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Fluids And Electrolytes Flashcards

1
Q

What two compartments does water account for?

A
  1. Intracellular
  2. Extracellular
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2
Q

What is fluid status maintained by?

A

Vasopressin

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3
Q

What are the 3 most common causes of hypervolemia?

A
  1. HF
  2. Cirrhosis
  3. Hypoalbuminemia
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4
Q

What are 4 symptoms of hypervolemia?

A
  1. Pitting edema
  2. Muscle weakness
  3. Pulmonary edema
  4. Distended neck veins
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5
Q

What are 2 vital signs that are indicative of hypervolemia?

A
  1. Increased BP
  2. Full peripheral pulses
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6
Q

What are 2 laboratory values used in hypervolemia?

A
  1. Low BUN
  2. Low Hct
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7
Q

How would you clear the fluid for hypervolemia?

A

Loop Diuretics

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8
Q

How much fluid should you restrict for hypervolemia?

A

1-2 L

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9
Q

The most common cause of hypovolemia is renal losses due to _______ or _________.

A

Hyperglycemia; high urea

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10
Q

What are symptoms of hypovolemia? 5

A
  1. Fatigue
  2. Thirst
  3. Orthostasis
  4. Chest pain —> if severe
  5. Confusion —> if severe
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11
Q

A patient presents with symptoms of diminished skin turgor, dry oral mucosa, orthostatic tachycardia or orthostatic hypotension, what do they have?

A

Hypovolemia

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12
Q

An increase in HR of 15-20 bpm when standing

A

Orthostatic tachycardia

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13
Q

> 10-20 mmHg drop in bp when standing

A

Orthostatic hypotension

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14
Q

Laboratory values used for hypovolemia diagnostics?

A
  1. Increased BUN
  2. Increases SCr
  3. Bicarbonate
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15
Q

How would bicarbonate be lost with hypovolemia?

A

Diarrhea

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16
Q

What can you give IV for hypovolemia? 3

A
  1. Normal saline
  2. Colloids
  3. Hypotonic solution
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17
Q

For hypovolemia, what’s the maintenance of fluids?

A

25-30 ml/kg/day

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18
Q

When would you give less fluid in hypovolemia?

A
  1. HF
  2. elderly and frail
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19
Q

What is hypernatremia associated with?

A

High Mortality

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20
Q

What is the most common type of electrolyte abnormality?

A

Hyponatremia

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21
Q

What is the level for hyponatremia?

A

Na <135 mEq/L

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22
Q

What are mild symptoms of hypernatremia? 4

A
  1. Lethargy
  2. Weakness
  3. Restlessness
  4. Twitching
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23
Q

Severe symptoms of hypernatremia include?

A
  1. Seizures, coma, and death
24
Q

What is the level for hypernatremia?

25
In hypovolemic hypernatremia, water loss __ sodium loss
> (Greater)
26
In Euvolemic Hypernatremia, what is lost?
Water only
27
For hypervolemic hypernatremia, water gain ___ sodium gain
<< ( Less)
28
Drug induced hypo_________ is very common
Natremia
29
What drugs can induce hyponatremia? 4
1. Thiazide Diuretics 2. Psychiatric medications 3. Carbamazepine 4. Oxcarbamazepine
30
What is the most common type of electrolyte abnormality?
Hypervolemia hyponatremia
31
What 3 ways can you treat hyponatremia?
1. treat underlying cause 2. If drug induced- change therapy 3. If too much fluid intake, mild fluid restriction
32
What is the level for hyperkalemia?
>5
33
What should you follow with hyperkalemia?
Trends, not a single lab
34
What 4 things can cause hyperkalemia?
1. Acute kidney injury 2. Increased intake 3. Drug induced 4. Transient shifts
35
What 6 drug classes can cause hyperkalemia?
1. Trimethoprim 2. ACEI/ARBs 3. Aldosterone antagonists 4. Calcineurin inhibitors 5. Lithium 6. Potassium sparing diuretics
36
When is hyperkalemia treated?
Chronically, if K is consistently above normal
37
What is the level for hypokalemia?
<3.5
38
What are symptoms that determine the severity in hyperkalemia when K < 2.5?
Palpitations, EKG changes, history of cardiovascular disease
39
What are 3 causes of hypokalemia?
1. Abnormal losses 2. Lack of absorption (Mg deficiency) 3. Drug induced
40
What drugs can cause hypokalemia? 3
1. Diuretics 2. Laxatives 3. Amphotericin B
41
How would you manage hypokalemia?
Replace magnesium first!
42
If hypokalemia is not as severe, how would you treat it?
By trying to remove the underlying cause
43
What is the level for hypercalcemia?
>10.5
44
What is the level for hypocalcemia?
<8.8
45
What form of calcium is best to give for hypocalcemia?
Calcium gluconate
46
What is the most common type of natremia abnormality?
Hypervolemic hyponatremia
47
Orthostatic ____ mostly occurs in women.
Tachycardia
48
Orthostatic _____ occurs mostly in men.
Hypotension
49
If you get a hemolyzed sample for hyperkalemia, what should you do?
Recheck another sample
50
What are transient shifts? 2
1. Acidosis 2. Insulin deficiency
51
When can you consider a bonus of 500 mL with hypovolemia? What should you increase fluids to?
If patient is hypotensive; above 30 mL/kg/day
52
You should match the output at ______ for maintenance then what if hypovolemic?
Minimum; increase above
53
What is the sodium level for severe hypernatremia?
>180 mEq/L
54
For mild fluid restriction of hyponatremia, how much can you increase by at a time?
No more than 12 mEq
55
What is the urine osmolality for hypovolemia?
>450 mOsm/kg

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