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ACNP Fluid & Electrolytes: Questions And Solutions
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ACNP Fluid & Electrolytes: Questions And Solutions
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ACNP Fluid & Electrolytes: Questions And SolutionsIsotonic Hyponatremia Right Ans - Pseuohyponatremia- nl Sosm- artifact
d/t lipids or Protein
Hypotonic hyponatremia- 3 types Right Ans - Sosm=low; state of body H20
excess--check UrNa and volume status
(Renal or non-renal)
Hypovolemic w/ UrNa <10 Right Ans - dehydration
diarrhea
vomiting
Hypovolemic w/ UrNa >10 Right Ans - diuretics
ACEI
mineralocorticoid deficiency (adrenal insuff)
SIADH
hypothyroidism
Hypervolemic hypotonic hyponatremia Right Ans - Restrict H2O
edematous states
CHF
liver dz
Advanced RF
Hypertonic hyponatremia Right Ans - Sosm=up
Hyperglycemia
Sosm formula Right Ans - Quick- 2(Na) + 8 (nl BUN/glucose) OR
(2 * (Na) + (BUN / 2.8) + (glucose / 18)
Tx hyponatremia w/ CNS sx Right Ans - hypertonic saline (3%)
Hypernatremia Right Ans - Excess water loss
Sosm=up
Tx of Hypernatremia Right Ans - hypovolemic- NS then 1/2 NS
euvolemia=D5W
hypervolemia= D5 with diuretics
, Hypokalemia- causes Right Ans - diuretics
GI loss
alkalosis
EKG changes hypokalemia Right Ans - decreased amplitude
broad T waves
prominent U waves
PVC's
Oral K replacement Right Ans - > 2.5 and no EKG changes
IV K replacement Right Ans - < 2.5 40 mEq/L/hr IV
10 mEq/hr if stable and can't take po
Electrolyte to check impairing K correction Right Ans - Mg
Hyperkalemia- causes Right Ans - excess intake
renal failure
drugs (NSAIDS)
hypoaldosteronism
cell death
acidosis
EKG changes Hyperkalemia Right Ans - Tall peaked T waves (50% won't
have changes
Hyperkalemia management Right Ans - Time- Kayexalate
>6.5 or cardiac toxic-Insulin 10U & 1 amp D50
Calcium levels are affected by what 3 things? Right Ans - calcitonin
PTH
Vit D
Calcium normal values Right Ans - 8.5-10.5
Ical normal value Right Ans - 4.5-5.5
Which Ca varies with albumin? Right Ans - Total Ca
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