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30 Cards in this Set
- Front
- Back
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Osmosis
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H2O shift between ECF and ICF; controlled by serum Na+ and glucose
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Serum Na+ ~ TBNa+/TBW
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decreased TBNa+ dehydration; increased TBNa+ pitting edema
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Isotonic loss
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serum Na+ normal; adult diarrhea, loss whole blood; Rx with 0.9% saline
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Isotonic gain
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serum Na+ normal; Rx with salt and H2O restriction
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Hyponatremia
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ICF expanded; central pontine myelinolysis with rapid IV correction
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Hyponatremia hypotonic gain pure water:
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inappropriate ADH syndrome
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Hyponatremia hypotonic gain TBNa and TBW:
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pitting edema; cirrhosis, RHF
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Hyponatremia hypertonic loss TBNa
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dehydration; loop diuretic, Addison's, 11-hydroxylase deficiency
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Hypertonic state
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hypernatremia or hyperglycemia; ICF contraction
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Hypernatremia hypertonic gain TBNa
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pitting edema; sodium bicarbonate
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Hypernatremia hypotonic loss of water
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diabetes insipidus
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Hypernatremia hypotonic loss of TBNa and TBW
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osmotic diuresis, sweat, baby diarrhea
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Acidosis
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potential for hyperkalemia (shift out of ICF)
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Alkalosis
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potential for hypokalemia (shift into ICF)
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Hypokalemia
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loop and thiazide diuretics MCC; alkalosis, albuterol/insulin; U wave
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Hyperkalemia
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renal failure MCC; acidosis, beta-blocker, digitalis toxicity; peaked T wave
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Rx for hyperkalemia
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calcium gluconate -+ insulin with glucose-+ loop diuretic
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Respiratory acidosis
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PaCO2 > 45 mm Hg; compensation metabolic alkalosis
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Causes of Respiratory acidosis
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chronic bronchitis, ARDS, barbiturate poisoning, paralysis diaphragms
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Respiratory alkalosis
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PaCO2 < 33 mm Hg; compensation metabolic acidosis
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Causes of Respiratory alkalosis
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pulmonary embolus, anxiety, early bronchial asthma, restrictive lung disease
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Metabolic alkalosis
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HCO3 -> 28 mEq/L; compensation respiratory acidosis
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Causes of Metabolic alkalosis
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loop/thiazide diuretics, vomiting, primary aldosteronism
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Metabolic acidosis
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compensation respiratory alkalosis
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inc Anion Gap metabolic acidosis
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add anions of acid to extracellular fluid
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Causes of Anion Gap metabolic acidosis
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lactate, AcAc, R-OHB, salicylate, oxalate (ethylene glycol), formate (methyl alcohol, phosphate/sulfate (renal failure)
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Ethylene glycol, methyl alcohol pathogenesis
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compete with alcohol for alcohol dehydrogenase
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Ethylene glycol poisoning
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antifreeze; converted to oxalic acid; renal failure
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Methyl alcohol poisoning
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window wiper fluid; converted to formic acid; blindness
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Normal AG metabolic acidosis
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lose HCO3 ; e.g., diarrhea, proximal/distal renal tubular acidosis
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