5 Written Questions
5 Matching Questions
- hypotonic, can be defined as?
- Nephrogenic diabetes insipidus (have ADH, but no kidney response) can be caused by?
- what is normal solute concentration?
- tonicity can be defined as?
- a Crystalloids can be defined as?
- a -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)
- b -more solutes inside cells and less outside-more water outside and cell lysis-cerebral edema
- c - (275 - 290 mOsm/kg)
- d -Tubular unresponsiveness to ADH --> renal concentrating defect --> excessive renal losses of water -->hypernatremia
- e -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)
5 Multiple Choice Questions
- 3/4 ECFV
- 1/4 ECFV
- -Head trauma
- -Cases of abnormal ECFV size (hypervolemia vs. hypovolemia) are due to problems with the sodium control mechanism
- -ECF sodium concentration (hypernatremia vs. hyponatremia) are due to problems with water control mechanisms
5 True/False Questions
Signs and symptoms of hypernatremia include? → -seizures, coma, permanent brain damage, respiratory arrest, brain herniation, death (severe <115)
Syndrome of inappropriate ADH release (SIADH) can be defined as? → -Nonosmotic ADH release leading to water retention & hyponatremia (go down because hanging on to more water diluting [Na+]
-Hanging on to more water than Na+, serum Na goes down!
Non-Emergent Hypervolemic Hypotonic Hyponatremia is treated how? → -3% NaCl (preferred, only in severely symptomatic patients)
-Goal: serum Na+ > 120 mEq/L; No greater than 12 mEq/day increase in serum Na+
Intracellular fluid volume (ICFV = inside cells)? → 2/3 TBW
what are potential causes of Euvolemic Hypotonic Hyponatremia? → -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"