5 Written questions
5 Matching questions
- if the Osmolal gap (OSM GAP) = OSM(measured) - OSM (calculated), is greater than 10 what does this indicate?
- what is normal solute concentration?
- Treatment of Hypervolemic Hypernatremia due to Na excess is done how?
- how is Determining volume status done?
- 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?
- a -ADH is suppressed: UOsm < 100 mOsm/kg VERY DILUTE URINE
-Euvolemic Hypotonic Hyponatremia
- b -clinical assessment
- c - (275 - 290 mOsm/kg)
- d -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
- e -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 Multiple choice questions
- -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)
- 3/4 ECFV
- -Restriction of water < 1 - 1.2 L/day
-Restrict Na+ < 1 - 2 g/day
-Improve circulating blood volume: to ↓ ADH release
- -Na+, glucose and urea
- -Tubular unresponsiveness to ADH --> renal concentrating defect --> excessive renal losses of water -->hypernatremia
5 True/False questions
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)
what are potential causes of Euvolemic Hypotonic Hyponatremia? → -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
Hypovolemic Hypernatremia results in what? → -Na+ gain > Water gain
-Iatrogenic = if give the patient a Na+ overload, its medically induced over infusion
-Hyperaldosteronism = conserves Na+ = conns syndrome
when treating Hypovolemic Hypotonic Hyponatremia with Diuretics, what has to be considered? → -Loop diuretics: proportional loss of Na+ and water (don't become hyponatremic!)
-Thiazides: more Na+ loss than water (high chance of having a low serum Na)
Intracellular fluid volume (ICFV = inside cells)? → 2/3 TBW