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AHN 568 Fluids Electrolytes Exam Study Guide Solutions
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AHN 568 Fluids Electrolytes Exam Study Guide Solutions Serum Osmolality (normal range) - ANSWER-280-295 mOsm/kg Serum osmolality equation - ANSWER-1. (2 x Na) + BUN /2.8 + Glucose /18 2. When glucose and BUN are normal : 2 x Na Serum Sodium (normal range) - ANSWER-135-145 mEq/L Sodium replac...

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  • November 25, 2024
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  • 2024/2025
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AHN 568 Fluids Electrolytes Exam
Study Guide Solutions


Serum Osmolality (normal range) - ANSWER✔✔-280-295 mOsm/kg


Serum osmolality equation - ANSWER✔✔-1. (2 x Na) + BUN /2.8 +

Glucose /18


2. When glucose and BUN are normal : 2 x Na


Serum Sodium (normal range) - ANSWER✔✔-135-145 mEq/L


Sodium replacement formula - ANSWER✔✔-1. (0.5 or 0.6 x kg) x (desired

Na - serum Na) = mEq Na over 4 hrs


2. Need/Have mEq Na x 1 liter = L/4hrs = ml/hr


3. Maximum correction rate is 8-12 mEq/L/24 hr. OR 25 mEq/L/48 hr.


Anion Gap - ANSWER✔✔-(Na + K) - (Cl + HCO3)


Calcium (normal range) - ANSWER✔✔-8.6-10.2 mg/dL


Ionized Calcium (normal range) - ANSWER✔✔-4.6-5.3 mg/dL
Copyright ©EMILLYCHARLOTE 2025 ACADEMIC YEAR, ALL RIGHTS RESERVED. Page 1/33

,Total Body Water (TBW) formula - ANSWER✔✔-50% of body weight in

women; 60% in men


Phosphorus (normal range) - ANSWER✔✔-2.5-4.5 mg/dL


Potassium (normal range) - ANSWER✔✔-3.5-5.0 mEq/L


Magnesium (normal range) - ANSWER✔✔-1.5-2.5 mg/dL


Severe HypoNatremia management - ANSWER✔✔-1. Only hypotonic

hyponatremia requires treatment directed at sodium.


2. (<120 mEq/L): infuse 3% hypertonic saline to increase Na by 1-2/hr until

rises by 4-6mEq/L


3. Max correction: 8-12 mEq/L per 24hr period or 25 mEq/L per 48hrs.


4. Restrict fluids to 1000ml/24hrs except in hypovolemic


Moderate HypoNatremia Management - ANSWER✔✔-1. Only hypotonic

hyponatremia requires treatment directed at sodium.


2. (120-129 mEq/L): infuse 3% hypertonic saline


3. Restrict fluids to 1000ml/24hrs except in hypovolemic



Copyright ©EMILLYCHARLOTE 2025 ACADEMIC YEAR, ALL RIGHTS RESERVED. Page 2/33

,Mild HypoNatremia Management - ANSWER✔✔-1. Only hypotonic

hyponatremia requires treatment directed at sodium.


2. (130-134 mEq/L): infuse 0.9% saline to correct


3. Restrict fluids to 1000ml/24hrs except in hypovolemic


HyperNatremia Management - ANSWER✔✔-1. >145 mEq/L


2.Correct 1-2 mEq/L to avoid cerebral edema.


3.D/c or reduce saline administration.


4. Increase oral water intake.


5.Mild volume depletion: D5%W


6. Moderate volume depletion: 0.45% NS


7. Severe volume depletion: 0.9% NS; follow with 0.45%NS or D5W when

cardio status stabilized.


FENa - ANSWER✔✔-1. Fractional Excretion of sodium in urine


2. Decrease--> increased renal reabsorption


3. Increase--> renal wasting from ATN



Copyright ©EMILLYCHARLOTE 2025 ACADEMIC YEAR, ALL RIGHTS RESERVED. Page 3/33

, 4. Formula: 100 x [Na (urine) x Creatinine (plasma) /


Na (plasma) x Creatinine (urine)]


HypoCalcium Management, Symptomatic - ANSWER✔✔-1. Acute


2. Calcium chloride 1gm 10% IV over 3-5 mins


3. Calcium gluconate 1gm 10% IV over 3-5 mins x 2 doses


HypoCalcium Management, Asymptomatic - ANSWER✔✔-1. Chronic


2. Calcium carbonate 2-3 gm divided doses daily


3. Adjunct therapy: docusate/senokot


4. Adequate fluid intake


5. Vitamin D supplement: Calitriol (Rocaltrol) 0.5-2mcg/day


HyperCalcium Management, Severe - ANSWER✔✔-1. Malignancy


2. 0.9%NS to restore volume


3. Calcitonin 4-8 IU/kg Q12hrs SQ/IV


4. Bisphosphonates (treatment of choice)


5. Lasix 40-80mg IV Q8-12hrs to maintain urine output 150-200ml/hr


Copyright ©EMILLYCHARLOTE 2025 ACADEMIC YEAR, ALL RIGHTS RESERVED. Page 4/33

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