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Chapter 27. Fluid and Electrolytes

Which of the following may cause an osmolar gap?

A. Ethanol

B. Lorazepam

C. Mannitol

D. A and B only

E. All of the above are correct

LM is a 67-year-old man admitted with esophageal cancer. Patient parameters are height 185 cm (6'1") and weight 84 kg (185 lb). Determine the patient’s fluid requirements.

A. 1680 mL/day

B. 2780 mL/day

C. 2840 mL/day

D. 2980 mL/day

E. 3180 mL/day

A 48-year-old man was admitted to the intensive care unit after sustaining head trauma. His sodium concentration increased from 142 mEq/L (142 mmol/L) on admission to 162 mEq/L (162 mmol/L) 2 days after admission. His weight at admission was 71 kg (156 lb). Which of the following amounts most closely approximates the free water deficit in this patient?

A. 2 L

B. 4 L

C. 7 L

D. 10 L

E. 12 L

A 67-year-old woman (80 kg) with a history of congestive heart failure presents to the clinic with a potassium of 3.1 mEq/L (3.1 mmol/L). Her medications include digoxin 0.125 mg daily, amlodipine 10 mg daily, furosemide 40 mg daily, lisinopril 20 mg daily, and aspirin 81 mg daily. What strategy would your recommend with regard to potassium in this patient?

A. Begin potassium liquid 20 mEq/mL (20 mmol/mL) as 30 mL orally three times daily

B. Begin potassium chloride tablets 8 mEq (8 mmol) orally daily

C. Begin potassium chloride tablets 20 mEq (20 mmol) orally daily

D. Admit to the hospital and give IV potassium chloride 40 mEq/L (40 mmol/L) over 1 hour

E. No action is necessary

A 76-year-old intubated man (90 kg) has been receiving fluid resuscitation with normal saline. His morning labs are sodium 142 mEq/L (142 mmol/L), potassium 4.1 mEq/L (4.1 mmol/L), chloride 119 mEq/L (119 mmol/L), bicarbonate 17 mEq/L (17 mmol/L), BUN 50 mg/dL (17.9 mmol/L), and creatinine 3.2 mg/dL (283 μmol/L). Blood gases are pH ...

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