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18 Cards in this Set
- Front
- Back
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Definition of Hypernatremia
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Sodium above 145
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2 types of water loss
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Renal loss
Extra-renal loss (G.I., Skin, Respiratory tract) |
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TEST QUESTION
Increased water loss with what unnatural mechanisms? (3 majors) |
Fever
Burns ****Mechanical ventilation**** |
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Risk factors for hypernatria upon admission to hospital
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Increased age
Infection Fever Decreased urine concentrating ability Diuretics, hyperglycemia, chronic kidney disease |
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Risk factors for hypernatremia while in hospital (in addition ot previous factors)
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Decreased level of consciousness
Decreased enteral or intravenous fluids |
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Symptoms of Hypernatremia
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Neurological: Water shifts out of brain cells
Decreased brain cell volume increases risk for subarachnoic and intracerebral hemorrhage Altered mental status Weakness, focal neurological deficits Seizures Coma |
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Causes of central diabetes insipidus
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hypothalamus/pituitary tumor, trauma, surgery, etc
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Causes of nephrogenic DI
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Chronic Kidney Disease
Drugs: Lithium, Propoxyphene (Darvocet), Amphotericin, Demeclocycline |
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TEST QUESTION
Diagnosis of DI |
subcutaneous Vasopressin (DDAVP) – ADH
Urine concentrates: Central D.I. No concentration: Nephrogenic D.I. |
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TEST QUESTION
Clinical signs of DI |
Polyuria (3 -10 liters/day)
Urine osmolality < 100, plasma osmolality high Polydipsia |
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Treatment of DI
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Central: Replace ADH with Vasopressin (DDAVP)
Nephrogenic: Replace fluids, Correct low K, high Ca |
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Calculation of water deficit
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Deficit = (Na – 140)/140 x 0.5 x kg
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Preffered route of replacing water deficit in hypernatremia
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Preferred route: gastrointestinal tract
Orally Nasogastric tube |
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TEST QUESTION
Describe IV water replacement in Hypernatremia |
Secondary option: Intravenous
Hypotonic solution: D5W or ½ Normal saline |
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TEST QUESTION
Daily needs of fluid in L/day |
3 liters per day
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Osmolality of normal saline
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310
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Osmolality of D5W
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253
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Calories / l of D5W
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170
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