By Richard Arthur Preston
Univ. of Miami, FL. Concise instruction manual on fixing difficulties relating advanced fluid, electrolyte, and acid-base problems. For clinical scholars, interns, citizens, nurses and nurse practitioners, and first-year nephrology fellows. Softcovers.
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Extra info for Acid-Base, Fluids, and Electrolytes Made Ridiculously Simple (1st Edition)
Thiazide diuretics Thiazide diuretics impair renal water excretion by blocking the kidney's ability to produce a dilute urine (Chapter 1). Thiazide diuretics are an important cause of hyponatremia, especially in elderly women. Such hyponatremia may be severe if solute intake is low or water intake is high. Thiazide diuretics are contraindicated in all patients with hyponatremia, including those with edema-forming states. SIADH What would happen if ADH secretion persisted in spite of a falling serum sodium concentration and continued water intake?
0 mEqL! Thankfully, we do not double our potassium concentration after four glasses of orange juice because homeostatic mechanisms maintain the striking difference between intracellular and extracellular potassium concentrations and, therefore, the ECFV potassium concentration. 23. How much potassium is there in the ECFV of a 40 kg woman? 8 mEq The calculated amount of potassium in the entire ECFV is about one supplemental 20 mEq dose of KCl! 24. Calculate the total amount of HC03- present in the ECFV of a 50 kg woman with an ECF HC03- concentration of 25 mEqL.
25 g d d l above 8 g d d l for every 1 mEq/L fall in the serum sodium concentration. In a nutshell: If the blood of the patient is not lipemic and the protein concentration in plasma is less than 10 g d d l , then pseudohyponatremia is not present. Another point is that the measured osmolality is normal and the calculated osmolality is low in cases of pseudohyponatremia. This results in an increased osmolal gap. The osmolality of 270 mOsrn/L in this patient is low and indicates one of the causes of hyponatremia with hypotonicity.
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