2023-10-26T05:30:12+03:00[Europe/Moscow] en true <p>kidney(hypothalamic feedback mechanism), ADH, RAAS</p>, <p>Na/K/ATPase pump</p>, <p>Serum osmolality </p>, <p>b</p>, <p>detects decreases in circulating volume through baroreceptors &amp; afferent arteriole </p>, <p>a</p>, <p>b</p>, <p>a</p>, <p>hospitalization, NH residents, exercise-induced, medication-induced, parenteral nutrition </p>, <p>a phenomenon in which the calculated lab values show hyponatremia when the patient has normal serum Na levels; caused by large amounts of proteins &amp; lipids.</p>, <p>caused by excessive amounts of serum glucose that moves water from ICF compartment to the ECF; diluting the existing sodium</p>, <p>b</p>, <p>will diffuse into all of the fluid compartments </p>, <p>will stay in the ECF compartment </p>, <p>NS will remain in ECF; D5W will distribute to all other compartments </p>, <p>2 Na + Glucose/18 + BUN/2.8</p>, <p>assess serum osmolality </p>, <p>central venous access device</p>, <p>(NaIV-Nas)/ (TBW+volumeIV) </p>, <p>0.5 mEq/L per hour</p>, <p>osmotic demyelination syndrome </p>, <p>ODS</p>, <p>nausea, malaise, headache, lethargy, restlessness, seizure</p>, <p>water restriction</p>, <p>isotonic fluids</p>, <p>NS, lactated ringers</p>, <p>water/sodium restriction; diuretics, VRAs</p>, <p>vasopressin 2; collecting duct</p>, <p>rifampin, carbamazepine, st.john's wort</p>, <p>azoles, clarithromycin, grapefruit juice</p>, <p>can cause hypernatremia; first dose started in hospital; </p>, <p>dominant polycystic disease; can cause hepatic failure </p>, <p>Samsca </p>, <p>Jynarque </p>, <p>b</p>, <p>a</p>, <p>carbamazepine, antipsychotics, SSRIs, chlorpropamide, NSAIDs</p>, <p>100mg/dL; 1.5-1.9 mEq/L</p> flashcards
Hyponatremia

Hyponatremia

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  • kidney(hypothalamic feedback mechanism), ADH, RAAS

    What are the homeostatic mechanisms for retaining Na? (3)

  • Na/K/ATPase pump

    ECF & ICF osmolality is maintained by _________.

  • Serum osmolality

    _______ regulates ADH secretion.

  • b

    ADH is secreted by the _________.

    a) hypothalamus

    b) posterior pituitary gland

  • detects decreases in circulating volume through baroreceptors & afferent arteriole

    How does the RAAS regulate sodium retention?

  • a

    A loss of Total Body water. (TBW)

    a) Dehydration

    b) Hypovolemia

  • b

    A loss of ECF volume only.

    a) Dehydration

    b) Hypovolemia

  • a

    Which results in hypertonicity?

    a) Dehydration

    b) Hypovolemia

  • hospitalization, NH residents, exercise-induced, medication-induced, parenteral nutrition

    What are the risk factors associated with hyponatremia? (5)

  • a phenomenon in which the calculated lab values show hyponatremia when the patient has normal serum Na levels; caused by large amounts of proteins & lipids.

    Explain Pseudohyponatremia.

  • caused by excessive amounts of serum glucose that moves water from ICF compartment to the ECF; diluting the existing sodium

    Explain Hypertonic Hyponatremia.

  • b

    Which can result in polyuria & polydipsia?

    a) hypovolemic hyponatremia

    b) hypertonic hyponatremia

    c) Pseudohyponatremia

    d) Euvolemic Hyponatremia

    e) Hypervolemic Hypotonic Hyponatremia

  • will diffuse into all of the fluid compartments

    If we give a patient D5W, how will it be distributed in the body?

  • will stay in the ECF compartment

    If we give a patient NS, how will it be distributed in the body?

  • NS will remain in ECF; D5W will distribute to all other compartments

    If we give a patient D5W-1/2 NS, how will it be distributed in the body?

  • 2 Na + Glucose/18 + BUN/2.8

    Calculated Osmolarity Formula?

  • assess serum osmolality

    What is the first step in treating hyponatremia?

  • central venous access device

    How must 3% NaCl be administered?

  • (NaIV-Nas)/ (TBW+volumeIV)

    Change in Na Serum formula?

  • 0.5 mEq/L per hour

    What is the rate for changing sodium?

  • osmotic demyelination syndrome

    What can occur if we correct sodium too fast?

  • ODS

    -a rare neurological disorder that primarily affects the central nervous system, particularly the myelin sheath that surrounds nerve cells in the brain.

  • nausea, malaise, headache, lethargy, restlessness, seizure

    Symptoms of Acute-Hyponatremia? (6)

  • water restriction

    How would a patient with Euvolemic Hyponatremia be treated?

  • isotonic fluids

    How would a patient with Hypovolemic Hyponatremia be treated?

  • NS, lactated ringers

    Which fluids are Isotonic? (2)

  • water/sodium restriction; diuretics, VRAs

    How would a patient with Hypervolemic Hyponatremia be treated? (3)

  • vasopressin 2; collecting duct

    ADH stimulates _________ receptors of the ________; causing water to flow back into the bloodstream to correct volume deficits.

  • rifampin, carbamazepine, st.john's wort

    Which drugs can induce(decrease drug concentrations) CYP3A4? (3)

  • azoles, clarithromycin, grapefruit juice

    Which drugs can inhibit (increase drug concentrations) CYP3A4?

  • can cause hypernatremia; first dose started in hospital;

    What is the BBW for Tolvaptan?

  • dominant polycystic disease; can cause hepatic failure

    Patients with what condition must use Tolvaptan with caution? Why?

  • Samsca

    Tolvaptan

  • Jynarque

    Tolvaptan (DPD)

  • b

    Which is available via IV?

    a) Tolvaptan

    b) Conivaptan

  • a

    Which is more selective?

    a) Tolvaptan

    b) Conivaptan

  • carbamazepine, antipsychotics, SSRIs, chlorpropamide, NSAIDs

    What medications can cause SIADH? (5)

  • 100mg/dL; 1.5-1.9 mEq/L

    Every _______ increase in glucose will cause sodium to fall by ______.