Term
| what is the normal range for Na |
|
Definition
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|
Term
if hypovolemic what is the situaiton with the Na?
what is hypervolemic? |
|
Definition
DEPLETED EVEN IF SHOWS HYPERNATREMIC
OVERLOADED, EVEN IF LAB SHOWS DEPLETION |
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|
Term
| if labs and sxs show hypovolemia and hyponatremia, what does this mean? |
|
Definition
| the person lost more Na than water |
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Term
| if person hypovolemic and hypernatremic what does this mean |
|
Definition
| person lsot most water than Na, so jsut use 1/2 Ns and 1/2 normal water |
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Term
| if pt is hypervolemic an adhyponatremic what shoudl be done? |
|
Definition
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Term
| if pt is hypervoelmic and hypernatremic what should be done? |
|
Definition
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Term
| if Na is below about 120 what are the symtpoms?-2 |
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Definition
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Term
| if Na below 115 what is the symtpoms?-2 |
|
Definition
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|
Term
how do you calculate serum osmolality of Na?
what does this determine? |
|
Definition
2 x Na + glucose/18 + BUN/2.8
tonicity |
|
|
Term
| what is the normal Na serum osmalality/tonicity |
|
Definition
|
|
Term
| causes of hypertonic hyponatremia-2 |
|
Definition
hyperglycemia
mannitol/toxic alcogol |
|
|
Term
for hyperglycemia what need to be done for Na?
what is the equation |
|
Definition
corrected
1.6 x (glucose-100/100)+ Na |
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|
Term
| for the mannitol causes hyponatremia, what can you calculate to check it is due to this alcohol toxicity? |
|
Definition
osmolal gap (measured -calculated)
>10 = gap |
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|
Term
| Na is falsely _ due to hyperglycemia |
|
Definition
|
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Term
| causes of isotonic hyponatremia-2 |
|
Definition
hyperprotein
hyperlipid
bladder irrigation
pseudohyponatremia |
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|
Term
| Go look at slide 36 to review drugs causing nyponatremia right before test |
|
Definition
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Term
| if hyponatermic and hypotonic what is the next quesiton you ask to deterrmine cause? |
|
Definition
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|
Term
| if ECF volume is decreased in hyponatremia what cna bea cause-3 |
|
Definition
HF
cirrohis
renal insufficeincy |
|
|
Term
| if ECF volume is normal in hypotonic hyponatremia what can be causes?-2 |
|
Definition
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|
Term
| if ECF is decreased with hyponatremia and hypotonic what dfferentiaes causes and then what cna be causes: |
|
Definition
<10 mosm: NA loss, diuretic use
>20 mmol/L: Na easter, diuretic |
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|
Term
Treatment Hyponatremia:
if hypertonic |
|
Definition
| treat underlying condition |
|
|
Term
Treatment Hyponatremia:
if isotonic |
|
Definition
| treat underlying condition |
|
|
Term
Treatment Hyponatremia:
hypotonic and hypovolemic-
when do you use .3% saline? |
|
Definition
do fluid replacment with .9% saline
if severely symptomatic |
|
|
Term
| what rate of correction of sdoium should be used for Na in hypotonic hyponatremic and HYPOvolemic? |
|
Definition
| less than 12 mEq/L in 24 hours |
|
|
Term
Treatment for hyponatremi:
hypotonic and hypervolemia-2
when can you use drugs? -2 |
|
Definition
treat underlying condition
fludi restrciton <1500 mL/day
diuretics can be used in CHF or cirrohis |
|
|
Term
Treatment for hyponatremi:
hypotonic and euvolemic-3 |
|
Definition
fluid restiction <1500 mL/day
IV 3% saline if severe symptoms
+/- loop diuretic |
|
|
Term
what tetracycline can be used for hypotonic hyponatremia euvolemic
what is its MOA
Dose: |
|
Definition
demeclocycline
inhibits the ADH on kidneys
600-1200 per day |
|
|
Term
demeclocycline is good for what kind of cases and why?
ADEs-2 |
|
Definition
chronic, bc onset is several days
photosens, nephrotox |
|
|
Term
| AVP receptor anatagonists cna be used for- |
|
Definition
| hyponatremia, hypotonic, euvolemic |
|
|
Term
| what are the AVP antagonists-3 |
|
Definition
conivaptan
lixivaptan
tolvaptan |
|
|
Term
| what is MOa of AVP recpt antags |
|
Definition
stimulate free water excretion
imrpove sodium conc |
|
|
Term
dosing for conivaptan
loading:
maintenance: |
|
Definition
20 mg IV via 30min infusion
continuous 20 mg Q24 hrs and repeat ev 1-3 days |
|
|
Term
rate correciton for Na in hyponatremia if asymptomatic-
what is max |
|
Definition
increase by .5-1mEq/hr
10-12 per hours |
|
|
Term
| if symtpomatic, what should correction for Na for hyponatremia be? |
|
Definition
|
|
Term
| what happens if correct Na too fast- what are the symtpoms? |
|
Definition
osmotic demylination
paralysis, dysarthia |
|
|
Term
| symtpoms of hypernatremia-3 |
|
Definition
| anorexia, muscle weakness, altered mental status, coma |
|
|
Term
| ppl with hypernatremia are usually what kind of tonicity |
|
Definition
|
|
Term
| causes of hypovolemia HYPERNATREMIA-2 |
|
Definition
|
|
Term
| cause of hypernatremia and euvolemia |
|
Definition
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|
Term
hypernatremia treatment:
what ist he rate of Na corection? |
|
Definition
|
|
Term
| what is normal range fro potassium |
|
Definition
|
|
Term
| when do you see symptoms of hypokalmeia |
|
Definition
|
|
Term
how do you know if hypokalmeia caused by renal losses?
if not this (so extrarenal losses) what is the major cause |
|
Definition
if urien potassium >20
GI loss (laxative, diarrhea, etc) |
|
|
Term
| what is the most common cause of hypokalemic? |
|
Definition
|
|
Term
| drugs that cause hypokalemia-4 |
|
Definition
diuretic
Bicarb
insulin
albuterol |
|
|
Term
what supplement is best for hypokalemia?
why |
|
Definition
potassium chloride
most effetive when caused by diuretic or diarrhea |
|
|
Term
| when do you use K phosphorus for hypoK? |
|
Definition
|
|
Term
| if need to replete K quickly what form of supplement is used |
|
Definition
|
|
Term
| when do yuo do IV hypoK treatment |
|
Definition
| symtpomatic and unable to tolerate oral |
|
|
Term
rate for hypoK if unmonitored
if telemetry |
|
Definition
|
|
Term
| if K doesnt improve in48-72 hours, what other electroylte deficiency is probbably the cause? |
|
Definition
|
|
Term
| hyperkalemia, how do you knwo if it is severe?-2 |
|
Definition
|
|
Term
| drugs that cause hyperK-4 |
|
Definition
ARB
ACEi
spirnonalactone
heparin |
|
|
Term
| what disease can cause hyper K |
|
Definition
|
|
Term
if severe hyper K what other treatment besides lower K needs to be done?
how do you do tis? |
|
Definition
membrane stablization
Ca gluconate IV |
|
|
Term
treatment for hyperK:
insulin |
|
Definition
| 10 units insulin (+ 50 mL of dextrose if not hyperglycemic) |
|
|
Term
treatment for hyperK:
B agonist |
|
Definition
s10-20 mg/mL per dose
lasts for 2 hours |
|
|
Term
treatment for hyperK:
sodium bicarb |
|
Definition
| increases pH, but not effective |
|
|
Term
| what is the most effective but most unreasonable treamtent for hyperK |
|
Definition
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