Flashcards in Hyponatremia and Electrolyte Disorders CIS Deck (28)
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1
serum osmolarity
2xNa + BUN/2.8 + glucose/18
2
dehydrated low sodium
because of ADH secretion - water retention
3
hyponatremia
most cases involved excess of ADH
4
normal serum osmolarity
280-295
5
isotonic hyponatremia
hyperprotein
hyperlipid
6
hypertonic hyponatremia
hyperglycemia
mannitol, maltose
contrast dye
ethylene glycol
7
hypotonic hyponatremia
look at volume status
8
hypervolemic hypotonic hyponatremia
UNa < 10
edema
-CHF, liver disease, nephrotic, advanced kidney disease
9
euvolemic hypotonic hyponatremia
UNa >20
SIADH
10
hypovolemic hypotonic hyponatremia
extrarenal or renal
-look at NUa
UNa 20 renal
11
hypovolemic hypotonic hyponatremic with UNa <10
extrarenal salt loss
-dehydration, vomiting, diarrhea, burns
12
hypovolemic hypotonic hyponatremia with UNa >20
renal salt loss
-diuretics
-ACE (-)
-addisons
-cerebral sodium wasting
-obstruction
-type IV RTA
13
hyponatremia definition
Na < 135
14
for every 2 Na you absorb
dump 1K and 1H
-makes it hypokalemia and alkalotic
15
tests for low K
EKG
-flat, inverted T waves and U waves
16
increased BUN
elevated reabsorption with increased ADH (creates gradient for water)
-also - prox tub higher BUN gradient if volume low
17
elevated BUN/Cr
high protein
pre-renal disease
post-renal disease
18
low BUN/Cr
<10/1
liver failure, malnutrition, overhydration, preganancy, SIADH
19
BUN/Cr of 10:1
normal renal function (Cr1)
20
muddy brown casts
acute tubular necrosis
21
causes of ATN
ischemia
toxins
22
EKG hyperkalemia
prolonged PR interval and peaked T waves
23
crush injury rhabdomyolysis
massive release of phosphate, uric acid, and K
24
slow phosphate replacement
to avoid hypocalcemia
25
pigmented granular casts and renal tubular epithelial cells
ATN
26
ischemic ATN
shock
hypoP
27
toxic ATN
myoglobin
28
