Flashcards in Fluid Balance Deck (31):
What is the normal range for K+?
What is the normal range for Na+?
What is the normal range for Cl-?
What is the normal range for Mg++?
What is the normal range for Ca++?
What is the management of hyperkalaemia?
dextrose and insulin - make K+ go in the cells (can also use salbutamol 12 puffs)
calcium gluconate/carbonate - stabilise cell membrane
frusemide, resonium (30g), or dialysis - get rid of the K+
What should always be given with resonium?
What are the ECG signs of hyperkalaemia?
peaked T waves, flat and wide P waves, broad flat QRS complexes, torsades
What causes hyperkalaemia?
potassium sparing diuretics, potassium supplements, fluid with too much potassium
What causes hypokalaemia?
frusemide, refeeding syndrome
What is the management of hypokalaemia?
oral: slow K or chlorvescence
IV: 10mmol KCl in 100mL NS over 1 hour or 30mmol in 1L over 6-8 hours
What are the ECG signs of hypokalaemia?
T wave inversion, high and wide P waves, ST depression, long QT, torsades
How much K+ should you give in maintenance fluid therapy?
30mmol in every third bag/litre
What should you also give when topping up K+?
What are the causes of hyponatraemia?
too much water
What is the management of a hyponatraemic patient who is seizing?
100mL bolus of 20% saline
What is the complication of correcting sodium too quickly?
central pontine myelinolysis
What is the appropriate rate to correct sodium at?
8mmol per day
What three investigations are diagnostic for SIADH?
high urine osmolality
low serum osmolality
high urinary Na+
How do you treat hyponatraemia if they're also hypovolaemia?
0.9% normal saline 10hrly
How do you treat hyponatraemia if they're also euvolaemic?
fluid restrict - no free water (only fluids with solute in them e.g. tea, juice
How do you treat hyponatraemia if they're also hypervolaemic?
What do you do if you over correct sodium too quickly?
fill them with dextrose
What are the causes of hypernatraemia?
being intravascularly deplete
too much hypertonic saline
What is the management of hypernatraemia?
5% dextrose 10 hourly
low salt diet
What is the cause of hypercalcaemia?
metastatic cancer (breast, prostate)
tumour lysis syndrome
too much PTH
What is the management of hypercalcaemia?
frusemide with normal saline
What are the signs and symptoms of hypercalcaemia?
stones (kidney stones)
bones (bone related complications)
abdominal groans (indigestion, nausea)
thrones (constipation and polyuria)
psychiatric overtones (depression, psychosis, delirium)
What is magnesium used to treat?
What is the side effect of too much normal saline?