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Therapeutics I > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

What is the normal sodium range?

A

135-145

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2
Q

What is the normal potassium range?

A

3.5-5

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3
Q

What is the normal Calcium range?

A

8.5-10.5

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4
Q

What is the normal phosphate range?

A

2.5-4.5

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5
Q

What is the normal magnesium range?

A

1.5-2.5

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6
Q

A patient is hypernatremic. What is the first thing you look at?

A

Volume status–are they hypovolemic, isovolemic, or hypervolemic?

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7
Q

A patient is hyponatremic. What is the first thing you look at?

A

Osmolarity

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8
Q

A patient has hypertonic hyponatremia. What now?

A

Is there blood glucose high? Calculate corrected Na status (Na + (glucose-100)/100). Treat hyperglycemia with insulin

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9
Q

A patient has isotonic hyponatremia. What now?

A

The patient has pseudohyponatremia. High lipids/proteins are causing an inaccurate lab reading

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10
Q

A patient has hypotonic hyponatremia. What now?

A

Assess the patient’s volume status (hypovolemic, isovolemic, hypervolemic)

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11
Q

What might cause isovolemic hypotonic hyponatremia?

A

SIADH,

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12
Q

What drugs can cause SIADH?

A

antipsychotics, antidepressents (sertraline and fluoxetine), carbamezapine

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13
Q

How do you treat isovolemic hypotonic hyponatremia?

A
  1. Stop administering the drug that you suspect is causing SIADH
  2. Administer Diuretic (furosemide)
  3. Administer vaptans, as secondary line of treatment
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14
Q

What is the characteristic TBW and Na of isovolemic hypotonic hyponatremia?

A

TBW is increased

Na is also increased, but not as high

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15
Q

What might cause hypovolemic hypotonic hyponatremia?

A

Dehydration, fluid loss, burns,

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16
Q

How do you treat hypovolemic hypotonic hyponatremia?

A
  1. Administer fluids–NS
    Calculate sodium deficit to determine amount to administer
    Do not correct by more than 12 mEq/day
    Follow rule of 8’s: Half in first 8 hours, then a quarter in the next 8 and a quarter in the next 8
17
Q

What causes hypervolemic hypotonic hyponatremia?

A

Fluid retention?

18
Q

How do you treat hypervolemic hypotonic hyponatremia

A

Diuretics

19
Q

A patient has has hypovolemic hypernatremia. What do you do?

A

Calculate FWD. (TBW(Naserum/140)-1)

Administer 1/2 the FW over the first 24 hours, and the remaining half in the next 1-2 days

20
Q

What cause hypovolemic hypernatremia?

A

Fluid loss

21
Q

A patient has hypervolemic hyponatremia. What do you do?

A

Diuretics

22
Q

What do you do if a patient has hypokalemia and is asymptomatic?

A

Administer Potassium orally. Can come in liquid or solid dosage forms, as KCl, K acetate, etc.

23
Q

How much does 10mEq of potassium increase serum potassium?

A

by 0.1 mEq

24
Q

What do you do if a patient has hypokalemia and is symptomatic?

A

IV K+
Increase by no mare than 10mEq/hr
20mEq/hr if the patient is on continuous cardiac monitoring

25
Q

What do you do if a patient has hypomagnesemia and is asymptomatic?

A

Administer Mag Orally.

Milk of Mag or Ox-Mag

26
Q

What do you do if a patient has hypomagnesemia and is symptomatic

A

Administer Mag by IV.
If Mag is 1-2: 0.5 mEq/L
If mag is <1: 1 mEq/L

27
Q

What do you do if a patient has hypermagnesemia?

A
  1. Administer CaCl
  2. If normal renal function: Forced diuresis and
  3. If renal dysfunction: Hemodialysis
28
Q

What do you do if patient has hyperkalemia?

A
  1. Administer CaCl (to antagonize heart contractions)
  2. Administer Insulin/Dextrose/albuterol/NaHCO3 (to draw the K into the cell)
  3. Administer hemodialysis, diuretics, or polystyrene (to excrete K)
29
Q

What do you do if a patient has chronic hyperkalemia?

A

Administer Promitene–to decrease potassium absorption from GI tract

30
Q

What do you do if a patient has hypocalcemia?

A
  1. Fix underlying Magnesium problem

2. Administer Ca–Calcium gluconate preferred, CaCl possible if dire situation (administers faster–1 gm/3gm)

31
Q

What do you do if a patient has hypercalcemia?

A
  1. Volume expansion/Loop diuretics
  2. Calcitonin (decrease bone resorption and renal tubular reabsorption)
  3. Bisphosphonate (decrease bone resorption)
  4. Glucocorticoids (decrease GI absorption)
32
Q

What do you do if a patient has hypophosphatemia?

A

Administer phosphate:
NaPHO if K >4
KPhos if K <4
Follow potassium administration rules

33
Q

What do you do if a patient has hyperphosphatemia?

A

Administer Ca gluconate

Reduce GI absorption of phosphate

Therapeutics I (9 decks)

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