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Flashcards in clinical: electrolytes Deck (13):
1

describe hypotonic fluid

- dilute fluid
- pushes fluid into a cell
- e.g. 5% dextrose

2

describe hypertonic fluid

- pushes fluid out of cells
- less dilute, stronger concentration
- only really given in ICU

3

describe isotonic fluid

- free flow as tonicity is the same as cells
- e.g. 0.9% SodChlr or plasma-lyte

4

what are ways of assessing volume status

- BP
- weight (change over time)
- JVP

5

why do we give patients IV fluid

1. maintenance (keeping them euvolemic as they cant drink)
2. replacement of losses
3. resuscitation (e.g. shock)

6

describe hyponatraemia

- low Na+
mainly due to excess water

7

causes of sodium loss

- GI loss (vomiting, diarrhea)
- hypo-aldosteronism
- sweat (rare)
- diuretics

8

describe pseudohyponatremia

Na+ looks low but is due to a lab error

having hypertriglyceridemia or hyperproteinemia can cause Na+ to look low

9

causes of water excess

water overload from:
- cirrhosis
- heart failure
- nephrotic syndrome

SIADH (normal BP)
Polydipsia (over drink water)

10

steps in identifying the fluid state of patient's

1. history e.g. GI symptoms, medication, dehydration

2. examination of fluid status

3. osmolality (would be low in hyponatremia)

11

symptoms and causes of water excess with euvolaemia

- no signs of dehydration or edema
- no elevation of JVP
- no evidence of fluid overload

causes:
- SIADH
- polydipsia
- diuretics
- hypotonic fluid overload

12

describe SIADH and its causes

- ADH release despite not being dry or hypotensive

causes:
- tumours
- CNS
- drugs
- lung disease

13

how do we treat patients with hyponatremia

dehydrated patients with Na+ loss
= saline

patients with water excess
= fluid restriction (1L daily)