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5 Written questions

5 Matching questions

  1. if the Osmolal gap (OSM GAP) = OSM(measured) - OSM (calculated), is greater than 10 what does this indicate?
  2. what is normal solute concentration?
  3. Treatment of Hypervolemic Hypernatremia due to Na excess is done how?
  4. how is Determining volume status done?
  5. 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?
  1. a -ADH is suppressed: UOsm < 100 mOsm/kg VERY DILUTE URINE
    -Euvolemic Hypotonic Hyponatremia
  2. b -clinical assessment
  3. c - (275 - 290 mOsm/kg)
  4. 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
  5. 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

  1. -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)
  2. 3/4 ECFV
  3. -Restriction of water < 1 - 1.2 L/day
    -Restrict Na+ < 1 - 2 g/day
    -Improve circulating blood volume: to ↓ ADH release
  4. -Na+, glucose and urea
  5. -Tubular unresponsiveness to ADH --> renal concentrating defect --> excessive renal losses of water -->hypernatremia

5 True/False questions

  1. 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)

          

  2. 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

          

  3. 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

          

  4. 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)

          

  5. Intracellular fluid volume (ICFV = inside cells)?2/3 TBW

          

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