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5 Written Questions

5 Matching Questions

  1. Signs and symptoms of hypernatremia include?
  2. Isovolemic Hypernatremia can cause Diabetes Insipidus Centrally, how?
  3. the Main solutes of ECFV are?
  4. IVNa = sodium concentration of infusate 3% is how much mEq?
  5. IVNa = sodium concentration of infusate 0.9% is how much mEq?
  1. a -Na+, glucose and urea
  2. b 154mEq
  3. c 513mEq
  4. d -Weakness, lethargy, restlessness, irritability, confusion
    -More severe or rapidly developing: twitching, seizures, coma, death
  5. e -Head trauma
    -CNS malignancy

5 Multiple Choice Questions

  1. -Administer 0.9% NaCl at 200 - 400 ml/h until symptoms of hypovolemia improve, then lower to 100 - 150 ml/h (calculate volume deficit)
    -No greater than 12 mEq/L/day increase in serum Na+
    -Monitor serum Na+ q2-4h, signs of hypovolemia, volume overload
  2. -Diarrhea, sweating, diuretics, dehydration
    -Hypovolemic: decrease in total body Na+ ↓ ECFV
    -Renal response (the kidney makes concentrated urine, responsing to ADH)
    -Uosm > 450 mOsm/kg (concentrated urine)
  3. -Fluids that contain water, dextrose, Na, Cl and other electrolytes
    -0.9% NaCl (or normal saline [NS]), 0.45%NS, lactated ringer, Dextrose 5% Water (D5W)
  4. -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)
  5. -Absence or deficiency of ADH leading to excessive renal water loss and hypernatremia, urinate a lot = causing high [Na] hypernatremia
    -TCA-antidepressants = cause SIADH commonly

5 True/False Questions

  1. Primary or psychogenic polydipsia (drinking a lot of water= psychological condition); Intake of more water than kidneys can excrete (> 20L/day) what does this cause?-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

          

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

          

  3. ratio of water to Na+, are related to what abnormality?-Cases of abnormal ECFV size (hypervolemia vs. hypovolemia) are due to problems with the sodium control mechanism

          

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

          

  5. Treatment of Hypovolemic Hypernatremia is done by treating how?-Initial: 200 - 300 ml/h of 0.9% NaCl until stable, regardless of what Na+ is (posterial hypotension).
    -Water deficit = Present TBW x [(SNa / 140) - 1] (140 is the goal) O-5 - 1.0 mEq/L/hr, no > 10 mEq/L/day, because tonicity outside the cells is less and water would move inside the cells and they can swell and cause edema (make sure Na is corrected b/f correct! 1.7)

          

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