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NCA 623 Electrolyte And Hyperglycemia Exam Latest Update
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NCA 623 Electrolyte AndHyperglycemia Exam Latest
Update
Total body water is __% for men and __% for women. - Answer 60% for men and 50% for
women
TBW consists of __% intracellular fluid and __% extracellular fluid, which is __%
interstitial fluid and __% plasma fluid - Answer 65% intracellular fluid
35% extracellular fluid
- 28% interstitial fluid
- 7% plasma fluid
What assessment and diagnostics are critical for fluid and electrolyte status? - Answer
1. History
2. Serum electrolytes
3. Urine electrolytes, 24h urine collection is the gold standard
4. Serum osmolality
5. Urine osmolality, more exact than specific gravity
What is the risk associated with hypotonic hyponatremia? - Answer Fluid shift from
extra- to intracellular space causing cellular swelling and neurological compromise
What is the description and symptoms of hypovolemic hypotonic hyponatremia? -
Answer State of free water volume and sodium loss
- signs of dehydration, dry mucous membrane, tachycardia
How do you distinguish between renal and non-renal causes of hypovolemic hypotonic
hyponatremia? - Answer Urine sodium
- > 20 indicates renal salt wasting
- < 10 indicates salt conservation by the kidneys
What are the causes of hypovolemic hypotonic hyponatremia, with a uNa > 20 mEq/L? -
Answer Low volume and kidneys are unable to conserve sodium:
, Thiazide diuretics
ACE inhibitors
Osmotic diuresis
Mineralocorticoid deficiency
Cerebral salt wasting
What are some causes of hypovolemic hypotonic hyponatremia with a uNa < 10 mEg/L? -
Answer Non-renal causes:
Sweating
Vomiting
Diarrhea
Third spacing
How is hypovolemic hypotonic hyponatremia treated? - Answer 1. Treat the cause
2. Sodium replacement
3. Volume replacement
4. Holding diuretics
How is chronic hyponatremia treated in mildly symptomatic patients? - Answer NS IV,
may give a diuretic once volume corrected
Correct at a rate of 0.5 mEq/L/hr or less
Recheck in 2 hours
How is acute hyponatremia treated in severely symptomatic patients? - Answer 3% NS
with loop diuretics once volume corrected
Correct at a rate of 2 mEq/L in the first two hours until symptoms resolve
Recheck Na Q2h
What are some causes of hypervolemic hypotonic hyponatremia? - Answer Fluid
retention and overload secondary to cardiac, hepatic, and renal disease
How is hypervolemic hypotonic hyponatremia treated? - Answer 1. Treat the cause
2. Loop diuretics
3. Free water restriction
What are some causes of euvolemic hypotonic hyponatremia? - Answer SIADH
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