Fluids And Electrolytes

Front 1

impermeable solute concentration

Back 1

Tonicity

Front 2

total solute concentration(impermeable + permeable)

Back 2

Osmolality

Front 3

Normal values of Osmolality

Back 3

275-290 mOsm/L

Front 4

Blood draws are taken from here

Back 4

Intravascular fluid

Front 5

Arterial blood volume is also referred to as?

Back 5

ECV: effective circulating volume

Front 6

D5W is used to replace fluids under what condition?

Back 6

Water deficit or hypernatremia

Front 7

NS; normal saline is replacement fluid for what?

Back 7

GI tract fluid losses; hypotension; dehydration; minor blood loss

Front 8

Which stays in intravascular more? D5W or NS

Back 8

NS

Front 9

3% NS is used for what condition?

Back 9

SIADH

Front 10

LR; Lactated Ringers are used for fluid replacement in what conditions?

Back 10

acidosis; fluid loss from pancreas or small bowel

Front 11

What remains in IVF; intravascular fluid better than crystalloids?

Back 11

Plasma expanders such as albumin, hetastarch, dextrans

Front 12

In hypovolemia, what fluid is used and its purpose?

Back 12

NS to replace fluids. (If cause is from blood loss then blood transfusion)

Front 13

In Euvolemia, how is daily maintenance fluid volume calculated?

Back 13

100mL/kg for first 10kg
add 50ml/kg for 10kg-20kg
add 20ml/kg for >20kg

Front 14

What fluid combination may be used in Euvolemia conditions?

Back 14

D5W/0.45%NS

Front 15

In Hypervolemia, what should be restricted or given to correct this?

Back 15

Restrict fluids, Restrict sodium.
May give diuretic.

Front 16

Which of these would be less likely to distribute out of the IVF?
Albumin, D5W, NS

Back 16

Albumin

Front 17

The most common electrolyte abnormality encountered is?

Back 17

Hyponatremia

Front 18

An increase in osmolality will cause the release of this ? and stimulate this ?

Back 18

Release ADH allowing free water reabsorption.
Stimulate thirst.

Front 19

The etiology of excess ECF water due to impaired excretion of water or a non-osmotic release of ADH causes this?

Back 19

Hyponatremia

Front 20

Elevated/normal osmolality in hyponatremia may suggest what?

Back 20

Presence of another effective osmole, such as glucose.

Front 21

These commonly cause hyponatremia within 2 weeks of use.

Back 21

thiazide diuretics

Front 22

Name 2 medications that can cause SIADH.

Back 22

SSRIs and carbamazepine

Front 23

Hypervolemic hypotonic hyponatremia will increase ECF but will decrease what?

Back 23

ECV; effective circulating volume

Front 24

Headache, lethargy, seizures, and permanent brain damage are signs of moderate/severe what?

Back 24

hyponatremia

Front 25

Dry mucous membranes, orthostatic hypotension, and decreased skin turgor suggest?

Back 25

hypovolemia

Front 26

Edema or weight gain may suggest?

Back 26

hypervolemia

Front 27

The rapid correction of hyponatremia will cause what? What is considered rapid?

Back 27

Osmotic demyelination syndrome[para or quadraparesis]
>12mEq/L

Front 28

For hypovolemic hypotonic hyponatremia what fluid is used?

Back 28

0.9% NS

Front 29

For euvolemic or hypervolemic hyponatremia what is usually the first strategy?

Back 29

fluid restriction

Front 30

Hypervolemic hypotonic hyponatremia is treated with fluid restriction and what else?

Back 30

furosemide

Front 31

A patient with GI fluid losses would be expected to have? Hypervolemic, euvolemic, or hypovolemic hyponatremia

Back 31

hypovolemic hyponatremia

Front 32

Demeclocycline is used to treat this electrolyte imbalance and has this ADR?

Back 32

Treats Euvolemic hypotonic hyponatremia.
ADR: nephrotoxicity

Front 33

Conivaptan(Vaprisol) is used to treat this electrolyte imbalance and has this ADR?

Back 33

Treats Euvolemic hypotonic hyponatremia.
ADR:Infusion site reaction

Front 34

Tolvaptan(Samsca) is used to treat this electrolyte imbalance?

Back 34

Treats Euvolemic hypotonic hyponatremia.

Front 35

Monitoring for acute hyponatremia should include?

Back 35

mental status exam, cardiac/pulmonary status exam, sodium, potassium, urine osmolality.

Front 36

An acute rise in sodium causing water movement from ICF to ECF occurs in this electrolyte imbalance?

Back 36

Hypernatremia

Front 37

Diabetes insipidus from the decrease of ADH secretion occurs in this electrolyte imbalance?

Back 37

Hypernatremia

Front 38

Diabetes insipidus can be caused by what drugs?

Back 38

lithium, demeclocycline

Front 39

Muscle weakness, lethargy, coma, permanent neurologic damage occurs in this electrolyte imbalance?

Back 39

hypernatremia

Front 40

Overly rapid administration of hypotonic fluids can cause?

Back 40

cerebral edema

Front 41

Desmopressin treats this condition and has this ADR?

Back 41

Treats diabetes insipidus.
ADR: severe hyponatremia .

Front 42

If Crcl<50ml/min then this drug is contradicted for use in diabetes insipidus?

Back 42

desmopressin

Front 43

Monitoring for hypernatremia should include?

Back 43

Serum sodium, fluid status

Front 44

Hypotonic fluids should be used to treat? hypernatremia or hyponatremia

Back 44

hypernatremia

Front 45

What 5 drugs can induce hypocalcemia?

Back 45

Bisphosphonates, calcitonin, cinacalcet, denosumab, furosemide

Front 46

PTH insufficiency, Vitamin D insufficiency and calcium chelation can cause what electrolyte imbalance?

Back 46

Hypocalcemia

Front 47

When evaluating total serum calcium levels, it is important to consider?

Back 47

albumin levels

Front 48

Tetany and prolonged QT occur in which electrolyte imbalance?

Back 48

hypocalcemia
Tetany is an involuntary muscle contraction.

Front 49

IV calcium products may cause this ADR?

Back 49

severe cardiac dysfunction

Front 50

What 3 oral calcium products may be given for hypocalcemia treatment? Which is more effective in elderly? What are the 2 IV calcium products

Back 50

Oral: CaCO3, CaCitrate, CaLactate
CaCitrate more effective in elderly.
IV: CaCl, Cagluconate

Front 51

What 2 medications may cause hypercalcemia?

Back 51

lithium, thiazides

Front 52

Primary hyperparathyroidism, malignancy, hyperthyroidism all may cause this electrolyte imbalance?

Back 52

hypercalcemia

Front 53

PTH causes calcium from bone to be ? and calcium from renal tubules to be ?

Back 53

Increased in resorption of Ca from bone and reabsorption from renal tubules

Front 54

anorexia, nausea, vomiting, AKI, tetany, obtundation, ventricular arrythmias are presentation signs of this electrolyte imbalance?

Back 54

hypercalcemia

Front 55

Furosemide use in hypercalcemia may cause these ADRs and should be used when?

Back 55

ototoxicity, hypokalemia
Use after hydration with normal saline has been initiated.
*Furosemide can treat Hypermagnesemia and Hyperkalemia.

Front 56

Bisphosphonates are used to treat this electrolyte imbalance and cause these ADRs?

Back 56

Hypercalcemia.
ADR: osteonecrosis of jaw, AKI

Front 57

This is the drug of choice for hypercalcemia of malignancy and reduces serum ca in how many hours?

Back 57

Bisphosphonates in 48 hours.

Front 58

If a patient has CKD or HF with hypercalcemia, then what drug should be used?

Back 58

calcitonin

Front 59

Chronic granulomatous disease may be given this treatment?

Back 59

Bisphosphonates with Glucocorticoid such as prednisone.

Front 60

Refeeding syndrome, insulin, alcoholism, respiratory alkalosis, diarrhea are all etiologies of this electrolyte imbalance?

Back 60

hypophosphatemia

Front 61

What 2 drugs may cause hypophosphatemia?

Back 61

CaCO3, sevelamer

Front 62

Respiratory alkalosis increases intracellular pH which stimulates glycolysis, causing what electrolyte imbalance?

Back 62

hypophosphatemia

Front 63

Diets high in carbs cause increase in insulin release resulting in this electrolyte imbalance?

Back 63

hypophosphatemia

Front 64

seizures, rhabdomyolysis, hemolysis are presentations of this electrolyte imbalance?

Back 64

hypophosphatemia

Front 65

If a patient is receiving hyperalimentation( administration of nutrients) adding how much phos to the fluid may prevent hypophosphatemia?

Back 65

12-15mmol/L

Front 66

NaPhos contains how many mEq Na and how many mmol phos/ml? When is it recommended?

Back 66

4mEq Na, 3mmol phos/ml
Recommend when serum K>3.5mEq/L

Front 67

KPhos contains how many mEq Na and how many mmol phos/ml? When is it recommended?

Back 67

4.4 mEq Na, 3mmol phos/ml
Recommend when serum K<3.5mEq/L

Front 68

IV phosphorous products usually give desired response in what time frame?

Back 68

24hours

Front 69

Phos-NaK contains how much Na,K,Phos?

Back 69

Na 6.9mEq, K 7.1mEq, 8 mmol phos

Front 70

K-Phos neutral contains how much Na,K,Phos?

Back 70

Na 13mEq, K 1.1mEq, 8 mmol phos.

Front 71

Oral phosphorous products have this ADR? and give desired response in what time frame?

Back 71

ADR:osmotic diarrhea
Response: 7-10 days

Front 72

Monitoring of hypophosphatemia should include?

Back 72

Serum Phos, K, Mg, Ca

Front 73

Which has the higher K content? Phos-NaK or K-phos neutral

Back 73

Phos-NaK

Front 74

Phos containing laxatives/enema and AKI/CKD are etiologies of this electrolyte imbalance?

Back 74

hyperphosphatemia

Front 75

Decrease in vitamin D synthesis, hypocalcemia, and increase in PTH are related to this electrolyte imbalance?

Back 75

hyperphosphatemia

Front 76

Obstructive uropathy, organ damage, and osteodystrophy are present in this electrolyte imbalance?

Back 76

hyperphosphatemia

Front 77

If both Ca and Phos levels are in imbalance which should be corrected first?

Back 77

Ca should be fixed first.

Front 78

Calcium Acetate is used to treat this electrolyte imbalance? and may cause this electrolyte imbalance?

Back 78

Treats hyperphosphatemia.
Causes hypercalcemia.

Front 79

Sevelamer(Renvela) is used to treat this electrolyte imbalance? and has beneficial effects on ?

Back 79

Treats hyperphosphatemia. Beneficial effects on HDL and LDL.

Front 80

Lanthanum(Fosrenol) is used to treat this electrolyte imbalance? and should be taken how?

Back 80

Treats hyperphosphatemia. Taken by mouth and chewed.

Front 81

Aluminum hydroxide (Amphojel) is used to treat this electrolyte imbalance? ADRs?

Back 81

Treats hyperphosphatemia.
ADR: anemia, bone disease, CNS disorders.

Front 82

Magnesium hydroxide (Milk of Magnesia) is used to treat this electrolyte imbalance? and may cause this electrolyte imbalance?

Back 82

Treats hyperphosphatemia.
Causes hypermagnesemia.

Front 83

Insulin, beta agonists, loop and thiazide diuretics, and bicarbonates cause this electrolyte imbalance?

Back 83

hypokalemia

Front 84

heart failure, cirrhosis, nephrotic syndrome, dehydration, vomiting, diarrhea, malabsorption can cause this electrolyte imbalance?

Back 84

hypokalemia

Front 85

Metabolic alkalosis may result in this electrolyte imbalance?

Back 85

hypokalemia

Front 86

Moderate hypokalemia has this presentation? Severe hypokalemia has this presentation?

Back 86

Moderate:cramping
Severe:EKG changes

Front 87

Potassium salts can cause this ADR?

Back 87

GI irritation/ulceration

Front 88

In hypokalemia, if there is also a phos deficiency then this drug is given?

Back 88

KPhos

Front 89

In hypokalemia, if there is metabolic acidosis then this drug is given?

Back 89

KBicarb

Front 90

The patient should be monitored by EKG if potassium chloride is given at this rate?

Back 90

>10mEq/H

Front 91

Concentrations of potassium chloride can cause irritation when given peripherally at this rate?

Back 91

>40mEq/L

Front 92

Hemolysis of sample, AKI/CKD,acidosis, NSAIDS, ACEI, B-blockers may cause this electrolyte imbalance?

Back 92

hyperkalemia

Front 93

K elevation is accompanied by low what values? and elevated what?

Back 93

Low: HCO3
High: BUN Scr

Front 94

Hyperkalemia may be treated with what kind of diuretics?

Back 94

Loop

Front 95

Sodium polystyrene sulfonate is used to treat this electrolyte imbalance?

Back 95

hyperkalemia

Front 96

This drug should never be mixed with orange juice?

Back 96

SPS

Front 97

Calcium chloride and calcium gluconate are used to treat these electrolyte imbalances? which is associated with more tissue necrosis?

Back 97

Treat: Hyperkalemia, Hypocalcemia, Hypermagnesemia
CaCl more tissue necrosis

Front 98

Dextrose/insulin therapy may be use to treat this electrolyte imbalance?

Back 98

hyperkalemia

Front 99

sodium bicarbonate is used to treat this electrolyte imbalance? and has these ADRs?

Back 99

Treat: hyperkalemia.
ADR: hypernatremia, fluid overload

Front 100

If a patient has metabolic acidosis, hyperkalemia, this drug would be most useful?

Back 100

sodium bicarbonate

Front 101

Albuterol (proventil) is used to treat this electrolyte imbalance?
and has this ADR?

Back 101

hyperkalemia
ADR: tachycardia

Front 102

What drug removes K from the body?

Back 102

SPS

Front 103

For the treatment of hyperkalemia, which drug has fastest onset, slowest?

Back 103

Fastest: Calcium
Slowest: SPS

Front 104

Alcohol, diuretics, chronic diarrhea, malnutrition cause this electrolyte imbalance?

Back 104

hypomagnesemia

Front 105

Hypomagnesemia is commonly present with what other deficiencies?

Back 105

K and Ca

Front 106

Tetany, seizures, and arrhythmias are present with this electrolyte imbalance?

Back 106

hypomagnesemia

Front 107

Magnesium sulfate is used to treat this electrolyte imbalance? and causes these ADRs when given IV?

Back 107

Treat: hypomagnesemia
ADR: hypotension, vasodilation

Front 108

Mg levels take how long to be replaced?

Back 108

3-5 days

Front 109

AKI/CKD, antacids/laxatives can cause?

Back 109

hypermagnesemia

Front 110

As CrCl descend below 30ml/min, this increases?

Back 110

hypermagnesemia

Front 111

what products are used to treat hypermagnesemia?

Back 111

IV calcium products, diuretics, fluids