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exam 1 fluid and electrolytes Flashcards

(54 cards)

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1
Q

equation for Sosm

A

2(Na) + glucose/18 + BUN/2.8

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2
Q

equation for corrected Ca

A

measured Ca + 0.8(4 – albumin)

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3
Q

normal Na

A

135-145

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4
Q

normal K

A

3.5-4.5

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5
Q

normal Cl

A

98-106

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6
Q

normal CO2 (bicarbonate)

A

21-30

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7
Q

normal Mg

A

1.4-2.2

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8
Q

normal Ca

A

total 9-10.5
ionized 1.1-1.4

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9
Q

normal phos

A

3-4.5

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10
Q

intracellular fluid

A

2/3 TBW
rich in K, Mg, phos, AA

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11
Q

extracellular fluid

A

1/3 TBW
rich in Na, Cl, HCO3

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12
Q

extracellular divided into

A

intravascular 8% TBW
interstitial 25% TBW

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13
Q

transcellular fluid

A

1% TBW
digestive juices, cerebrospinal fluid, pleural fluid

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14
Q

labs

A

BUN:SCr (cannot be used as sole marker)
>20:1 suggests pre-renal kidney disease

FENa or FEUrea
FENa <1% or FEUrea <30% indicates pre-renal kidney injury

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15
Q

physical signs of fluid deficit

A

dry mucous membrane
decreased skin turgor
tachycardia

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16
Q

physical signs of fluid overload

A

pitting edema
juglar distention
hepatojugular reflex
pulmonary crackles

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17
Q

clinical signs of fluid deficit

A

hypotension
decreased urine output
weight loss

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18
Q

clinical sign of fluid overload

A

hypertension
weight gain
SOB

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19
Q

urine output goal

A

0.5ml/kg/hr

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20
Q

nutritional estimation fluid requirement

A

30ml/kg/day

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21
Q

crystalloids contain

A

water
Na
Cl

increases osmotic pressure
Na and Cl do not cross freely into cells and distribute in the extracellular space

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22
Q

dextrose is rapidly metabolized int

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A

H2O and CO2

water can cross freely across cell membranes

23
Q

colloids contain

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A

large molecules (albumin, hespan, PRBC)

increase oncotic pressure

24
Q

distribution and tonicity of 0.9% NaCl

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A

25% intravascular
75% interstitial
isotonic

25
distribution and tonicity of 0.45% NaCl
33% intracellular 17% intravascular 50% interstitial hypotonic
26
distribution and tonicity of 3% NaCl
0% intracellular hypertonic can cause severe hyponatremia
27
distribution and tonicity of normosol
25% intravascular 75% interstitial isotonic
28
distribution and tonicity of plasma-lyte
25% intravascular 75% interstitial isotonic
29
distribution and tonicity of LR
25% intravascular 75% interstitial isotonic
30
free water content and tonicity of D5W
1000mL hypotonic can cause severe hyponatremia
31
free water content and tonicity of D5 in 1/2 NS
500mL hypertonic
32
free water content and tonicity of D5 in 1/4 NS
750mL hypertonic
33
free water content and tonicity of D5 in LR
0 hypertonic
34
free water content and tonicity of D5 in NS
0 hypertonic
35
normal daily intake of sodium most abundant where
2300mg ECF
36
when do symptoms of hyponatremia start and what are they and life threatening symptoms
<125 nausea, impaired gait, cognitive disturbances, HA, lethargy <110 seizures, coma, respiratory arrest
37
treatment of hyponatremia depends on
cause osmolality volume status
38
if pt has hyponatremia and is hyperosmolar
assess glucose and calculate corrected Na if hyperglycemia is present
39
if pt has hyponatremia and is isotonic
assess for elevated serum proteins
40
if pt has hyponatremia and is hypotonic
assess volume status
41
if pt has hyponatremia and is hypotonic, if hypervolemic
assess for underlying condition
42
if pt has hyponatremia and is hypotonic, if euvolemic
assess urine Na and osmolality
43
if pt has hyponatremia and is hypotonic, if hypovolemic
assess source of water loss
44
hyponatremia hypotonic hypervolemia is normally caused by
primary medical condition- HF, hepatic insufficiency, CKD stage 3b-5
45
what is the most common cause of hyponatremia hypotonic euvolemia
SIADH
46
what level is considered severe hyponatremia
<115
47
when pt has severe hyponatremia do not increase sodium by more than
5 in the first hour OR 10 in 24 hours
48
hypernatremia level
>160 do not decrease too quickly, could cause cerebral edema
49
what is normal daily intake for potassium
4700mg
50
potassium is most abundant where
ICF
51
mild hypokalemia level
3.1-3.5 asymptomatic
52
moderate hypokalemia level
2.5-3 asymptomatic, cramps, weakness, malaise
53
severe hypokalemia
<2.5 CV: ST segment depression, T wave inversion, elevated U wave, arrhythmia, heart block, tachycardia, v fibs musculoskeletal: impaired muscle contraction and cramps
54

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