Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CK - IM > SUM - CH8 - Fluids 2: > Flashcards

SUM - CH8 - Fluids 2: Flashcards

1
Q

Hypotonic + Mild Hyponatremia (120-130) treatment

A

Restrict water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypotonic + Moderate hyponatremia (110-120) treatment

A

Loop diuretics + Saline (to prevent renal concentration with ADH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypotonic + Severe hyponatremia (<110): Treatment

A

Give hypertonic saline to increase 1 - 2 mEq/L/h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypovolemic + Hypernatremia: Treatment

A

Isotonic NaCl to restore hemodynamics. Correction of Na+ can wait, until hemodynamically stable. Then replace free water deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Isovolemic + hypernatremia: Treatment

A

Oral fluids or D5W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypervolemic + Hypernatremia: Treatment

A

Diuretics + D5W (dialyze patients with renal failure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ionized Calcium calculation

A

= Total Ca++ - (Albumin*0.8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hypomagnesemia and Ca+

A

Decreased Mg –> decreased PTH –> Decreased Ca++

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chvostek’s sign

A

Tapping facial nerve leads to twitching of facial muscles in hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Trousseau’s sign

A

Inflate BP cuff > Systolic for 3 min –> carpal spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hypocalcemia: S/S (2)

A
  1. Neuromuscular irritability (hyperactive reflexes, tetany, grand mal seizures)
  2. Arrythmias / Prolonged QT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hypocalcemia: Diagnosis (3)

A
  1. BUN, Cr, Mg, Albumin, Ionized Ca++
  2. PO4
  3. PTH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hypocalcemia: treatment (3)

A
  1. Emergency: Ca++ gluconate
  2. Long term: Ca++ / Vit. D suppliments
  3. PTH def: give Ca++ suppliment with thiazide * also important to correct Mg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Milk-Alkali syndrome

A

Ca++ based antacids –> hypercalcemia and Alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lithium & Ca++

A

Lithium –> PTH in some pts –> Hyper Ca++

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hypercalcemia: S/S

A

Stones

  • nephrocalcinosis/nephrolithiasis

Bones (Osteitis fibrosa cystica)

Groans

  • Muscle aches,
  • pancreatitis,
  • PUD,
  • Constipation,
  • Gout

Psychiatric overtones

  • Depression,
  • fatigue,
  • anorexia,
  • sleep disturbance,
  • anxiety

Other

  • polyuria,
  • HTN,
  • Weight loss,
  • Shortened QT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Urinary cAMP levels

A

Markedly elevated in primary hyperparathyroidism

18
Q

Hypercalcemia: treatment

  • osteoclastic disease
  • Vit. D overload - renal failure
A
  1. Increase urinary excretion:
    1. IV fluids [NS],
    2. Loop diuretics
  2. Inhibit bone resorption in pts with osteoclastic disease:
    1. bisphosphonates,
    2. Calcitonin
  3. Glucocorticoids if Vit. D dependent mechanism or MM
  4. Hemodyalysis in renal failure pts.
19
Q

Hypokalemia: S/S (7)

A
  1. Arrythmias (prolongs normal conduction)
  2. Muscle weakness, fatigue, paralysis, cramps
  3. Decreased DTR
  4. Paralytic ileus
  5. Polyuria / polydipsia
  6. Digitalis tox
  7. Flattening of T-wave (if severe U-wave appears)
20
Q

Hypokalemia: treatment

A

KCl

21
Q

Hypokalemia: Causes

A
  • GI Losses
  • Renal losses
    • Diuretics,
    • hyperaldosteroinism,
    • Excessive glucocorticoids
    • Magnesium deficiency
    • Bartter’s syndrome
  • Other: Epinephrine / insulin
22
Q

Hyperkalemia: S/S

A
  • Arrythmia: Peaked T-waves, Widened QRS, Widened PR interval, loss of P-waves, Sine wave pattern
  • Muscle weakness,
  • Decreased DTR
  • Respiratory failure
23
Q

HyperKalemia: Treat

A
  1. If severe (EKG changes): Give Ca++ IV to stabolize cellular membranes
  2. Shift into cells: Insulin / Glucose (if severe sodium bicarb)
  3. Remove K+ from body
    1. Kayexelate - GI potassium exchange resin
    2. Hemodialysis - only intractable hyperkalemia
    3. Diuretics
24
Q

Hypomagnesemia: Causes

A
  1. GI causes (malabsorption)
  2. Alcohol
  3. Renal causes
    1. SIADH,
    2. Bartters sydnrome,
    3. Gentamicin, amphotericin B, Cisplatin
  4. Other:
    1. Post-parathyroidectomy,
    2. DKA, Thyrotoxicosis,
    3. Lactation,
    4. pancreatitis
25
Q

Hypomagnesemia: treatment

A

oral Mg++

26
Q

Hypermagnesemia: Causes

A

Renal failure

Excessive Mg++ containting laxitives / antacids

Adrenal insufficiency

Rhabdomyolysis

27
Q

Hypermagnesemia: S/S

A
  • Facial Paresthesias
  • Progressive loss of deep tendon reflexes
  • ECG: Increased PR interval, Widened QRS, elevated T waves
  • Death by respiratory failure or cardiac arrest
28
Q

Hypermagesemia: Treatment

A

Emergency: IV Calcium gluconate

Administer Saline and furosemide

29
Q

Hypophosphatemia: causes

A

Decreased intestinal absorption

  • Alcohol use
  • Vit. D deficieny
  • Excessive use of P binding antacid

Increased renal excretion

  • Excess PTH
  • Hyperglycemia
  • Oncogenic osteomalacia
  • ATN
  • Renal tubular acidosis
  • Hypokalemia / Hypomagnesemia

Other

  • Respiratory alkalosis
  • Anabolic steroids
30
Q

Hypophosphatemia: treat

A

Oral supplimentation

31
Q

Hyperphosphatemia: Causes

A
  1. Decreased renal function
  2. Bisphosphonates, Hypoparathyroidism, Vit. D intox,
  3. Tumor Calcinosis
  4. Rhabdomyolysis
  5. Acidosis
32
Q

Hyperphosphatemia: S/S

A
  1. Metastatic calcification and soft tissue calcifications
  2. Hypocalcemia –> neurologic changes
    1. Tetany, neuromuscular irritability
      3.
33
Q

Hyperphosphatemia: Treatment

A

Phosphate binding antacids containing aluminum hydroxide or carbonate

34
Q

Acidosis: Effects

A
  • Right shift in O2 bindng curve: More O2 delivery
  • Depresses CNS
  • Decreased Pulmonary Blood flow
  • Impaired myocardial function
  • Hyperkalemia
35
Q

Alkalosis: effects

A
  • Left shift in O2 Saturation curve: less O2 delivered
  • Decreased cerebral blood flow
  • Arrhythmias
  • Tetany/seizures
36
Q

Metabolic Acidosis: S/S

A
  • Hyperventilation: Kussmaul breathing
  • Decreased Cardiac output / decreased tissue perfusion
    • Acid –| Catecholamine action
37
Q

Saline sensitive metabolic Alkalosis

A

ECF Contraction and hypokalemia, (urine chloride <10 mEq/L)

38
Q

Saline resistant metabolic alkalosis

A

ECF expansion, hypertension, urine chloride > 20 (dt/ excessive mineralocorticoids, Severe K+ deficiency, Bartters)

39
Q

Acute Respiratory Acidosis: Bicarb Change

A

1 per every 10 CO2 change

40
Q

Chronic respiratory Acidosis: Bicarb change

A

4 per 10 CO2 change

41
Q

Situations requiring intubation: resp acidosis

A
  1. Severe acidosis
  2. PACO2 >60 or inability to increase Pa O2 with supplimental oxygen
  3. Deterioration in mental status
  4. Impending respiratory fatigue
42
Q

Respiratory Alkalosis: S/S

A
  • Decreased cerebral blood flow: Associated symptoms
  • Tetany (similar to hypocalcemia)
  • Arrythmias

CK - IM (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions