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House Clinical Pathology > Correction of Electrolyte Imbalance > Flashcards

Correction of Electrolyte Imbalance Flashcards

(54 cards)

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1
Q

HYPERNATREMIA

Sodium levels greater than _____mmol/L

Produces a state of _____osmolality

A

145

hyper

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2
Q

CAUSES of hypernatremia

•Impaired _____ mechanisms, Coma.

•___ diuresis.

•Diabetic __________

•___________ coma, _______ administration

A

thirst

Solute

ketoacidosis

non ketotic hyperosmolar

mannitol

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3
Q

CAUSES of hypernatremia

•Excessive _____ loss.

•_______________

•_______________

A

water

Neurogenic diabetes insipidus

nephrogenic diabetes insipidus

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4
Q

Clinical features of hypernatremia

Neurological manifestations are as a result of __________

Restlessness

Lethargy

_________reflexia

_________

A

cellular dehydration.

Hyper

Seizures

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5
Q

Clinical features of hypernatremia

_______-______may occur

Rapid decreases in brain volume can ____________ causing _________ or __________________

A

Coma-death

rupture cerebral veins

subarachnoid or intracerebral haemorrhage.

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6
Q

TREATMENT OF hypernatremia

Restore _______ to normal and treat the __________

Water deficit Correction should be done over ______ with a ______tonic solution like __________ in water.

A

plasma osmolality; underlying cause.

48hours; hypo

5% dextrose

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7
Q

Water deficit is calculated by:-

Free water deficit=_______ ((_____/_____)-__)x _____.

A

plasma

Na/140

1

TBW

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8
Q

TREATMENT of hypernatremia

Rapid correction of hypernatraemia can result in ______, cerebral _______,permanent ________ and death.

A

seizures

oedaema

neurological damage

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9
Q

TREATMENT pf hypernatremia

Decrease in plasma sodium concentration should not be faster than ____mmol/L/hour.

A

0.5

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10
Q

Treatment of hypernatremia

Hypernataemia has been demonstrated to increase the MAC for _________

A

inhalational anaesthetics.

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11
Q

Elective surgery is postponed in patients with significant hypernatraemia.

T/F

A

T

Elective surgery is postponed in patients with significant hypernatraemia. Na >150mmol/L

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12
Q

Treatment of Hypernataemia

For Elective surgery

________________ must be corrected prior to elective surgery.

A

Both water and isotonic deficits

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13
Q

Most common electrolyte disorder is ??

A

HYPONATRAEMIA

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14
Q

HYPONATRAEMIA

Caused by cellular ______ with the presence of _____tonicity.

A

oedema

hypo

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15
Q

CAUSES OF HYPONATRAEMIA

RENAL CAUSES.

_______

_______ deficiency

_____ losing nephropathies

osmotic diuresis (___ ,______and ______ )

renal tubular (alkalosis or acidosis?) .

A

Diuretics

mineralocorticoid

salt

glucose, urea and mannitol

acidosis

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16
Q

CAUSES OF HYPONATRAEMIA

EXTRARENAL CAUSES.

_________, diarrhea

_______

_______,______

A

Vomiting

sweating

burns, third spacing.

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17
Q

Third-space fluid shift is the ___________ to a __________ rendering it _______ to the circulatory system.

A

mobilisation of body fluid

non-contributory space

unavailable

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18
Q

CLINICAL MANIFESTATIONS of hyponatremia

Patients with Na >___mmol/L may be asymptomatic. Serious manifestations begin to occur below _____mmol/L.

A

125

120

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19
Q

CLINICAL MANIFESTATIONS of hyponatremia

Early symptoms are (specific or non specific?) and may include anorexia, nauusea and weakness.

Progressive ________ results in lethargy, and confusion, seizures, coma and death.

A

non specific

cerebral oedema

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20
Q

TREATMENT of hyponatremia
The Na deficit= _____x (_____-______)

Excessive rapid correction of hyponatraemia has been associated with _________ in the _______ (central _______________)

A

TBW

desired Na; present sodium

demyelinating lesions in the pons

pontine myelinolysis

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21
Q

TREATMENT of hyponatremia

Rates of correction

Mild symptoms-____mmol/L/h
Moderate symptoms-___mmol/L/h or less
Severe symptoms-___mmol/L/h or less.

A

0.5

1

1.5

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22
Q

Na _____mmol/L is safe for patients undergoing general anaesthesia.

23
Q

In most cases correct sodium to greater than ___mmol/L for elective proceedures even in the absence of neurological symptoms.

24
Q

(Lower or higher?) Na concentrations may result in significant cerebral oedema that can manifest intraoperatively as a _____ in ____ or post operatively as _____,______, or _______

Study These Flashcards
A

Lower

decrease in MAC

agitation, confusion or somnolence.

25
MAC = ????
Mean Alveolar Concentration
26
HYPOKALAEMIA Defined as plasma K less than _____mmol/L
3.5
27
HYPOKALAEMIA A decrease of K from 4 to 3mmol/L represents a ___ to ____ mmol/L deficit
100 to 200
28
HYPOKALAEMIA Plasma K below 3mmol/L represents a deficit anywhere between ____-_____mmol/L of K
200-400
29
Causes of hypokakemic EXCESS RENAL LOSS. __________excess primary _______ (______ syndrome; ____ excess renovascular _______; diuresis chronic metabolic (acidosis or alkalosis?)
Mineralocorticoid Hyperaldosteronism Conn’s ; renin hypertension; alkalosis.
30
Causes of hypokakemic Gastrointestinal loss. _____ and _____
Diarrhoea and vomiting
31
Causes of hypokakemic ECF-ICF shifts. Acute (acidosis or alkalosis?) hypokalaemic periodic _____ ______ ingestion, _____ therapy
alkalosis paralysis barium Insulin
32
CLINICAL PRESENTATION of hypokalemia Most patients are asymptomatic until ___________________________
plasma K falls below 3mmol/L
33
CLINICAL PRESENTATION of hypokalemia _______ effects are most prominent and include an abnormal ____ arrhythmias, ___eased cardiac contractility and a labile arterial blood pressure due to autonomic dysfunction
Cardiovascular ECG decr
34
TREATMENT of hypokalemia Intravenous replacement is reserved for those at risk for significant _______ manifestations or those with severe __________
cardiac muscle weakness
35
TREATMENT of hypokalemia K is _____ to peripheral _____ .so, never give more than __mmol/L/h
irritating; veins; 8
36
TREATMENT of hypokalemia ______ containing solutions should be avoided because the resulting hyperglycaemia and secondary ______ may actually worsen the low potassium.
Dextrose insulin secretion
37
TREATMENT of hypokalemia More rapid intravenous potassium replacement (___-___mmol/l/h) requires __________ administration and _____ monitoring
10-20 central venous ECG
38
TREATMENT of hypokalemia IV replacement should not exceed ____mmol/L/day
240
39
general surgery can proceed with K levels of 3-3.5mmol/L. T/F
T
40
ANAESTHETIC CONSIDERATION In chronic mild hypokalaemia of ____mmol/L without _____ changes anaesthetic risk is minimal.
3-3.5 ECG
41
ANAESTHETIC CONSIDERATION Intraoperatively potassium should be given if _____ or ________ should occur.
atrial or ventricular arrhythmias
42
CLINICAL MANIFESTATION of hyperkalemia The most important are _____ and ______ manifestations.
skeletal and cardiac muscle
43
CLINICAL MANIFESTATION of hyperkalemia Skeletal muscle weakness is generally not seen until _________
K levels of 8mmol/L is reached
44
CLINICAL MANIFESTATION of hyperkalemia Cardiac manifestations occur at ___mmol/l of K and is due to _______
7 delayed repolarisation.
45
HYPERKALAEMIA K > ___mmol/L Kidneys can excrete as much as ____mmol/L of K per day
5.5 500
46
Hyperkalaemia occurs often in normal individuals. T/F
F Hyperkalaemia rarely occurs in normal individuals.
47
TREATMENT of hyperkaelemia Hyperkalaemia exceeding ___mmol/l should always be corrected.
6
48
TREATMENT of hyperkaelemia ________ of cardiac manifestations and skeletal muscle weakness.
Reversal
49
TREATMENT of hyperkaelemia 10% __________ (5-10 mls) to antagonise the effects of hyperkalaemia.
Calcium gluconate
50
TREATMENT of hyperkaelemia When metabolic acidosis is present, give IV _________ usually 45meq will promote _____________ and can reduce plasma K within 15 mins.
sodium bicarbonate cellular uptake of K
51
TREATMENT OF hyperkaelemia •IV ______ and _______. •________ in symptomatic patients.
GLUCOSE AND INSULIN Dialysis
52
Anaesthesia and surgery can be taken in patients with hyperkalaemia. T/F
F Anaesthesia and surgery should not be taken in patients with hyperkalaemia.
53
Most errors fall into this category Pre analytical, analytical, or post analytical
Pre analytical
54
analytical errors are rare T/F
T

House Clinical Pathology (45 decks)

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