NP Exam: Fluid and electrolyte balance Questions 100% Well Answered.
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Course
NRNP 6550
Institution
NRNP 6550
Hyponatremia - Answer Low sodium. Most common electrolyte abnormality
Urine sodium - Answer Normal is 10-20 mEq/l
Serum osmolality - Answer Usually 2x Na (275-295)
Urine sodium greater than 20 mEq/l - Answer Suggests salt wasting, a problem with the kidneys, intrarenal kidney d...
NP Exam: Fluid and electrolyte balance
Questions 100% Well Answered.
Hyponatremia - Answer Low sodium. Most common electrolyte abnormality
Urine sodium - Answer Normal is 10-20 mEq/l
Serum osmolality - Answer Usually 2x Na (275-295)
Urine sodium greater than 20 mEq/l - Answer Suggests salt wasting, a problem with the kidneys,
intrarenal kidney disease
Urine sodium less than 10 mEq/l - Answer suggests renal retention of sodium to compensate for
extrarenal fluid losses - not a problem in the kidneys - postrenal kidney disease
Occurs with extreme hyperlipidemia or hyperproteinemia
Body water is normal and patient is asymptomatic
Treatment: Cut down fat
No fluid restriction
Hypotonic Hyponatremia - Answer state of body water excess diluting all body fluids, clinical signs arise
from water EXCESS
Serum osmolality less than 280
Hypotonic hyponatremia - Answer Hypovolemic with Urine NA less than 10
-Dehydration
-Diarrhea
-Vomiting
, Hypovolemic with Urine NA greater than 20 (low volume and kidneys cannot conserve Na)
-Diuretics
-ACE inhibitors
-mineralocorticoid deficiency
Hypervolemic (need to restrict water)
-Edematous states
-CHF
-Liver disease
-advanced renal failure
HYPERtonic Hyponatremia - Answer Serum Osmo greater than 290
Hyperglycemia (often from HHNK)
Osmolality is high but Na is low
Hyponatremia management - Answer Treatment based on cause, treat underlying condition
If hypovolemic, give NS IV
If hypervolemic, implement water restriction
If patient is symptomatic, give NS with loop diuretic
If CNS symptoms are present, consider 3% NS with loop diuretics
Hypernatremia - Answer Usually due to excess water loss, always indicates hyperosmolality (ie deficit
of water) Excessive intake of sodium is rare
Management of hypernatremia - Answer 1. Severe hypernatremia with hypovolemia - NS IV followed
by 1/2 NS
2. Hypernatremia with euvolemia should be treated with free water
3. Hypernatremia with hypervolemia should be treated with free water and loop diuretics. May need
dialysis
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