Fluid And Electrolytes Flashcards
Normal Sodium level
135-145
What is a normal urine sodium level? What is indicated if it is elevated vs low
Normal: 20
Low: Renal retention of sodium
Elevated: renal salt wasting
What is the normal serum osmo and what does it mean when its high vs low
Normal is x2 serum sodium (275-285)
High: concentrated urine
Low: diluted urine
Causes of isotonic hyponatremia and tx
Occurs with hyperlipidemia or hyperproteinemia
Tx Cut down on fats
Causes of hypertonic hyponatremia and tx
Elevated glucose, HHNK
Treat underlying cause
Causes of hypotonic hypervolemic hyponatremia and treatment
RF, CHF, cirrhosis, nephrotic syndrome
Tx: Water restriction, lasix
Causes and treatment of hypotonic hypovolemic hyponatremia
Dehydration, salt wasting, vomiting/diarrhea, diuretics
Tx: IVF
Hypotonic euvolemic hyponatremia Causes
SIADH, hypothyroidism, glucocorticoid insufficiency
Hypernatremia causes
Typically excessive water loss
Tx of hypovolemic hypernatremia
NSS followed by 1/2 NSS IV
Tx of Euvolemic hypernatremia
D5W
Treatment of hypervolemia hypernatremia
Free water and lasix
Normal CA level and iCal level
Ca: 8-10
iCal 1.2-1.3
Causes of hypercalcemia and treatment
Causes: Hyperthyroidism, hyperparathyroidism, vitamin D toxicity, thiazide diuretic use, immobility, malignancies
Tx: Calcitonin, NSS, diuretic, phosphate
Hypocalcemia causes, s/s, and treatment
Causes: Pancreatitis, blood transfusions, hypothyroidism, hypomagnesium, low albumin, alkalemia, post Parathyroidectomy, hungry bone syndrome, rhabdo
S/S: hyperactive symptoms, Trop sauces, chvoteks sign, prolonged t interval
Tx: Phoslo, calcium replacement, vitamin D
Normal potassium level
3.5-4.5
Causes of hypokalemia, s/s, ekg changes, and tx
Causes: Excessive diuretic use, GI loss, alkalosis, DKA, cooling/hypothermia, albuterol, epinephrine
S/S: Weakness, fatigue, muscle cramps, constipaiton, ileus, polydipsea, polyuria, paralysis, restless leg
EKG: Short QRS, decreased amplitutde, broad T and U waves, and PVCs
Treatment: KCL raises serum levels 0.2 for 10meq
Hyperkalemia causes, s/s, EKG changes, and treatment
Causes: Too much dietary intake, Rhabdo, digoxin, succinylcholine, RF, hemolysis, NSAIDS, acidosis
S/S: Flaccid paralysis
EKG: Peaked t waves and prolonged QRS, sine wave
TX: 10units of insulin with 1 amp of D5 and 1 amp of calcium gluconate, can also give albuterol neb
Causes of hypomagnesemia
Malnutrition, chronic ETOH, CHF, PPOs, celiacs, diuretics
Hypermagnesemia causes and treatment
Causes: primary hyperparathyroidism
Tx: CaGL
Complications of over correction of hypernatremia
Risk of osmotic demlyination syndrome
What does a urine sodium >20 and <10 indicate
> 20 indicates a kidney problem
<10 indicates a problem elsewhere
Causes of hypotonic hypovolemic hyponatremic hypnatremia with a U Na<10
Dehydration
Diarrhea
Vomiting
Causes of Hypotonic Hypovolemic Hyponatremia with U Na >20
Diuretics
ACE
Mineralcorticoids deficiency
