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16 Cards in this Set
- Front
- Back
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Dehydration -how to calculate fluid deficit -define 5%, 10%, 15% dehydration -treatment |
Fluid deficit (in L) = % dehydration x weight in kg 5% = decreased tears 10% = sunken eyes and fontanelle, poor turgor, hypernatremia, dry mucous membranes, tachycardia 15% = poor cap refill + signs of shock give half the deficit over 8 hours, then the rest over the next 16 hours (if giving boluses then subtract from the 8 hour fluids) |
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FeNa calculation |
(UNa/UCr)/(PNa/PCr) |
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low FeNa -definition -seen in? |
below 1% = prerenal dehydration gastroenteritis (if given too much free water) nephrotic syndrome |
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high FeNa -definition -seen in? |
above 2-3% = acute tubular necrosis/renal failure diuretics psychogenic polydipsia acute water intoxication SIADH cerebral salt wasting |
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Assume urine sodium < _____ is a low FeNa. (if that's all you're given) |
<20 |
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Correcting hyponatremic dehydration |
(desired Na - measure Na) x (weight in kg) x 0.6 then add 3mEq/kg (daily maintenance of sodium) to that amount = total amount of sodium needed for the next 24 hours **desired Na should not be more than 12 above the measured |
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Correcting hyponatremic dehydration TOO rapidly (faster than ___ mEq/day) causes _______. |
12 mEq/day central pontine myelinolysis |
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Correcting hypernatremia TOO rapidly (faster than ___ mEq/day) causes _______. |
12 mEq/day intracranial hemorrhage due to fluid shifts causing tearing of bridging vessels |
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If patient is noted to have hypernatremic dehydration, always assume she is at least ____ dehydrated. |
10% |
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Common causes of hypernatremia |
DI excessive sweating increased salt intake |
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Pyloric stenosis causes what electrolyte abnormality? |
hypochloremic hypokalemic metabolic alkalosis *vomiting HCl so low chloride + kidneys trying to hang onto H by losing K so low potassium |
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CF causes what electrolyte abnormality? |
hypochloremic hyponatremic metabolic alkalosis with dehydration *losing NaCl in sweat |
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Post-op brain surgery/brain injury can result in what two problems? |
SIADH = low urine output, low urine sodium, low serum osmolality, high urine osmolality (treat with restriction) cerebral salt wasting = high urine output, high urine sodium, higher serum osmolality, high urine osmolality (treat by replacing fluid) |
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Diabetes Insipidus -labs -central vs nephrogenic |
hypernatremia, high serum osmolality, low urine osmolality central = not enough ADH, treat with DDAVP nephrogenic = doesn't respond to ADH, usually x-linked recessive (in males), treat with hydrochlorothiazide and salt restriction |
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Hypokalemia -symptoms -EKG changes |
muscle pain, weakness, paralysis, constipation, ileus flattened T waves, ST depression |
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Hyperkalemia -EKG changes -treatment if severe vs mild |
peaked T waves if high K > 10, watch out for absence of P waves and widened QRS = electromechanical dissociation treatment if severe = IV calcium chloride treatment if mild = glucose/insulin, inhaled albuterol, lassie, sodium bicarb |
