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CHAPTER 7 Endocrine, Metabolic, Fluid, and Electrolyte Disorders Kenny V. Banh, MD Fluid and Hydration 385 BASICDEFINITIONS 385 ...

Hypo-/Hyperglycemia 402 INSULINPHYSIOLOGY 402 KETONES 402 HYPOGLYCEMIA 403 HYPERGLYCEMIA 404 DIABETICKETOACIDOSIS 404 HYPERGLYCE ...

TABLE 7.1. Comparison of Intracellular and Interstitial Fluid % TBW % WEIGHT Na+ Cl- HCO 3 - K+ Ca^2 + Mg^2 + INCLUDES Intracell ...

ENDOCRINE, METABOLIC, FLUID, AND ELECTROLYTE DISORDERS Fluid Balance WATER ■ Adults need 2000–3000 mL of water a day on average. ...

ENDOCRINE, METABOLIC, FLUID, AND ELECTROLYTE DISORDERS Digoxin directly inhibits the Na+/K+pump. Severe hypokalemic and hypercal ...

Hyponatremia (Na+<135 mEq/L) SYMPTOMS ■ Headache ■ Confusion ■ Seizures ■ Many patients are asymptomatic. EXAM ■ Besides ofte ...

■ Euvolemic hypo-osmolar hyponatremia ■ Urine sodium is usually high (>20 mEq/L) ■ Etiology is either endocrine or nonendocri ...

ENDOCRINE, METABOLIC, FLUID, AND ELECTROLYTE DISORDERS ■ Sodium deficit can be approximated with this equation: Na+deficit (in t ...

COMPLICATIONS ■ Overly aggressive correction of chronic hypernatremia can lead to cerebral edema. A patient with a history of re ...

CAUSES ■ History and physical are usually sufficient in diagnosing the cause of potas- sium loss. ■ Renal losses ■ With metaboli ...

■ Always remember to check for and correct any associated hypomagne- semia. In patients with hypokalemia and malnutrition, it is ...

ENDOCRINE, METABOLIC, FLUID, AND ELECTROLYTE DISORDERS Do not use succinylcholine for RSI on patients who have known or suspecte ...

■ Ca^2 +has a host of critical functions, including: ■ Control of cell membrane depolarization ■ Coagulation and platelet aggreg ...

ENDOCRINE, METABOLIC, FLUID, AND ELECTROLYTE DISORDERS Symptoms of hypercalcemia— Stones, bones, abdominal groans, psychiatric o ...

Hypomagnesemia (Mg^2 +<1.4 mEq/L) CAUSES ■ Inadequate intake/absorption ■ Malnutrition ■ Inadequate supplementation in IV flu ...

SYMPTOMS ■ Weakness ■ Slurred speech ■ Drowsiness →lethargy→coma and respiratory failure. EXAM ■ Hyporeflexia ■ Cardiovascular ■ ...

A 70-year-old female presents with fever, tachypnea, and AMS. Her ABG shows pH =7.44, PO 2 =90, PCO 2 =20, HCO 3 −=12. The chemi ...

■ Ketone wasting ■ Toluene ■ High anion gap (anion gap >20) caused by increased concentrations of anions other than K+and Cl− ...

■ Hyperkalemic normal gap acidosis: ■ Adrenal insufficiency ■ Renal insufficiency ■ Posthypocapnia ■ Increased anion gap [Na+−(K ...