Fluid Balance Flashcards
What is the normal range for K+?
3.5-5
What is the normal range for Na+?
135-145
What is the normal range for Cl-?
98-107
What is the normal range for Mg++?
0.66-1.07
What is the normal range for Ca++?
1.13-1.32
What is the management of hyperkalaemia?
dextrose and insulin - make K+ go in the cells (can also use salbutamol 12 puffs)
calcium gluconate/carbonate - stabilise cell membrane
frusemide, resonium (30g), or dialysis - get rid of the K+
What should always be given with resonium?
20mL lactulose
What are the ECG signs of hyperkalaemia?
peaked T waves, flat and wide P waves, broad flat QRS complexes, torsades
What causes hyperkalaemia?
potassium sparing diuretics, potassium supplements, fluid with too much potassium
What causes hypokalaemia?
frusemide, refeeding syndrome
What is the management of hypokalaemia?
oral: slow K or chlorvescence
IV: 10mmol KCl in 100mL NS over 1 hour or 30mmol in 1L over 6-8 hours
What are the ECG signs of hypokalaemia?
T wave inversion, high and wide P waves, ST depression, long QT, torsades
How much K+ should you give in maintenance fluid therapy?
30mmol in every third bag/litre
What should you also give when topping up K+?
Mg++
What are the causes of hyponatraemia?
SIADH
too much water
drugs