Fluid and Electrolytes

Question 1

What is osmosis?

Answer 1

Movement of water from low to high solute concentration.

Question 2

What is diffusion?

Answer 2

Passive movement of molecules from high to low concentration.

Question 3

What is filtration?

Answer 3

Movement of water and solutes through a membrane due to hydrostatic pressure.

Question 4

What is active transport?

Answer 4

Movement of substances against the concentration gradient requiring energy.

Question 5

What role do the kidneys play in fluid balance?

Answer 5

Regulate water and electrolytes through urine output.

Question 6

How do the lungs contribute to fluid balance?

Answer 6

Remove water through exhalation (~300mL daily, more with increased RR).

Question 7

What is the function of ADH (Antidiuretic Hormone)?

Answer 7

Released from the hypothalamus to retain water.

Question 8

What does aldosterone do?

Answer 8

Promotes sodium and water retention.

Question 9

What are natriuretic peptides (ANP & BNP)?

Answer 9

Counteract RAAS by promoting sodium and water excretion.

Question 10

What is fluid volume deficit (hypovolemia)?

Answer 10

A condition characterized by a decrease in blood volume.

Question 11

What are common causes of hypovolemia?

Answer 11

• Vomiting
• Diarrhea
• Sweating
• GI suctioning
• Third-spacing (burns, ascites)
• Polyuria

Question 12

What are clinical manifestations of hypovolemia?

Answer 12

• Hypotension
• Tachycardia
• Dry mucous membranes
• Decreased urine output

Question 13

What is the management for hypovolemia?

Answer 13

• IV/oral fluids
• Monitor I&O
• Assess mental status and vital signs

Question 14

What is fluid volume excess (hypervolemia)?

Answer 14

A condition characterized by an increase in blood volume.

Question 15

What are common causes of hypervolemia?

Answer 15

• Excess IV fluids
• Heart failure
• Renal failure
• SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)
• Liver cirrhosis

Question 16

What are clinical manifestations of hypervolemia?

Answer 16

• Edema
• Hypertension
• Pulmonary congestion
• Weight gain

Question 17

What is the management for hypervolemia?

Answer 17

• Diuretics
• Fluid restriction
• Sodium restriction
• Monitoring electrolyte levels

Question 18

What is hypernatremia?

Answer 18

Sodium level >145 mEq/L.

Question 19

What are the causes of hypernatremia?

Answer 19

• Water loss (diabetes insipidus, dehydration)
• Sodium gain

Question 20

What are clinical manifestations of hypernatremia?

Answer 20

• Thirst
• Restlessness
• Seizures
• Coma

Question 21

What is the management for hypernatremia?

Answer 21

• Hypotonic IV fluids
• Diuretics
• Monitor CNS changes

Question 22

What is hyponatremia?

Answer 22

Sodium level <135 mEq/L.

Question 23

What are the causes of hyponatremia?

Answer 23

• SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion)
• Excessive water intake
• Diuretics

Question 24

What are clinical manifestations of hyponatremia?

Answer 24

• Confusion
• Seizures
• Headache
• Nausea

Question 25

What is the management for hyponatremia?

Answer 25

* Fluid restriction * Sodium replacement * Monitor neuro status

Question 26

What is hyperkalemia?

Answer 26

Potassium level >5.0 mEq/L.

Question 27

What are the causes of hyperkalemia?

Answer 27

* Renal failure * Acidosis * Tissue trauma

Question 28

What are clinical manifestations of hyperkalemia?

Answer 28

* ECG changes (peaked T waves) * Muscle weakness * Cardiac arrest

Question 29

What is the management for hyperkalemia?

Answer 29

* Diuretics * Insulin with glucose * Calcium gluconate

Question 30

What is hypokalemia?

Answer 30

Potassium level <3.5 mEq/L.

Question 31

What are the causes of hypokalemia?

Answer 31

* Diuretics * Vomiting * Metabolic alkalosis

Question 32

What are clinical manifestations of hypokalemia?

Answer 32

* Weakness * Cramps * ECG changes (flattened T waves) * Dysrhythmias

Question 33

What is the management for hypokalemia?

Answer 33

* K+ supplements * Monitor ECG * Dietary potassium

Question 34

What is hypercalcemia?

Answer 34

Calcium level >10.5 mg/dL.

Question 35

What are the causes of hypercalcemia?

Answer 35

* Hyperparathyroidism * Malignancy * Excessive Ca/Vitamin D intake

Question 36

What are clinical manifestations of hypercalcemia?

Answer 36

* Lethargy * Kidney stones * Decreased reflexes

Question 37

What is the management for hypercalcemia?

Answer 37

* Hydration * Loop diuretics * Bisphosphonates

Question 38

What is hypocalcemia?

Answer 38

Calcium level <8.8 mg/dL.

Question 39

What are the causes of hypocalcemia?

Answer 39

* Hypoparathyroidism * Renal failure * Pancreatitis

Question 40

What are clinical manifestations of hypocalcemia?

Answer 40

Tetany (muscle spams), muscle cramps, and Chvostek’s/Trousseau’s sign

Question 41

What is the management for hypocalcemia?

Answer 41

* Calcium supplements * IV calcium gluconate * Seizure precautions

Question 42

What is hypermagnesemia?

Answer 42

Magnesium level >2.6 mg/dL.

Question 43

What are the causes of hypermagnesemia?

Answer 43

* Renal failure * Excessive Mg intake (antacids, laxatives)

Question 44

What are clinical manifestations of hypermagnesemia?

Answer 44

* Hypotension * Lethargy * ECG changes

Question 45

What is the management for hypermagnesemia?

Answer 45

* Calcium gluconate * Diuretics * Dialysis

Question 46

What is hypomagnesemia?

Answer 46

Magnesium level <1.8 mg/dL.

Question 47

What are the causes of hypomagnesemia?

Answer 47

* Chronic alcoholism * GI losses * Diuretics

Question 48

What are clinical manifestations of hypomagnesemia?

Answer 48

* Tremors * Seizures * Cardiac dysrhythmias

Question 49

What is the management for hypomagnesemia?

Answer 49

* IV Mg * Dietary Mg (nuts, green veggies)

Question 50

What is hyperphosphatemia?

Answer 50

Phosphate level >4.5 mg/dL.

Question 51

What are the causes of hyperphosphatemia?

Answer 51

* Renal failure * Tumor lysis * Hypoparathyroidism

Question 52

What are clinical manifestations of hyperphosphatemia?

Answer 52

* Tetany (muscle spams) d/t hypocalcemia (inverse) * Soft tissue calcifications

Question 53

What is the management for hyperphosphatemia?

Answer 53

* Phosphate binders * Dialysis * Hydration

Question 54

What is hypophosphatemia?

Answer 54

Phosphate level <2.7 mg/dL.

Question 55

What are the causes of hypophosphatemia?

Answer 55

* Malnutrition * Alcoholism * DKA recovery

Question 56

What are clinical manifestations of hypophosphatemia?

Answer 56

* Muscle weakness * Respiratory failure

Question 57

What is the management for hypophosphatemia?

Answer 57

* Phosphate replacement * Dietary intake (dairy, meat)