Hyponatremia and Electrolyte Disorders CIS Flashcards Preview

RENAL II Exam 3 > Hyponatremia and Electrolyte Disorders CIS > Flashcards

Flashcards in Hyponatremia and Electrolyte Disorders CIS Deck (28):
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

renal tubular cell regeneration

cuboidal first
-little water resorption
-lots of dilute urine

eventually - differentiates to brush border
-normal urine restored