Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CK - IM > SUM - CH8 - Fluids 2: > Flashcards

SUM - CH8 - Fluids 2: Flashcards

1
Q

Hypotonic + Mild Hyponatremia (120-130) treatment

A

Restrict water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hypotonic + Moderate hyponatremia (110-120) treatment

A

Loop diuretics + Saline (to prevent renal concentration with ADH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypotonic + Severe hyponatremia (<110): Treatment

A

Give hypertonic saline to increase 1 - 2 mEq/L/h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypovolemic + Hypernatremia: Treatment

A

Isotonic NaCl to restore hemodynamics. Correction of Na+ can wait, until hemodynamically stable. Then replace free water deficit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Isovolemic + hypernatremia: Treatment

A

Oral fluids or D5W

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hypervolemic + Hypernatremia: Treatment

A

Diuretics + D5W (dialyze patients with renal failure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ionized Calcium calculation

A

= Total Ca++ - (Albumin*0.8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hypomagnesemia and Ca+

A

Decreased Mg –> decreased PTH –> Decreased Ca++

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chvostek’s sign

A

Tapping facial nerve leads to twitching of facial muscles in hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Trousseau’s sign

A

Inflate BP cuff > Systolic for 3 min –> carpal spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hypocalcemia: S/S (2)

A
  1. Neuromuscular irritability (hyperactive reflexes, tetany, grand mal seizures)
  2. Arrythmias / Prolonged QT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hypocalcemia: Diagnosis (3)

A
  1. BUN, Cr, Mg, Albumin, Ionized Ca++
  2. PO4
  3. PTH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hypocalcemia: treatment (3)

A
  1. Emergency: Ca++ gluconate
  2. Long term: Ca++ / Vit. D suppliments
  3. PTH def: give Ca++ suppliment with thiazide * also important to correct Mg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Milk-Alkali syndrome

A

Ca++ based antacids –> hypercalcemia and Alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lithium & Ca++

A

Lithium –> PTH in some pts –> Hyper Ca++

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hypercalcemia: S/S

A

Stones

  • nephrocalcinosis/nephrolithiasis

Bones (Osteitis fibrosa cystica)

Groans

  • Muscle aches,
  • pancreatitis,
  • PUD,
  • Constipation,
  • Gout

Psychiatric overtones

  • Depression,
  • fatigue,
  • anorexia,
  • sleep disturbance,
  • anxiety

Other

  • polyuria,
  • HTN,
  • Weight loss,
  • Shortened QT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Urinary cAMP levels

A

Markedly elevated in primary hyperparathyroidism

18
Q

Hypercalcemia: treatment

  • osteoclastic disease
  • Vit. D overload - renal failure
A
  1. Increase urinary excretion:
    1. IV fluids [NS],
    2. Loop diuretics
  2. Inhibit bone resorption in pts with osteoclastic disease:
    1. bisphosphonates,
    2. Calcitonin
  3. Glucocorticoids if Vit. D dependent mechanism or MM
  4. Hemodyalysis in renal failure pts.
19
Q

Hypokalemia: S/S (7)

A
  1. Arrythmias (prolongs normal conduction)
  2. Muscle weakness, fatigue, paralysis, cramps
  3. Decreased DTR
  4. Paralytic ileus
  5. Polyuria / polydipsia
  6. Digitalis tox
  7. Flattening of T-wave (if severe U-wave appears)
20
Q

Hypokalemia: treatment

21
Q

Hypokalemia: Causes

A
  • GI Losses
  • Renal losses
    • Diuretics,
    • hyperaldosteroinism,
    • Excessive glucocorticoids
    • Magnesium deficiency
    • Bartter’s syndrome
  • Other: Epinephrine / insulin
22
Q

Hyperkalemia: S/S

A
  • Arrythmia: Peaked T-waves, Widened QRS, Widened PR interval, loss of P-waves, Sine wave pattern
  • Muscle weakness,
  • Decreased DTR
  • Respiratory failure
23
Q

HyperKalemia: Treat

A
  1. If severe (EKG changes): Give Ca++ IV to stabolize cellular membranes
  2. Shift into cells: Insulin / Glucose (if severe sodium bicarb)
  3. Remove K+ from body
    1. Kayexelate - GI potassium exchange resin
    2. Hemodialysis - only intractable hyperkalemia
    3. Diuretics
24
Q

Hypomagnesemia: Causes

A
  1. GI causes (malabsorption)
  2. Alcohol
  3. Renal causes
    1. SIADH,
    2. Bartters sydnrome,
    3. Gentamicin, amphotericin B, Cisplatin
  4. Other:
    1. Post-parathyroidectomy,
    2. DKA, Thyrotoxicosis,
    3. Lactation,
    4. pancreatitis
25
Hypomagnesemia: treatment
oral Mg++
26
Hypermagnesemia: Causes
Renal failure Excessive Mg++ containting laxitives / antacids Adrenal insufficiency Rhabdomyolysis
27
Hypermagnesemia: S/S
* Facial Paresthesias * Progressive loss of deep tendon reflexes * ECG: Increased PR interval, Widened QRS, elevated T waves * Death by respiratory failure or cardiac arrest
28
Hypermagesemia: Treatment
Emergency: IV Calcium gluconate Administer Saline and furosemide
29
Hypophosphatemia: causes
Decreased intestinal absorption * Alcohol use * Vit. D deficieny * Excessive use of P binding antacid Increased renal excretion * Excess PTH * Hyperglycemia * Oncogenic osteomalacia * ATN * Renal tubular acidosis * Hypokalemia / Hypomagnesemia Other * Respiratory alkalosis * Anabolic steroids
30
Hypophosphatemia: treat
Oral supplimentation
31
Hyperphosphatemia: Causes
1. Decreased renal function 2. Bisphosphonates, Hypoparathyroidism, Vit. D intox, 3. Tumor Calcinosis 4. Rhabdomyolysis 5. Acidosis
32
Hyperphosphatemia: S/S
1. Metastatic calcification and soft tissue calcifications 2. Hypocalcemia --\> neurologic changes 1. Tetany, neuromuscular irritability 3.
33
Hyperphosphatemia: Treatment
Phosphate binding antacids containing aluminum hydroxide or carbonate
34
Acidosis: Effects
* Right shift in O2 bindng curve: More O2 delivery * Depresses CNS * Decreased Pulmonary Blood flow * Impaired myocardial function * Hyperkalemia
35
Alkalosis: effects
* Left shift in O2 Saturation curve: less O2 delivered * Decreased cerebral blood flow * Arrhythmias * Tetany/seizures
36
Metabolic Acidosis: S/S
* Hyperventilation: Kussmaul breathing * Decreased Cardiac output / decreased tissue perfusion * Acid --| Catecholamine action
37
Saline sensitive metabolic Alkalosis
ECF Contraction and hypokalemia, (urine chloride \<10 mEq/L)
38
Saline resistant metabolic alkalosis
ECF expansion, hypertension, urine chloride \> 20 (dt/ excessive mineralocorticoids, Severe K+ deficiency, Bartters)
39
Acute Respiratory Acidosis: Bicarb Change
1 per every 10 CO2 change
40
Chronic respiratory Acidosis: Bicarb change
4 per 10 CO2 change
41
Situations requiring intubation: resp acidosis
1. Severe acidosis 2. PACO2 \>60 or inability to increase Pa O2 with supplimental oxygen 3. Deterioration in mental status 4. Impending respiratory fatigue
42
Respiratory Alkalosis: S/S
* Decreased cerebral blood flow: Associated symptoms * Tetany (similar to hypocalcemia) * Arrythmias

CK - IM (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions