Studydroid is shutting down on January 1st, 2019



keywords:
Bookmark and Share



Front Back
1/2 NS
Na: 77, 
%ECF: 67
%ICF: 33
free water: 500 mL
NS
Na: 154
%ECF: 100%
%ICF: 0%
free water: 0 mL
hypertonic (3%)
Na: 513
%ECF: 100%
%ICF: 0%
free water: -2331mL
max serum sodium rate change
1.5 mEq/L/h
no more than 6 mEq/L in first 4 hours
no more than 12 mEq/L in first 24 hours
Total Body Water in Litres
0.6 x body weight for childre and men <70yo
0.5 x body weight for men > 70yo, women <70yo
0.45 x body weight  for women > 70yo
change in sodium with 1 litre of infusate
(Na added - serium Na) / (total body water + 1)

put change over max rate of 1.5 to get time
hyPOnatremia serum level
serum sodium level less than 136 mEq/L
hyPOnatrmia presentation
confusion, disorientation, headache
seizures, lethargy, nausea, pulmonary edema
hyPOnatremia osmolality normal
280 mOsm/kg
calculated sodium  osmolality
(2 x serum Na) + (glucose/18) + (BUN/2.8)
hyPOnatrmia hypertonic mOsm
> 280
osmolar gap
serum osmolality - patient's calculated osmolality
osmolar gap if greater than 15 mOsm/kg
hyPOnatrmia hyperotnic treatment
normal saline
hyPOtonic HyPOnatremia hyPOvolemic
urine Na less than 20 cause:
losing fluid from somewhere outside vascular space
GI, skin, lungs
hyPOtonic hyPOnatremic hyPOvolemic
urine na greater than 20 mEq/L
cuased by diuretics, adrenal insufficieny
hypotonic, hyponatermic, hypovolemic treatment
d/c
normal saline or 1/2 NS
hyPOtonic hyPOnatremia hyPERvolemic
causes
cirrosis (liver damage)
neprhotic syndrome (serum protein, albumin lost)
decreased protein leads to fluid leak/edema
hyPOtonic hyPOnatremia hyPERvolemic
Urine NA
< 20mEq/L
hyPOtonic hyPOnatremia hyPERvolemic 
treatment asymptomatic
fluid restriction, dietary salt 1-2g/day, loops
hyPOtonic hyPOnatremia hyPERvolemic
treatment symptomatic
loops, hypertonic saline (3%), vasopressin receptor antagonists,
hypotonic hyponatremia euvolemic 
UNa greater than 20 mEq/L causes
SIADH (syndrome of inappropriate antidiuretic hormone)
renal failure, hypocortisolism, hypothyroidism
hypotonic hyponatremia euvolemic
UNa less than 20 causes:
psychogenic polydipsia
hypotonic hyponatremia euvolemic treatment
symptomatic
hypertonic 3% saline
water restriction
vasopressin receptor antagonist
hypotonic hypontremia euvolemic treatment
asymptomatic
water restriction
demecloycline 600-900 mg/day
sodium chloride tablets
x of y cards