Prodigy- fluids, lytes, acid-base Flashcards
What is the primary derangement in metabolic alterations vs respiratory alterations
metabolic alterations - bicarb = level = primary derangement
respiratory alterations- CO2 level = primary derangement
In the henderson-hasselbach equation, what 2 constants are used and what do they represent?
6.1 = pKa of carbonic acid
0.03 = solubility coefficient of CO2
What’s the solubility coefficient of CO2?
0.03
How is this compared to Henry’s law numbers? I thought o2 was 0.003 and co2 was 0.067
T/F: bicarb administration is not indicated in respiratory acidosis unless concomitant metabolic acidosis is identified
True
T/F: drug-induced ventilatory depression due to opioids or inhalational anesthetics is the most common cause of respiratory acidosis in the perioperative period
True
in treating hypernatremia, the total body water deficit should be replaced over what period of time?
24-48hrs
Which would most likely lead to cerebral edema - hyponatremia or hypernatremia
hyponatremia
remember you dont want to give 1/2 NS cause it’s hypotonic and it will diffuse into cells and make them swell
What ion has the highest concentration in the intracellular fluid?
K
T/F- hypokalemia can lead to an ileus
why or why not
True
hypokalemia
-often coexisting with hypocalcemia
-muscle weakness, decreased peristalsis
If the hypokalemia is severe enough to cause paralysis or cardiac dysrthimias, you can infuse potassium at rates as high as what?
what are the normal rates?
20meq over 30 minutes
-10meq/hr peripherally
-20meq/hr centrally
What is the most common cause of hypocalcemia
normal level
hypoalbuminemia
*total blood calcium levels parallel the serum albumin. Albumin decreases and so does total body calcium
why do chronic renal disease patients usually have low calcium levels
due to hyperphosphatemia
what is the corrected serum calcium meausrement
calcium + (0.8 x (4-albumin)
What does hypocalcemia in the presecne of a low or nomral phosphate level usually indicate?
vitamin D or mag deficiency
What electrolyte abnormality is tamoxifen associated with?
hypercalcemia
How is the ST segment affected by high calcium levels
shortened ST (&short QT)
T/F: symptoms of hypomagnesemia are most similar to those of hyponatremia
false- hypocalcemia
muscle weakness, tetany, cardaic dysrythmias, and seizures
The appropriate immediate treatement for severe hypermagnesemia is what (drug + dose)
calcium gluconate 15mg/kg IV
The chornic use of which drug would most likely be contribuiting to hypophosphatemia
Sodium citrate or aluminum-based antacids
alumin based antacids
Albumin, a colloid with a high oncotic pressure, distributes between the plasma volume and intersistial fluid volume in a ratio of about what
4:1
What electrolyte abnormality is most likely to be seen in a patient with chronic renal failure?
A. hypophosphatemia
B. hypocalcemia
C. hypomagnesemia
D. hypokalemia
B
You are performing the preoperative evaluation on a patient taking tamoxifen. What electrolyte abnormality would you most expect her to exhibit?
A. hyponatremia
B. hypernatremia
C. hypercalcemia
D. hyperkalemia
C
Which of the following is not a cause of high anion gap acidosis?
A. Uremia
B. Renal tubular acidosis
C. Salicylate ingestion
D. Diabetic ketoacidosis
B
A patient exhibits serious cardiac dysrhythmias due to hypokalemia. How fast can you administer 20 mEq of potassium to this patient intravenously?
A. Over 30 minutes
B. Over 3 hours
C. Over 60 minutes
D. Over 5 minutes
A
All of the following would be a likely cause of respiratory acidosis except
A. pulmonary edema
B. extensive burns
C. hyperventilation
D. prolonged seizure activity
C
Which of the following is a likely cause of hypocalcemia?
A. Hypermagnesemia
B. Hypoalbuminemia
C. Malignancy
D. Hyperparathyroidism
B
Which of the following is representative of normal anion gap acidosis?
A. Lactic acidosis
B. Ketoacidosis
C. Uremia
D. Hyperchloremic metabolic acidosis
D
Hypermagnesemia can potentially be caused by
A. hypoparathyroidism
B. forced diuresis using saline and loop diuretics
C. hyperthyroidism
D. excess ingestion of oral antacids
D
Which of the following disorders will result in a normal anion gap acidosis?
A. Renal failure
B. Salicylate ingestion
C. Small bowel fistula
D. Diabetic keotacidosis
Not A…. perhaps C
Which of the following would be least likely to aggravate hypophosphatemia?
A. hyperventilation
B. sodium bicarbonate administration
C. aluminum hydroxide antacids
D. acidosis
D
Antidiuretic hormone increases the absorption of solute-free water in the
A. loop of Henle
B. proximal convoluted tubule
C. collecting ducts
D. glomerulus
C
Which of the following factors is associated with elevated serum phosphate levels?
A. Fluid volume expansion with saline
B. Renal failure
C. Acetazolamide administration
D. Administration of oral aluminum hydroxide
B
Which of the following would most likely be a cause of hypovolemic hyponatremia?
A. Cirrhosis
B. SIADH
C. Nephrotic syndrome
D. Diuretic use
D
