na+ Disorders (lec 2) > Flashcards

Na+ Disorders (lec 2) Flashcards

1
Q

ECF Cationº?

Anionº?

A

Na+

Cl-

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2
Q

ICF Cationº?

Anionº?

A

K+

PO4-

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3
Q

TBW composition?

A

2/3 ICF

1/3 ECF: 3/4 ISF, 1/4 plasma

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4
Q

Osmolality is?

A

[solute] of a fluid

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5
Q

What osmotically active substances are used to calculate osmolality?

A

Na+
Glu
BUN (blood urea nitrogen)

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6
Q

Isotonic (proportional H2O/solute) Δ in ECF Fluid results in?

A

size of ECF compartment Δs but no fluid moves b/w ECF/ICF

*Δ confined to ECF

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7
Q

Isotonic ↓ in ECF results in?

e.g. dehydration

A

↓ size of ECF compartment

no fluid movement

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8
Q

Isotonic ↑ in ECF results in?

e.g. IV

A

↑ size of ECF compartment

no fluid movement

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9
Q

Hyponatrimic Δ (Na+ deficit) in ECF results in?

A

movement of fluid from ECF into ICF compartment,
cell swells
*Δ effects ICF

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10
Q

Hypernatremic Δ (Na+ excess) in ECF results in?

A

movmt of fluid from ICF into ECF compartment,
cell shrinks
*Δ effects ICF

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11
Q

Possible Volume status of pt? (3)

A

Euvolemic (normal)
Hypervolemic (overload)
Hypovolemic (dehydration)

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12
Q

Hypovolemia presentation?

A 
↑ thirst
↓ sweat
↓ urine output, ↑ concentration
Dry skin
CNS depression
Weak, mm cramps
Ortho hypoTN
Ortho ↑ pulse
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13
Q

Anasarca is?

A

total body edema

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14
Q

Hypervolemia presentation?

A 
Edema
SOB
Orthopnea/nocturnal
HTN
Tachycardia
JVD
Crackles
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15
Q

Hypovol caused by?

A

fluid loss
fluid sequestration
GI bleed

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16
Q

Hypervol caused by?

A

renal Na+ retention

heart, liver, renal dx

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17
Q

Intravascular Volume is?

A

fluid volume in bv

effective circulating vol

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18
Q

Intravascular Vol important why?

A

homeostasis mechanisms respond to intravasc vol, not total extracellular vol
\\\ dx w/ low intravas vol but high extracell vol keep stim salt/H2O retention
(HF, liver F)

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19
Q

Body responds to hypovol how?

A

Thirst

ADH (anti-di hormone)

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20
Q

Body responds to a change in osmolarity that causes hypovolemia how?

A

CNS stim:
ADH release -> H2O retention
Angio II stim -> thirst

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21
Q

Body responds to↓ circulating H2O vol how?

A

Baro stim:
ADH release -> H2O retention
Angio II stim -> thirst

22
Q

Body responds to Need for Salt Retention how?

A

Renin-Angio system

23
Q

Renin-Angio System

increases circulating blood vol how? (slide 28)

A 
↓ in circulating blood vol ->
↓ renal perfusion ->
stims juxtaglomerular cells ->
renin released ->
angiotensinogen to angio I (vasoconstrictor) ->
convert to angio II ->
aldosterone released ->
↑ Na+ retention ->
↑ circ blood vol
24
Q

Release of Aldosterone affects Na+ how?

K+ how?

A

↑ Na+ retention

↑ K+ excretion

25
Almost all Na+ located where in body?
ECF
26
Hypernatremia results from what level of Na+?
> 145
27
HyperNa+ caused by? (3)
low diet H2O high diet salt large H2O loss (Too little H2O relative to Na+)
28
HyperNa+ signs/sxs due to?
brain shrinkage
29
HyperNa+ signs/sxs ?
``` thrist (1st sign) altered mental state weakness neuromm irritability focal neuro defects seizure, coma ```
30
Methods of water loss that result in hyperNa+?
GI: Diarrhea Skin: Excess sweating, burn Renal: hyperglycemia in DM (obligate ↑ urine output to manage ↑ glucose) Drugs: diuretics, lithium
31
Hypovolemia need for ↑ blood volume affects osmotic needs how?
Need for ↑ blood volume overrides osmotic needs of body
32
Normal response to hyperNa+?
Thrist | concentrate urine to ↓ more H2O loss
33
Homeostatic Order of importance in body?
Volume, pH, electrolytes
34
Diabetes Insipidus is? Caused by?
collecting ducts impermeable to H2O Central: impaired ADH secretion Nephrogenic: kidney doesn't respond to ADH
35
D Insipidus results in?
dilute urine even though serum Na+ is high | should be concentrated
36
Nephrogenic D Insipidus etiology? Tx?
genetic or acquired (result of dxs) Thiazide diuretics Amiloride (K+ sparing diuretic)
37
HyperNa+ tx?
hospitalize severe stop H2O loss replace H2O* *slowly if been several days or will cause rapid swelling of brain
38
HypoNa+ results from what level of Na+?
< 135 | Danger zone < 125
39
HypoNa+ sxs?
weak, lethargic N/V mm cramps, seizure, coma
40
HypoNa+ is most common what?
electrolyte abnormality in hospitalized pts
41
Pseudohyponatremia is?
Hyper- glu, protein, lipids cause water movement from ICF into ECF ECS Solutes are diluted so Na+ registers as low but total body Na+ is actually not low (HypoNa+ from hyperosmolar state)
42
HypoNa+/Hypervol caused by?
fluid overload from: CHF renal dx cirrhosis
43
HypoNa+/Hypervol signs?
edema JVD (P) dilutional anemia
44
HypoNa+/Euvol caused by?
Hyperthyroidism SIADH Diuretics Adrenal insufficiency
45
SIADH (synd of inappr ADH secretion) due to?
impaired renal free water excretion (due to high ADH release) *most common cause of HypoNa+/Euvol
46
SIADH caused by?
neuropsych dx malignancy pulmonary dx drugs (TCA, carbamazepine, anti-neoplastic, narcotics)
47
SIADH characteristics? (3)
low serum osmolarity, high concentrated urine, high ADH (vasopressin) levels, normal renal, adrenal, thyroid fxn
48
HypoNa+/Hypovol caused by?
Renal: diuretics, osmotic diuresis, addisons Nonrenal: V, diarr, pancreatitis, peritonitis
49
HypoNa+/Hypovol characteristics?
dehydration: dry mmemb, poor turgor ortho BP/pulse Δs
50
HypoNa+ tx?
Hospitalize Tx cause vasopressin (ADH) anatgonists Hyper- or euvolemic: restrict fluids Hypovol: replace fluids w/ isotonic saline
51
Chronic HypoNa+ tx?
Demeclocycline to induce Nephrogenic DM Insipidus

Q3 Clin LAB Test 1 (UA, Na, K, CMP) (4 decks)

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