Fluid and Electrolytes

Question 1

Normal Serum Sodium Levels

Answer 1

136-145 mEq/L

Question 2

Normal Serum Potassium Levels

Answer 2

3.5-5.0 mEq/L

Question 3

Normal Serum Calcium Levels

Answer 3

9.0-10.5 mEq/L

Question 4

Normal Serum Magnesium Levels

Answer 4

1.3-2.1 mEq/L

Question 5

Hyponatremia

Answer 5

<136 mEq/L

Question 6

Hypernatremia

Answer 6

> 145 mEq/L

Question 7

Causes of Hyponatremia

Answer 7

GI losses, diuretics, excessive water intake, burns

Question 8

Causes of Hypernatremia

Answer 8

Increased water loss, Increased ingestion of sodium

Question 9

Symptoms of Hyponatremia

Answer 9

Muscle cramps and weakness
Depressed deep tendon reflexes
Nausea and vomiting
Headaches
Disorientation
Lethargy
Seizures/coma
Nausea and vomiting
Abdominal cramps

Question 10

Symptoms of Hypernatremia

Answer 10

Decreased blood pressure
Weak, rapid pulse
Increased thirst
Headache
Disorientation and agitation
Seizures (later stages)
Dry skin and mucous membrane

Question 11

Treatment of Hyponatremia

Answer 11

Identify underlying cause

Question 12

Treatment of Hypernatremia

Answer 12

Identify underlying cause

Question 13

Hypokalemia

Answer 13

<3.5 mEq/L

Question 14

Hyperkalemia

Answer 14

> 5.0 mEq/L

Question 15

Causes of Hypokalemia

Answer 15

Diuretics, GI losses, Extreme sweating

Question 16

Causes of Hyperkalemia

Answer 16

Renal failure, Diabetic ketoacidosis

Question 17

Symptoms of Hypokalemia

Answer 17

Cardiac irregularities or EKG changes
Confusion
depression
Increased sensitivity to digitalis
Muscle weakness
Muscle cramps and tenderness
Paraesthesia
Decreased GI motility
Anorexia, nausea, vomiting
Abdominal distention and flatulence

Question 18

Symptoms of Hyperkalemia

Answer 18

Nausea and vomiting
Abdominal cramps
Weakness
Paresthesias/Numbness and tingling
Cardiac irregularities on EKG

Question 19

Treatment of Hypokalemia

Answer 19

Potassium replacement

Question 20

Treatment of Hyperkalemia

Answer 20

Calcium administration, insulin, Kayexelate, dialysis

Question 21

Hypocalcemia

Answer 21

<9.0 mEq/L

Question 22

Hypercalcemia

Answer 22

> 10.5 mEq/L

Question 23

Causes of Hypocalcemia

Answer 23

Vitamin D deficiency, Pancreatitis

Question 24

Causes of Hypercalcemia

Answer 24

Hyperparathyroidism, Large doses of Vitamin D

Question 25

Symptoms of Hypocalcemia

Answer 25

Paresthesias especially numbness and tingling Tetany Skeletal muscle cramps Abdominal muscle spasms and cramps Positive Chvostek’s sign (twitching of the facial muscles) Positive Trousseau’s sign (flexion of the wrist, hyperextension of the fingers)

Question 26

Symptoms of Hypercalcemia

Answer 26

``` Polyuria Excessive thirst Flank pain Anorexia Lethargy Weakened muscles Hypertension ```

Question 27

Treatment of Hypocalcemia

Answer 27

Calcium supplementation

Question 28

Treatment of Hypercalcemia

Answer 28

identify underlying cause

Question 29

Hypomagnesemia

Answer 29

<1.3 mEq/L

Question 30

Hypermagnesemia

Answer 30

>2.1 mEq/L

Question 31

Causes of Hypomagnesemia

Answer 31

malnutrition and alcoholism, Diarrhea, NG suction

Question 32

Causes of Hypermagnesemia

Answer 32

Renal failure

Question 33

Symptoms of Hypomagnesemia

Answer 33

``` Personality changes Tetany Tachycardia Hypertension Cardiac arrhythmias ```

Question 34

Symptoms of Hypermagnesemia

Answer 34

``` Lethargy Hyporeflexia Confusion Coma Hypotension Cardiac arrhythmias Cardiac arrest ```

Question 35

Treatment of Hypomagnesemia

Answer 35

Magnesium administration

Question 36

Treatment of Hypermagnesemia

Answer 36

symptomatic

Question 37

SIADH

Answer 37

Syndrome of Inappropriate Diuretic Hormone; Serum Na+ - ↓, Serum osmolality- ↓, Extracellular volume-Normal (isovolemic), Urine osmolality and SG ↑ (concentrated urine with osmolality usually > 300 mmol/kg); retaining a lot of fluid

Question 38

DI

Answer 38

Diabetes Insepidus; Serum Na+ - ↑, Serum osmolality - ↑, Extracellular volume - Normal (isovolemic), Urine osmolality and SG - ↓; fluid lose, lots of urination

Question 39

Normal Blood Urea Nitrogen levels

Answer 39

5-25 mg/dl

Question 40

Normal serum creatinine

Answer 40

0.5 to 1.5 mg/dl