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Therapeutics II > Electrolytes > Flashcards

Electrolytes Flashcards

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1
Q

What is the normal range for Na levels?

A

135-145 mEg/L

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2
Q

Which is a primary extracellular cation needed to maintain cellular integrity by maintaining the osmolar gradient?
A. Na
B. K
C. Phos
D. Ca

A

A. Na

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3
Q

What value indicates hyponatremia?

A

< 135 mEq/L

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4
Q

What is the equation for Serum Osmolality?

A

Osm = (2 x Na) + (BUN/2.8) + (Glucose/18)

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5
Q

AW is a 46 yof admitted to the internal medicine service for “unknown intoxication.” Routine labs reveal:

What is AW’s calculated osmolality?

A

Osm= (2 x 145) + (10/2.8) + (90/18)= 299 mOsm/L

Elevated serum Osm indicates presence of other substance in blood

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6
Q

What value of mOsm indicates pseudo hyponatremia?

A

275-290 mOsm

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7
Q

Pseudohyponatremia can be seen with what two conditions?

A

hypertriglyceridemia or hyperproteinemia

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8
Q

What value of mOsm indicates hypertonic hyponatremia?

A

> 290 mOsm

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9
Q

KZ is a 63 yom with ESRD secondary to uncontrolled HTN and DM currently receiving HD. Today his labs reveal:

What is KZ’s calculated Osm? What does it indicate?

A

Osm= (2x128) + (50/2.8) + (600/18) = 307 mOsm/L

Hypertonic Hyponatremia

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10
Q

Serum sodium falls by ____ mEq/L for each _____ mg/dL incremental increase in BG > 100 mg/dL

A

Serum sodium falls by 1.6 mEq/L for each 100 mg/dL incremental increase in BG > 100 mg/dL

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11
Q

What is the equation for Corrected Na?

A

Na(serum) + 1.6[(BG-100)/100]

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12
Q

KZ is a 63 yom with ESRD secondary to uncontrolled HTN and DM currently receiving HD. Today his labs reveal:

What is his corrected serum sodium?
What is his treatment?

A

128 + 1.6[(600-100)/100]= 136 mEq/L

Normal (btwn 135-145), go give insulin

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13
Q

What value of mOsm indicates hypotonic hyponatremia?

A

<275 mOsm

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14
Q

Which volume status decrease TBW and highly decreases Na?

A

Hypovolemic Hypotonic Hyponatremia

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15
Q

Which volume status increases TBW and keeps Na neutral?

A

Isovolemic Hypotonic Hyponatremia

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16
Q

Which volume status increases TBW and increases Na?

A

Hypervolemic Hypotonic Hyponatremia

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17
Q

T/F: Hypovolemic hypotonic hyponatremia are only from renal causes

A

False: renal and non-renal

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18
Q

What is the common cause of isovolemic hypotonic hyponatremia?

A

SIADH- Syndrome of Inappropriate AntiDiuretic Hormone Release

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19
Q

What happens to extracellular fluid with an increase in TBW and around normal Na?

A

Slight excess of ECF

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20
Q

What type of medications most commonly cause drug-induced SIADH?
A. Diuretics
B. Diabetes Meds
C. Psychotropic Meds
D. Antibacterials

A

C. Psychotropic Meds

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21
Q

How should water intake and medication be regulated in the treatment of SIADH?

A

Restrict free water (limit water intake) and remove underlying cause (ex meds) if possible

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22
Q

What medication class may be used in the treatment of SIADH?

A

Vaptans

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23
Q

Which leads to expanded ECF volume and physical edema?
A. Hypovolemic hypotonic hyponatremia
B. Hypervolemic hypotonic hyponatremia

A

B. Hypervolemic hypotonic hyponatremia

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24
Q

In most cases the goal is to avoid rise in serum sodium > ____ mEq/L/hr or no more than (NMT) __-___ mEq/L/day

Study These Flashcards
A

In most cases the goal is to avoid rise in serum sodium > 0.5 mEq/L/hr or no more than (NMT) 8-12 mEq/L/day

25
What is the treatment option(s) for symptomatic hypovolemia? A. 3% NaCl B. 0.9% NaCl C. Furosemide D. Water Restriction
A. 3% NaCl
26
What is the treatment option(s) for asymptomatic hypovolemia? A. 3% NaCl B. 0.9% NaCl C. Furosemide D. Water Restriction
B. 0.9% NaCl
27
What is the treatment option(s) for symptomatic isovolemia? A. 3% NaCl B. 0.9% NaCl C. Furosemide D. Water Restriction
A. 3% NaCl C. Furosemide
28
What is the treatment option(s) for asymptomatic isovolemia? A. 3% NaCl B. 0.9% NaCl C. Furosemide D. Water Restriction
B. 0.9% NaCl and water restriction
29
What is the treatment option(s) for symptomatic hypervolemia? A. 3% NaCl B. 0.9% NaCl C. Furosemide D. Water Restriction
A. 3% NaCl C. Furosemide
30
What is the treatment option(s) for asymptomatic hypervolemia? A. 3% NaCl B. 0.9% NaCl C. Furosemide D. Water Restriction
C. Furosemide
31
What is the treatment recommendation for acute symptomatic hyponatremia?
Increase serum Na with 3% NaCl by 1-2 mEq/L/hr
32
What is the Na goal for acute symptomatic hyponatremia?
120 mEq/L
33
What can occur from correcting acute symptomatic hyponatremia too rapidly?
CPM (central pontine myelinolysis)
34
What is the max increase of mEq/L for the first 24 hrs?
8-12 mEq/L
35
What is the equation for Na deficit?
TBW x (Na(goal) - current Na(serum))
36
Hypernatremia is always associated with hyper_____
hypertonicity
37
What is the equation for free water deficit?
TBW x [(Na(serum)/140)-1]
38
What is the preferred treatment for isovolemic hypernatremia in diabetes insipidus? A. Diuretics B. Magnesium depletion C. Kayexalate D. Vasopressin
D. Vasopressin
39
What is the preferred treatment for hypervolemic hypernatremia? A. Diuretics B. Magnesium depletion C. Kayexalate D. Vasopressin
A. Diuretics (if needed)
40
What is the normal range for potassium?
3.5-5 mEq/L
41
What is the primary intracellular cation responsible for cell metabolism, glycogen and protein synthesis? A. Na B. K C. Phos D. Ca
B. K
42
What is a main cause of hypokalemia? Why? A. Magnesium depletion B. Calcium depletion C. Sodium depletion D. Phosphate depletion
A. Magnesium depletion- cofactor for Na/K ATPase
43
What value warrants treatment for hypokalemia?
<3 mEq/L
44
What is the infusion rate of potassium without cardiac monitoring? With cardiac monitor?
W/O: 10 mEq/hr W/: 20 mEq/hr; 40-60 if during cardiac arrest with severe hypokalemia
45
What values indicate mild, mod, and severe hyperkalemia?
Mild: 5.5-6 mEq/L Mod: 6.1-6.9 mEq/L Severe: >7 mEq/L
46
What is the goal of therapy for severe hyperkalemia (K>7 mEq/L)?
C A BIG K DROP 1. Antagonize the membrane actions (Calcium) 2. Decrease extracellular K conc (albuterol, bicarb, insulin + glucose) 3. Remove K from the body (Kayexalate/Lokelma, Diuretics (furosemide), renal unit for dialysis of patient)
47
What is the preferred chronic hyperkalemia treatment option? A. Diuretics B. Valtassa C. Kayexalate D. Vasopressin
B. Valtassa
48
What values are normal range for magnesium?
1.5-2.5 mg/dL
49
What is the most common medication to cause hypomagnesemia? A. Diuretics B. Valtassa C. Kayexalate D. Vasopressin
A. Diuretics
50
What is the normal range of calcium?
8.5-10.5 mg/dL
51
What are the three common reasons for hypocalcemia?
Magnesium deficiency, large volumes of blood products, and hypoalbuminemia
52
What is the equation for corrected Ca?
Measured Ca + [(4-measured albumin) x 0.8]
53
Which contains more elemental calcium: Ca chloride or Ca gluconate?
Ca chloride 1 gm Ca chloride = 3 gm Ca gluconate
54
What is the normal range for phosphorus?
2.5-4.5 mg/dL
55
What values are more mild-mod and severe hypophosphatemia?
Mild-Mod: 1-2 mg/dL Severe: <1 mg/dL
56
Use __Phos when K < 4 mEq/L Use __Phos when K > 4 mEq/L
Use KPhos when K < 4 mEq/L Use NaPhos when K > 4 mEq/L
57
1 mMol NaPhos= ? 1 mMol KPhos= ?
1 mMol NaPhos= 1.33 mEq Na + 1.33 mEq Phos 1 mMol KPhos= 1.47 mEq K + 1.47 mEq Phos
58
During phos replacement, infuse IV doses no faster than ___ mMol/hr
During phos replacement, infuse IV doses no faster than 7 mMol/hr

Therapeutics II (9 decks)

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