Sodium Flashcards
hyperosmolar hyponatremia
hyperglycemia or mannitol
isoosmolar hyponatremia
hyperproteinemia, hyperlipidemia
SIADH urine studies?
Una-increased, Uosm- inc
Dehydration urine studies?
Una- decreased, Uosm- increased
Hypoosmolar hyponatremia Euvolemia with urine osm <100?
psychogenic polydypsia, beer potomania, tea and toast
Hyponatremia hypervolemia urine Na <20
heart failure, cirrhosis, nephrosis
Hyponatremia urine osm >100, serum osm <275, urine Na >40
SIADH, CSW, AI, hypothyroidism, HCTZ
treatment for CSW?
fluids
Free water defecit calculation?
Kg x .6 x (serum Na/goal Na-1)
Hypervolemic hypernatremia?
primary hyperaldosteronism
Euvolemic Hypernatremia?
DI
testing to distinguish CDI and NDI?
first water restriction which both will fail to concentrate urine, second is exogenous ADH in which CDI will be able to concentrate urine
Central DI treatment?
vasopressin or desmopressin
Nephrogenic DI treatment?
diuretics, amiloride, indomethacin
pseudohyponatremia causes?
hyperlipidemia, hyperglycemia
SIADH uric acid?
decreased
HCTZ hyponatremia, uric acid level?
increased
rate of correction for acute (<48h) hypernatremia?
1 meq/hr, 24 meq in 24 hours
rate of correction for chronic hypernatremia?
<10 meq/24 hr
what surgical procedure can lead to severe acute hyponatremia?
TURBT
why does TURBT cause hyponatremia?
small bladder perforations leading to absorption of irrigation fluids
TURBT syndrome hallmarks?
hyponatremia, hemolysis, metabolic acidosis
how to trat severe acute hyponatremia?
rapid correct of 4-6 meq in first 6 hours. using hypertonic saline
CSW clinical stutus?
polyuria, high urine sodium, hypovolemia
treatment for SIADH
fluid restriction to < 800 cc a day, then salt tabs and IV saline if no improvement
central DI sx?
thirst wanting to drink cold water, and nocturia
correction rate for acute hypernatremia?
1meq/hr, 24 in a day
chronic hypernatremia correction?
10 meq/day
fluid choice in nephrogenic DI?
D5W
patient being infused with D5 1/2 NS can develop what?
euvolemic hyponatremia
pathophys of DI?
central- decreased release of AVP
nephrogenic- decreased renal sensitivity
threshold for urine osm post DDAVP challenge in DI?
increase in >50% of Uosm indicates complete DI
Hypervolemic hypernatremia?
Diarrhea, vomiting, dehydration