63 Questions
Which of the following statements about hypotonic solutions is most accurate?
Hypotonic solutions have lower osmotic pressure.
What is the main solute in plasma that largely determines the effective circulating volume (ECF)?
Sodium
Which of the following is responsible for the high extracellular sodium concentration and low extracellular potassium concentration?
Na/K-ATPase pumps
What is the term used to describe a solution that has equal osmotic pressure compared to human plasma?
Isotonic
Which of the following hormones is released in response to atrial distension due to fluid overload?
Natriuretic peptide
Which of the following is responsible for determining blood volume largely through sodium balance?
Aldosterone
Which of the following is a common cause of fluid loss in the body?
Medications
Which of the following lab values may indicate volume depletion?
BUN:SCr ratio > 20:1
Which of the following is a clinical presentation of volume depletion?
Orthostatic hypotension
Which of the following IV fluids is most appropriate for hypovolemia?
0.9% Sodium Chloride (Normal Saline)
Which of the following IV fluids provides more intravascular volume expansion than D5W?
0.9% Sodium Chloride (Normal Saline)
Which of the following IV fluids is less useful in intravascular volume resuscitation than Normal Saline?
5% Dextrose (D5W)
Which of the following IV fluid combinations is NOT recommended for hypovolemic patients?
22% Sodium Chloride (¼ NS)
Which of the following IV fluid combinations is NOT recommended for hyperglycemic patients?
5% Dextrose and 0.9% Sodium Chloride (D5NS)
Which IV fluid contains other electrolytes in concentrations to mimic plasma?
Plasma-Lyte
Which IV fluid is more efficient than normal saline at expanding intravascular volume?
Albumin 5%
Which IV fluid should be avoided in patients requiring fluid resuscitation?
Albumin 25%
Which IV fluid is associated with an increased risk of mortality and acute kidney injury?
HetaStarch
Which medication is a calcium-based phosphate binder used to control hyperphosphatemia in patients with chronic kidney disease (CKD)?
Calcium Acetate
Which medication is NOT used to shift potassium into cells as a treatment for severe hyperkalemia?
Sodium Polystyrene Sulfonate
Which electrolyte imbalance is commonly associated with hypokalemia and hypocalcemia?
Hypomagnesemia
Which medication is used to treat hypophosphatemia in symptomatic patients or patients with a phosphate level below 1.9 mg/dL?
Potassium Phosphate
Which electrolyte imbalance is typically controlled with phosphate binders, diet changes, and dialysis in patients with chronic kidney disease (CKD)?
Hyperphosphatemia
Which medication is used to treat severe hyperkalemia by preventing arrhythmias associated with hyperkalemia?
Calcium Gluconate
Which of the following is NOT a cause of hypovolemic hyponatremia?
SIADH
What is the dosing of Tolvaptan (Samsca) for euvolemic/hypervolemic hyponatremia maintenance?
15 mg PO daily while hospitalized
What is the dosing of Conivaptan (Vaprisol) for euvolemic/hypervolemic hyponatremia IV treatment?
20 mg loading dose over 30 minutes, then continuous infusion of 20 mg over 24 hours for 2-4 days
What is the goal for hypertonic saline treatment of severe or symptomatic hyponatremia?
Quick but small and controlled rise in Na by 0.75-1.0 mEq/hr to a goal of 120 mEq/L
What is the recommended initial dosing of potassium replacement for moderate hypokalemia?
20 mEq
What is the maximum change in serum sodium that should be targeted during hypertonic saline treatment?
10-12 mEq/L
Which of the following is responsible for maintaining high extracellular sodium concentration and low extracellular potassium concentration?
Na/K-ATPase pumps
Which of the following is a characteristic of hypertonic solutions?
They have higher osmotic pressure
Which hormone is released in response to atrial distension due to fluid overload?
Natriuretic peptide
Which of the following is a characteristic of hypotonic solutions?
They have lower osmotic pressure
Which of the following hormones is responsible for determining blood volume largely through sodium balance?
Aldosterone
Which of the following is a characteristic of isotonic solutions?
They have equal osmotic pressure
Which of the following lab values may indicate volume depletion?
BUN:SCr ratio > 20:1
Which of the following is a clinical presentation of volume depletion?
All of the above
Which medication is used to treat severe hyperkalemia by preventing arrhythmias associated with hyperkalemia?
Calcium gluconate
Which IV fluid is more efficient than normal saline at expanding intravascular volume?
Hypertonic saline
Which of the following IV fluids is associated with an increased risk of mortality and acute kidney injury?
Normal saline
Which of the following is a common cause of fluid loss in the body?
All of the above
Which of the following is the most appropriate treatment for severe hyperkalemia to prevent arrhythmias associated with hyperkalemia?
Insulin Regular 10 units IVP x1
Which of the following medications should be avoided in patients with gastrointestinal (GI) motility disorders when treating hyperkalemia?
Sodium Zirconium Cyclosilicate (Lokelma)
Which of the following is the most appropriate treatment for hypomagnesemia in symptomatic patients?
Magnesium sulfate IV
Which of the following electrolyte imbalances is commonly associated with hypokalemia and hypocalcemia?
Hypophosphatemia
Which of the following is the most accurate statement about hypotonic solutions?
Hypotonic solutions have a lower osmotic pressure compared to human plasma
Which of the following IV fluids is most appropriate for hypovolemia?
Lactated Ringer's
Which of the following is a treatment option for euvolemic or hypervolemic hyponatremia refractory to fluid restriction?
Conivaptan (Vaprisol)
Which of the following IV fluid combinations is NOT recommended for hypernatremic patients?
22% Sodium Chloride (¼ NS)
What is the dosing of Conivaptan (Vaprisol) for euvolemic/hypervolemic hyponatremia IV treatment?
20mg loading dose over 30 minutes, then continuous infusion of 20mg over 24 hours for 2-4 days
Which of the following IV fluids is NOT commonly used in patients with diabetes or post-op and L&D patients?
Lactated Ringers
What is the goal for hypertonic saline treatment of severe or symptomatic hyponatremia?
Increase serum sodium by 4-6 mEq/L in any 24-hour period
Which of the following IV fluids is associated with the risk of dilutional coagulopathy?
5% Dextrose and 0.9% Sodium Chloride (D5NS)
Which of the following is NOT a cause of hypovolemic hyponatremia?
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Which of the following IV fluids is NOT recommended for patients requiring fluid resuscitation?
Lactated Ringers
Which of the following is a common cause of fluid loss in the body?
Diarrhea
Which of the following IV fluids provides calories for dehydrated patients?
5% Dextrose and 0.9% Sodium Chloride (D5NS)
What is the main solute in plasma that largely determines the effective circulating volume (ECF)?
Sodium
Which of the following IV fluids contains calcium, potassium, and lactate in concentrations to mimic plasma?
Lactated Ringers
Which of the following is NOT a cause of third-spacing fluid loss?
Dehydration
Which of the following is a potential consequence of third-spacing fluid loss?
Hypovolemia
Which of the following is NOT a characteristic of third-spacing fluid loss?
Fluids can easily return to where they should be
Test your knowledge on the adverse effects and considerations of 22% Sodium Chloride IV fluids. Explore topics such as fluid overload, hypernatremia, hyperchloremic acidosis, and the potential risks associated with this particular IV fluid.
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