DECK 2- FLUIDS IN THE BODY Flashcards
An 120 lb adult has about ___ of water
50 liters (a liter weighs a kg)
an 8.8 lb baby has about _____ of water
a 2-LITER
Newborns are about ___ water, by 1 year they are ___ while adults are about ___
75%, 65%, 60%
What is dehydration?
loss of fluid from the space INSIDE of the cell - ICF, the intracellular space
What are the SPACES for fluids?
ICF (intracellular), ECF (extracellular). ECF is composed of interstitial and vascular.
What is interstitial and intravascular?
both outside of the cells, interstitial is between them and intravascular is in the veins.
8 31: How would 12 liters of water in the body be divided among: IN CELLS: BETWEEN CELLS:IN VEINS?
8:3:1. 8 intracellular, 3 interstitial, 1 intravascular
Flow rate for adults and easy math? Tko
60ml/hr
pediatric flow rate? tko
4ml/kg/hr under 10. add additional 2ml/kg for next 10 up to 20, add 1ml/kg for each kg over 20.
what is a solute?
the powder, the thing being dissolved- EX: the koolaid powder - the drug - salt (think: I solute you, KoolAid Man)
what is a solvent?
the water, or what the solute is being dissolved in. (think- water solves everything)
making kool-aid what is the solute and sovent?
kool-aid is the solute. Water is the solvent. “I solute you, Kool-Aid MAN!”
0.9% normal saline. What is solute and solvent?
Salt (NaCl) is the solute, water (H2O) is solvent.
If only the water moves out of your kool-aid, what happens to the volume, the concentration and the flavor?
volume decreases, It gets more concentrated. It tastes sweeter.
If you add water to your kool-aid, what happens to the volume, the concentration and the flavor?
volume gets bigger, becomes less concentrated - less sweet. Watered down.
what is OSMOSIS?
ONLY WATER moves across membrane, solute stays.
what is DIFFUSION?
In diffusion, both water (solvent) and koolaid (solute) move around between spaces to even things out. The volumes of don’t change. This would be like completely removing a wall separating two concentrations of koolaid. It evens out.
explain difference between OSMOSIS and DIFFUSION
both balance the concentrations- OSMOSIS- only water moves so volumes change. DIFFUSION- both water and koolaid move, volumes may not change
Give two examples of passive transport
passive means “NO ENERGY” . The two transports that don’t require energy are osmosis and diffusion
When water leaves a space, what happens to the volume and concentration of the space it left?
The volume decreases, and it becomes more concentrated. It gets sweeter with less water.
When water enters a space, what happens to the volume and concentration of the space it enters?
The volume increases and it becomes less concentrated (watered down). It gets less sweet.
what is “osmotic pressure?”
When two spaces have different concentrations, water wants to balance it, it wnts make them equally as sweet. (add sweeter koolaid to bland koolaid, you get something in between). The larger the difference in concentrations between spaces, the more osmotic pressure. If the two spaces are balanced, then there is no reason for water to move (no pressure for it to move).
Can osmosis or diffusion go in reverse?
No. in order to increase the imbalance, you need active transport, which requires energy.
What is active transport?
It generally moves SOLUTES instead of SOLVENTS, and it can move them into more concentrated areas, increaseing the imbalance. It REQUIRES ENERGY unlike passive transport.
what is a solution’s tonicity?
hypotonic, isotonic, hypertonic
isotonic
same concentration (won’t go into cells)
hypotonic
lower concentration (water heads out, water leaves veins and goes into interstitial and cells)
hypertonic
higher concentration (water heads into veins, water leaves cells and intersitial and comes into veins)
Give example of OSMOSIS with hypertonic
Add high 10% salt solution via IV, (normal is 0.9%).. When this enters the veins it makes it very salty, the water in cells wants to leave the less salty cells and make the blood less salty. This decreases cell and interstitial volume and increases blood/vascular space volume. GOOD TO REDUCE EDEMAS (fluid build up) OR TBI (traumatic brain injury) to reduce ICP (intracranial pressure). Good for TRAUMA, so popular in military. It draws the water out of these spaces. The vascular volume increases by more than you infuse.
Give examplle of OSMOSIS with hypotonic
If you put a low salt solution in vascular system via IV, then the water in that solution wants to run to higher concentrations to even it out. So it will leave the vascular space and end up in the interstitial or cellular space. GOOD DEHYDRATION- It rushes out to the dehydrated cells.
Give example of OSMOSIS with isotonic
Isotonic solution have same concentration as body and generally stay in the extracellular space (does not go into cells).GOOD FOR MEDS AND MAINT. It has a 3:1 distribution in the ECS. Every 400ml of isotonic, 300ml gointerstitial and 100 stay vascular.
What are crystalloids?
a solution of water (solvent) and a electrolytes ( a solute like salt or glucose)
What are colloids?
solutions that contain large molecules that stay in vascular space.
Common Crystalloids for IV?
Normal Saline 0.9%, Ringers Lactate, Hartmann’s solution, dextrose D5, D25, D50
what are DEXTROSE crystalloids?
D5- isotonic (but hypo once absorbed), D25 hyper, D50 Hyper
Common colloid?
albumin- (made of plasma proteins)
Categories of crystalloids?
hypotonic, isotonic, hypertonic
What are common electrolytes?
sodium most common in the blood and interstitial, potassium most common in the cells.( the others are calcium, potassium, magnesium, chloride, phosphate)
Diff between colloid and crystalloid?
Colloids cost more, last hours or days, 1:1 blood volume replacement. Large molecules stay in vascular space, can cause allergic reaction. Crystalloids are cheap, only last an hour, 3:1 replacement, sall molecules move around, no allegies.
What is ringer’s lactate and how is it diff from saline?
ringer’s lactate electrolytes similar to body (sodium, potassium, calcium). It is isotonic like water, but it releases sodium bicarbonate, so it is a basic solution that is GOOD FOR ACIDOSIS and SEPSIS – (BUT NOT LACTIC ACIDOSIS). (aka, sodium lactate or lactated ringers or hartman’s)
What is Hartman’s solution
Same a ringers lactate
Common ISOTONIC solutions
0.9%NS, RL, Abumin
What causes HYPERKALEMIA
High potassium: Burns, Crush injuries, diabetic ketoacidosis, sepsis, renal failure
What gets hidden potassium out of interstitial space and into cells?
D50 and Insulin, Sodium Bicarbonate, Calcium Gluconate,
What causes HYPOKALEMIA?
HARD TO DIAGNOSE low potassium intake, medications, diarrhea, vomiting, burns
Treat hypokalemia?
Potassium replacement. POTASSIUM CHLORIDE
How much isotonic solution for 1 Liter blood loss?
generally about 3:1, so 3 liters crystalloid to replace 1 liter of blood.
How much colloid solution for 1 liter blood loss?
1 liter
