B) Correct Na+ level for glucose level in diabetic ketoacidosis
This is true for any condition with hyperglycemia – a high serum glucose causes fluid shifts that may result in pseudohyponatremia when measuring sodium. Correction factor: for every 100 mg/dL increase in serum glucose above normal, add 1.6 mEq/L to the measured serum sodium. Hyperkalemia can occur in rhabdomyolysis, but the measured level is not corrected for CK level. Abnormalities in serum calcium and magnesium can affect symptoms and correction of each other, but there is no correction factor used. Potassium may move between intracellular and extracellular spaces in exchange for H+ ions in patients with DKA, initially and with correction of the acidosis, affecting the measured potassium levels. However, there is no specific correction factor. Treatment of hyponatremic and hypernatremic dehydration differs, but there is no correction factor used with urine specific gravity. Hypoalbuminemia can result in pseudohypocalcemia – calcium levels should be corrected as follows: decrease serum Ca++ level by 0.8 mg/dL for ever 1 g/dL serum albumin below normal.
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February 17, 2024 at 6:29 am
B) Correct Na+ level for glucose level in diabetic ketoacidosis
This is true for any condition with hyperglycemia – a high serum glucose causes fluid shifts that may result in pseudohyponatremia when measuring sodium. Correction factor: for every 100 mg/dL increase in serum glucose above normal, add 1.6 mEq/L to the measured serum sodium. Hyperkalemia can occur in rhabdomyolysis, but the measured level is not corrected for CK level. Abnormalities in serum calcium and magnesium can affect symptoms and correction of each other, but there is no correction factor used. Potassium may move between intracellular and extracellular spaces in exchange for H+ ions in patients with DKA, initially and with correction of the acidosis, affecting the measured potassium levels. However, there is no specific correction factor. Treatment of hyponatremic and hypernatremic dehydration differs, but there is no correction factor used with urine specific gravity. Hypoalbuminemia can result in pseudohypocalcemia – calcium levels should be corrected as follows: decrease serum Ca++ level by 0.8 mg/dL for ever 1 g/dL serum albumin below normal.