Sodium and Water Flashcards

1
Q

what are U&E’s

A

urea and electrolytes

such as Na, K, Cl, HCO3, urea and creatinine

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2
Q

what are the basic subtypes of abnormal electrolyte disorders

A

can indicate primary state disease

secondary consequence of a multitude of diseases

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3
Q

why, physiologically, are electrolytes important

A

maintenance of cellular homeostasis
implications on cardiovascular physiology
implications on renal physiology
electrophysiology (CNS, heart)

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4
Q

what are some clinical examples of electrolyte disturbances

A
haemorrhage 
D&V 
poor intake 
increased losses
DI 
DM
diuretic therapy 
endocrine disorders (ADH, aldosterone)
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5
Q

what are the 5 concepts of electrolyte balance

A

concentrations, compartments, contents, volumes rates of gain and loss

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6
Q

what does the concentration of electrolytes depend on

A

water in and out

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7
Q

what is the normal Na+ plasma conc

A

140 mmol/L

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8
Q

what would happen to electrolyte conc in decreasing or increasing ECF/ICF fluid volume

A

decreasing ICF/ECF = increase conc of electrolyte in plasma

increasing ICF/ECF = decreased conc of electrolyte in plasma

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9
Q

what happens when you lose isotonic fluid

A

nothing as conc roughly same as blood, no change in conc and no fluid redistribution
cell shrink

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10
Q

what happens when you lose hypotonic solution

A

eg water and fluid of lower conc than blood
greater loss from ICF than ECF = increase in Na conc
cell shrink

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11
Q

what happens when you gain isotonic fluid

A

no change in conc but an increase in BP

cell oedema

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12
Q

what happens when you gain hypotonic fluid

A

greater gain to ICF than ECF
small decrease in Na
causes cell oedema

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13
Q

what are the three physical compensatory mechanisms of alter electrolyte balance

A

thirst
ADH
RAS

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14
Q

what is the role of ADH is electrolyte balance

A

produced by median eminence with increased water osmolality
decreases water loss and increase water retention
increases thirst

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15
Q

how does the RAS aid electrolyte balance

A

renin - angiotensin - aldosterone
activated by reduced vascular volume, sodium depletion or haemorrhage
causes renal sodium retention

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16
Q

what are two therapeutic techniques for electrolyte imbalance

A

IV therapy

diuretics

17
Q

what is hyponatraemia, hypernataemia, dehydration in terms of water and sodium

A

hypo - small Na in ECF with excess water
hyper - large Na in ECF with small water
Dehy - na and water depletion

18
Q

how is hyponatraemia caused by diuretics

A

decrease in urine Na re-absoprtion so more na released in urine which decreases GFR and increases plasma creat, urea and ADH

19
Q

how is hyponatraemia caused by SIADH

A

syndrome of inappropriate ADH

stops water loss so dilutes Na in your system

20
Q

describe how hypernatreamia is caused by decreased water intake

A

less water = more Na conc in blood, increase in urine osmolality and decrease in urine volume
increase in plasma creat and urea

21
Q

describe how hypernatraemia is caused by osmotic diuresis

A

increase in plasma glucose which increases renal loss - this increase haemoconcentraiton and increases plasma Na conc
also increases plasma creat and urea