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Week 12 Fluids, Electrolytes, Acid and Base

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khfsu1's version from 2015-04-13 01:42

Normal Ranges

Question Answer
Na+135-145
K+3.5-5
Cl-95-105
Mg2+1.7-2.1
Ca2+8.5-10.5
pH7.35-7.45
pCO235-45
HCO322-27
Anion Gap (Normal)12 +/- 4
Anion Gap (Critically Ill)7 +/- 4
BUN:Creatinine10-20:1
Serum osmolality270-290 mOsm/kg
memorize

 

Question Answer Column 3
Hypotonic Hypovolemic HyponatremiaDirueticsStop diuretics
Hypotonic Isovolemic HyponatremiaSIADH (CBZ, TCAs, SSRIs)Remove drugs, restrict free water, loops, demeclocycline
Hypotonic Hypervolemic HyponatremiaHF or CirrhosisRestrict free water and sodium, diuretics
Hypertonic HyponatremiaHyperglycemiaSlowly correct levels to avoid central pontine myelinolysis
Hypovolemic HypernatremiaSweating/DehydrationRemove drugs, NS then 1/2 NS
Isovolemic HypernatremiaDiabetes Insipidus or LithiumLoops, replace the fluid with free water (D5W)
memorize

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