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Electrolytes Tutoring (Part 1): basics and sodium
By Alaina darby
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Which of the following is more abundant in the extracellular fluid than the intracellular fluid?
Sodium Potassium Phosphate Magnesium a
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Which of the following is true of the na-k pump?
It pumps K out of the cell It pumps Na+ into the cell It maintains a concentration gradient It is Ca-dependent c
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Which of the following is not included on the bmp fishbone diagram?
Sodium Potassium Phosphate Glucose c
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JK is a 79 y/o wf. She weighs 56 kg
JK is a 79 y/o wf. She weighs 56 kg. which of the following would most likely be her body water composition? 25 L 30 L 35 L 40 L b
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Which of the following makes the least contribution to serum osmolality?
Sodium Potassium Chloride HCO3 b
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Pancreatic drain Bile drain Gastric suction Small bowel suction
JD’s replacement fluid contains normal saline with large amounts of bicarb. Which of the following procedures has likely been done? Pancreatic drain Bile drain Gastric suction Small bowel suction a
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FD has a fever of 39 C. What would you expect his insensible losses to be?
500 mL 1000 mL 1750 mL 2250 mL c
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JD is a 54 y/o WM. His labs are the following:
Na+ 130 Ca 7.6 Mg 1.5 Phos 3.6 Albumin 3.0
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Decompensated heart failure Diabetes insipitus
JD is a 54 y/o WM. His labs are the following: Na+ 130; Ca 7.6; Mg 1.5; Phos 3.6; Albumin 3.0 If his BP is 165/102 and serum osmolality is elevated, what would be the most likely cause of his sodium level? Hyperglycemia Cerebral salt wasting Decompensated heart failure Diabetes insipitus a
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What would his glucose likely be? 200 300 400 500
JD is a 54 y/o WM. His labs are the following: Na+ 130; Ca 7.6; Mg 1.5; Phos 3.6; Albumin 3.0 What would his glucose likely be? 200 300 400 500 b
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How should he be treated? ½ NS NS Humalog infusion Humulin infusion
JD is a 54 y/o WM. His labs are the following: Na+ 130; Ca 7.6; Mg 1.5; Phos 3.6; Albumin 3.0 How should he be treated? ½ NS NS Humalog infusion Humulin infusion d
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JD is a 54 y/o WM. His labs are the following: Na+ 130; Ca 7. 6; Mg 1
JD is a 54 y/o WM. His labs are the following: Na+ 130; Ca 7.6; Mg 1.5; Phos 3.6; Albumin 3.0 If his BP is 100/52 and has a urine sodium of 15 mEq/L, what would be the most likely cause of his sodium level? Cerebral salt wasting Addison’s disease Significant vomiting Renal failure c
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What other signs and symptoms would he also likely be experiencing?
JD is a 54 y/o WM. His labs are the following: Na+ 130; Ca 7.6; Mg 1.5; Phos 3.6; Albumin 3.0 What other signs and symptoms would he also likely be experiencing? Increased HR Increased UOP Increased PCWP Increased EDVI a
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For which of the following would replacement with ns be appropriate?
Hypovolemic hypernatremia Euvolemic hypernatremia Hypervolemic hyponatremia Euvolemic hyponatremia a
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For which of the following would a diuretic be appropriate?
Hypovolemic hypernatremia Euvolemic hypernatremia Hypervolemic hyponatremia Euvolemic hyponatremia c
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For which of the following would desmopressin be appropriate?
Hypovolemic hypernatremia Euvolemic hypernatremia Hypervolemic hyponatremia Euvolemic hyponatremia b
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Na+ treatment guide Hypovolemic Euvolemic Hypervolemic Hyponatremia
Cause: ↓ water < ↓ Na Tx Goal: ↑ water & Na Treatment: Replacement with Na+ and water Cause: ↑ water Tx Goal: ↓ water Treatment: tolvaptan PO or conivaptan IV Cause: ↑ water > ↑ Na Tx Goal: ↓ water & Na Treatment: loop diuretic or conivaptan Hypernatremia Cause: ↓ water > ↓ Na Treatment: NS or LR then D5W or ½ NS Cause: ↓ water Tx Goal: ↑ water Treatment: desmopressin (cDI) or amilioride (nDI) Cause: ↑ water < ↑ Na Treatment: diuretics Na+ treatment guide
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Sodium Chloride Phosphate Magnesium
Your patient has hypotonic hypovolemic hyponatremia with metabolic acidosis. Which of the following should be most closely monitored in this patient if you are starting NS? Sodium Chloride Phosphate Magnesium b
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Your patient has hypotonic hypovolemic hyponatremia with metabolic acidosis. Which of the following would be most appropriate to start? ½ NS LR D5W Furosemide b
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HR has SIADH, which of the following should he receive for his Na+ abnormalities?
Conivaptan NS LR Furosemide a
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LR is a 55 y/o AAF whose Na+ is 123 meq/l and her urine sodium is 45 meq/l. she is 60 kg. what most closely approximates her sodium deficit? 60 65 70 75 b… 66
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Euvolemic hyponatremia Hypovolemic hyponatremia
LR is a 55 y/o AAF whose Na+ is 123 meq/l and her urine sodium is 45 meq/l. How would she be classified? Euvolemic hyponatremia Hypovolemic hyponatremia Hypervolemic hyponatremia Euvolemic hypernatremia a
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LR is a 55 y/o AAF whose Na+ is 123 meq/l and her urine sodium is 45 meq/l. how should she be treated initially? Conivaptan IV Tolvaptan PO 3% NaCl NS a
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Conivaptan IV Tolvaptan PO 3% NaCl NS
LR is a 55 y/o AAF whose Na+ is 123 meq/l and her urine sodium is 45 meq/l. what would be most appropriate if she needs chronic treatment? Conivaptan IV Tolvaptan PO 3% NaCl NS b
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Hypovolemic hypernatremia Hypervolemic hypernatremia
Which of the following is most common in decompensated HF and liver failure with ascites? Hypovolemic hypernatremia Hypervolemic hypernatremia Hypovolemic hyponatremia Hypervolemic hyponatremia d
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What would be a typical finding in a patient with decompensated HF and resulting hyponatremia?
Urine sodium of 15 mEq/L Urine sodium of 25 mEq/L Urine sodium of 35 mEq/L Urine sodium of 45 mEq/L a
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Central DI causing euvolemic hypernatremia
AR presents to the ER with a sodium level of 150, bp of 135/82, and a past history of bipolar disorder. Although you don’t have a medication history, Which of the following would be likely in this patient? Central DI causing euvolemic hypernatremia Nephrogenic DI causing euvolemic hypernatremia Central DI causing hypervolemic hypernatremia Nephrogenic DI causing hypervolemic hypernatremia b
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You later find out that ar is taking lithium. How should you treat him
You later find out that ar is taking lithium. How should you treat him? (na+ of 150) Amilioride HCTZ Sodium restriction Furosemide a
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Conivaptan D5W LR Furosemide
In the course of treatment for FK’s septic shock, physicians gave him too much NS. How should he be treated? Conivaptan D5W LR Furosemide d
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Euvolemic hypernatremia Euvolemic hyponatremia
In the course of treatment for FK’s septic shock, physicians gave him too much NS. How would he be classified? Euvolemic hypernatremia Euvolemic hyponatremia Hypervolemic hypernatremia Hypervolemic hyponatremia c
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