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5 Written questions

5 Matching questions

  1. the Main solutes of ECFV are?
  2. how is Determining volume status done?
  3. ratio of water to Na+, are related to what abnormality?
  4. tonicity can be defined as?
  5. if have Postural hypotension and have low BP the priority is to become hemodynamically stable, then address what?
  1. a -Na+, glucose and urea
  2. b -Ability of combined effect of all solutes to generate osmotic driving force that causes H2O movement from one compartment to another (if osmolality is high in EC-compartment, compared to what's inside cells, will be hypertonic)
  3. c -clinical assessment
  4. d -ECF sodium concentration (hypernatremia vs. hyponatremia) are due to problems with water control mechanisms
  5. e -volume
    -0.9% NaCl until hemodynamically stable
    -D5W or 0.45% NaCl, will effect IV-volume slower= give ½ normal saline is if it is due to hyperglycemia because it will only raise the sugar level-

5 Multiple choice questions

  1. -Water loss > Na+ loss
    -Insensible water loss in patients deprived of water, fever, mechanical ventilation, Diarrhea, vomiting,
    -Osmotic diuresis = have high serum glucose pulls water with it
  2. -Indicated for hypervolemic or euvolemic hyponatremia
    -Conivaptan (Vaprisol®): Non-selective V1A and V2 receptor antagonist; IV only
    -Tolvaptan (Samsca®): Selective V2 receptor antagonist; oral only also approved in patients with SIADH (but not first line option)
  3. 1/3 TBW
  4. 154mEq
  5. -SIADH (UOsm > 100 mOsm/kg) = [ADH] is high, and hang on to water and this dilutes Na+
    -Diseases: Tumors, CNS disorders, pulmonary disease
    Medications: desmopressin = vasopressin analog, carbamazepine, cyclophosphamide, SSRI's, TCA's, NSAIDs, "ecstasy"

5 True/False questions

  1. Plasma/intravascular volume (vessels where blood is)1/4 ECFV


  2. if the Osmolal gap (OSM GAP) = OSM(measured) - OSM (calculated), is greater than 10 what does this indicate?-there are substances in the blood that aren't being measured, there are exogenous compounds that aren't in the equation (Mannitol=hyperosmolol diuretic, sorbitol=induce diarrhea, ethanol, methanol=blindness cheap alcohol, ethylene glycol=antifreeze poisoning)


  3. total ECF sodium, are related to what abnormality?-ECF sodium concentration (hypernatremia vs. hyponatremia) are due to problems with water control mechanisms


  4. how is Na+ levels Monitor for Treatment of Hypovolemic Hypernatremia?-q2-3 hours over first 24 hrs, then q6-12h (when serum Na+ < 148 mEq/L and asymptomatic; fluid status q8-24h)


  5. Treatment of Hypervolemic Hypernatremia due to Na excess is done how?-Loop diuretic (excess Na+ and water) + D5W (to replace free water)
    -Monitoring: serum sodium q2-4 hours, then q6-12 hours when serum sodium < 148 mEq/L and symptoms of hypernatremia resolves


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