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33 Cards in this Set
- Front
- Back
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normal Na range
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135-145 mEq/L
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normal osmolality range
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275-290 mOsm/kg
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osmolality equation
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osmolality = 2Na + (Glu/18) + (BUN/2.8)
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TB Na and TBW status in hypovolemic hypotonic hyponatremia
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-2 TB Na
-1 TBW |
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TB Na and TBW status in isovolemic hypotonic hyponatremia
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+/- TB Na
+1 TBW |
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TB Na and TBW status in hypervolemic hypotonic hyponatremia
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+1 TB Na
+2 TBW |
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treatment of hyponatremia
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fluid restriction
3% NaCl (SLOWLY) +/- furosemide |
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dose and rate of Na correction in severe, symptomatic, acute onset (<48 hrs) hyponatremia
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1.5-2 mEq/L/hr
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dose and rate of Na correction in chronic (>2 days or unknown) hyponatremia
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0.5-1 mEq/L/hr
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max dose and rate of 3% NaCl administration
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12 mEq/L/24 hrs
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drugs that induce SIADH (12)
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-cyclophosphamide
-vincristine -haloperidol -thioridazine -thiothixene -carbamazepine -SSRIs (fluoxetine) -TCAs (amitriptyline) -desmopressin -NSAIDS -opiates -oxytocin |
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normal K levels
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3.5-5 mEq/L
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EKG changes seen in hyperkalemia
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-peaked/tented T waves
-prolonged PR interval -widened QRS complex -shortened QT interval |
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if EKG changes with hyperkalemia
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severe!!!
give CaCl2 or Ca gluconate IVP to increase membrane potential and stabilize electrical conduction |
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if no EKG changes with hyperkalemia
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less severe
get rid of excess K - dextrose to stimulate insulin, which pushes K back into cells insulin given with D5W to avoid hypoglycemia can also give diuretics |
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normal Cl levels
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95-106 mEq/L
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normal CO2 levels
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22-28 mEq/L
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anion gap equation
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AG = Na-(Cl+HCO3)
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normal BUN levels
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8-20 mg/dL
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normal Cr levels
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0.7-1.5 mg/dL
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normal Ca levels
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8.6-10.2 mg/dL
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diseases that cause hypocalcemia
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-hypoalbuminemia
-hypoMg -alkalosis -pancreatitis -sepsis -renal failure -hyperPO4 -secondary hyperparathyroidism |
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actions that cause hypocalcemia
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-low Ca/vitD intake
-citrated blood transfusion (chelator) -rapid IV PO4 administration |
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drugs that cause hypocalcemia
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-calcitonin (tones down Ca)
-pamidronate -steroids -loop diuretics -phenytoin (increase vitD catabolism) -phenobarbital (increased vitD catabolism) -aluminum antacids (suppresses PTH) -cisplatin |
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which ion abnormality should ALWAYS be corrected FIRST
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MAGNESIUM
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treatment of mild hypercalcemia
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hydration
0.9% NS ambulation |
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treatment of severe hypercalcemia
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hydration
IV furosemide bisphosphonates (etidronate, pamidronate, zoledronic acid) glucocorticoids, calcitonin dialysis |
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what should you avoid with hypercalcemia
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IV PHOSPHATES!!!
Ca combines with PO4 and will precipitate |
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normal PO4 levels
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2.6-4.5 mg/dL
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normal Mg levels
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1.5-2.4 mg/dL
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conditions that cause hypoMg
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-vomiting
-diarrhea -alcoholism -renal losses -starvation/malnutrition -trauma/surgery -infection |
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drugs that cause hypoMg
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-loops
-aminoglycosides -amphotericin B -cisplatin -cyclosporine -high dose steroids |
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hypoMg can lead to...
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refractory hypoK and hypoCa
arrhythmias (TdP) |
