Fluid & electrolyte disturbances Flashcards
(36 cards)
1
Q
hyponatremia- Sx
A
- Nausea, malaise, HA, disorientation
- Seizure
- Coma
- Brain damage
- Resp arrest
- Brainstem herniation
- Often due to H2O inbalance rather than Na
2
Q
hyponatremia- Dx
A
- Serum electrolytes
- creatinine,
- osmolality,
- urine sodium
3
Q
hyponatremia- Tx
A
- Restrict water
- Isotonic fluids
- Diuretics
- Discontinue meds
- Vasopressin antagonists
4
Q
Hypernatremia- Sx
A
- Orthostatic hypotension
- Oliguria
- Lethargy, irritability, weakness
- hyperthermia, delirium, seizures, coma
- May not be specific in elderly
5
Q
Hypernatremia- Dx
A
- Urine osmolality
- Serum osmolality
6
Q
Hypernatremia- Tx
A
- Correct fluid loss with dextrose & saline water over 48 hrs
- Add K & phosphate as needed
7
Q
Hypokalemia- Sx
A
- Muscular weakness, muscle cramps
- Hyporeflexia, hypercapnia, tetany, rhabdomyolysis
- Hypertension
8
Q
Hypokalemia- Dx
A
- ECG- U waves
- Serum & urine concentration
- TTKG
- Hypomagenesmia
9
Q
Hypokalemia- Tx
A
- Dietary to IV K
- Mg required to replete
10
Q
Hyperkalemia- Sx
A
- Abd distension & diarrhea
- Musc weakness, flaccid paralysis, ileus
- Cardiac arrythmias
11
Q
Hyperkalemia- Dx
A
- Plasma potassium
- Creatinine, lytes
- ABG
ECG- peaked T waves
12
Q
Hyperkalemia- Tx
A
- Withhold K
- Insulin, bicarb, beta agonists to shift K into cells
- IV Ca++ to stabilize myocardium
- Hemodialysis
13
Q
Hypocalcemia- Sx
A
- Extensive spasm- cramps & tetany
- Laryngospasm with stridor
- Covulsions, paresthesias, abd pain
- Trousseau sign
- Chvostek sign
14
Q
Hypocalcemia- Dx
A
- Serum calcium
- Elevated serum phosphate
- PTH
- Low serum Mg
- Vit D levels
- ECG- Prolonged QT interval
15
Q
Hypocalcemia- Tx
A
- Calcium infusion over 4-6 h
- Oral/ IV Ca++ carbonate
- Vit D
Thiazide diuretic to reduce renal loss
16
Q
Hypercalcemia- Sx
A
- GI, kidney & neuro fxn
- Constipation & polyuria
- N/V
- Hematuria
- Depression, stupor, lethargy
17
Q
Hypercalcemia- Dx
A
- Serum & ionized Ca
- Urine Ca
- PTH
18
Q
Hypercalcemia- Tx
A
- Establish euvolemia to induce renal excretion
- dialysis
- Bisphosphonates
19
Q
Hypophosphatemia- Sx
A
- Resp failure
- Encephalopathy
- Arrhythmia
- Anorexia
- Fracture
- Hemeolytic anemia- petechea
20
Q
Hypophosphatemia- Dx
A
- Urine phosphate
- PTH
21
Q
Hypophosphatemia- Tx
A
- Oral phoshate replacement
22
Q
Hyperphosphatemia- Sx
A
- Symptoms of underlying disease
- Extraosseous calcification of soft tissue/ vasculature
- Acute kidney injury
- Secondary hyperparathyroidism
- Renal osteodystrophy
23
Q
Hyperphosphatemia- Dx
A
Serum phosphate
24
Q
Hyperphosphatemia- Tx
A
- Tx underlying disorder
- Calcium carbonate
- Decreased intake- dairy, meats, processed foods
25
Hypomagnesemia- Sx
- Neuromuscular & nervous system hyper irritability
- Termors
- Babinski response
- Nystagmus
- HTN, tachycardia, ventricular arrhthymia
- Weakness & cramping
26
Hypomagnesemia- Dx
- Serum magnesium
- Urine excretion
- Low PTH
- Hypo kalemia, calcemia
27
Hypomagnesemia- Tx
- IV Mg sulfate
28
Hypermagnesemia- Sx
- Decreased DTR
- Confusion & weakness
- Mental obundation
- Resp muscle paralysis, cardiac arrest
29
Hypermagnesemia- Dx
- Serum Mg
| - Elevated- BUN, Serum creatinine, uric acid
30
Hypermagnesemia- Tx
- Calcium chloride as antagonist
31
Hyponatremia w/ high plasma osmolality
- Hyperglycemia
32
Hyponatremia w/ normal plasma osmolality
- Hyperlipidemia
- Hyperproteinemia
- Commonly due to lab error
33
Hyponatremia w/ low plasma osmolality
- Most common
- Hypovolemia
- Euvolemia
- Hyper volemia
34
Hyponatremia w/ low plasma osmolality- Hypovolemia
Thiazides, hypoaldosterone, renal salt wasting, V/D, blood loss, 3rd spacing
35
Hyponatremia w/ low plasma osmolality- Euvolemia
Most common
- SIADH
- Hypothyroid
- Adrenal insufficiency
- primary polydipsia
36
Hyponatremia w/ low plasma osmolality- Hypervolemia
HF, cirrhosis, liver failure, nephrotic syndrome
