DECK 2- FLUIDS IN THE BODY

Question 1

An 120 lb adult has about ___ of water

Answer 1

50 liters (a liter weighs a kg)

Question 2

an 8.8 lb baby has about _____ of water

Answer 2

a 2-LITER

Question 3

Newborns are about ___ water, by 1 year they are ___ while adults are about ___

Answer 3

75%, 65%, 60%

Question 4

What is dehydration?

Answer 4

loss of fluid from the space INSIDE of the cell - ICF, the intracellular space

Question 5

What are the SPACES for fluids?

Answer 5

ICF (intracellular), ECF (extracellular). ECF is composed of interstitial and vascular.

Question 6

What is interstitial and intravascular?

Answer 6

both outside of the cells, interstitial is between them and intravascular is in the veins.

Question 7

8 31: How would 12 liters of water in the body be divided among: IN CELLS: BETWEEN CELLS:IN VEINS?

Answer 7

8:3:1. 8 intracellular, 3 interstitial, 1 intravascular

Question 8

Flow rate for adults and easy math? Tko

Answer 8

60ml/hr

Question 9

pediatric flow rate? tko

Answer 9

4ml/kg/hr under 10. add additional 2ml/kg for next 10 up to 20, add 1ml/kg for each kg over 20.

Question 10

what is a solute?

Answer 10

the powder, the thing being dissolved- EX: the koolaid powder - the drug - salt (think: I solute you, KoolAid Man)

Question 11

what is a solvent?

Answer 11

the water, or what the solute is being dissolved in. (think- water solves everything)

Question 12

making kool-aid what is the solute and sovent?

Answer 12

kool-aid is the solute. Water is the solvent. “I solute you, Kool-Aid MAN!”

Question 13

0.9% normal saline. What is solute and solvent?

Answer 13

Salt (NaCl) is the solute, water (H2O) is solvent.

Question 14

If only the water moves out of your kool-aid, what happens to the volume, the concentration and the flavor?

Answer 14

volume decreases, It gets more concentrated. It tastes sweeter.

Question 15

If you add water to your kool-aid, what happens to the volume, the concentration and the flavor?

Answer 15

volume gets bigger, becomes less concentrated - less sweet. Watered down.

Question 16

what is OSMOSIS?

Answer 16

ONLY WATER moves across membrane, solute stays.

Question 17

what is DIFFUSION?

Answer 17

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.

Question 18

explain difference between OSMOSIS and DIFFUSION

Answer 18

both balance the concentrations- OSMOSIS- only water moves so volumes change. DIFFUSION- both water and koolaid move, volumes may not change

Question 19

Give two examples of passive transport

Answer 19

passive means “NO ENERGY” . The two transports that don’t require energy are osmosis and diffusion

Question 20

When water leaves a space, what happens to the volume and concentration of the space it left?

Answer 20

The volume decreases, and it becomes more concentrated. It gets sweeter with less water.

Question 21

When water enters a space, what happens to the volume and concentration of the space it enters?

Answer 21

The volume increases and it becomes less concentrated (watered down). It gets less sweet.

Question 22

what is “osmotic pressure?”

Answer 22

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).

Question 23

Can osmosis or diffusion go in reverse?

Answer 23

No. in order to increase the imbalance, you need active transport, which requires energy.

Question 24

What is active transport?

Answer 24

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.

Question 25

what is a solution’s tonicity?

Answer 25

hypotonic, isotonic, hypertonic

Question 26

isotonic

Answer 26

same concentration (won’t go into cells)

Question 27

hypotonic

Answer 27

lower concentration (water heads out, water leaves veins and goes into interstitial and cells)

Question 28

hypertonic

Answer 28

higher concentration (water heads into veins, water leaves cells and intersitial and comes into veins)

Question 29

Give example of OSMOSIS with hypertonic

Answer 29

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.

Question 30

Give examplle of OSMOSIS with hypotonic

Answer 30

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.

Question 31

Give example of OSMOSIS with isotonic

Answer 31

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.

Question 32

What are crystalloids?

Answer 32

a solution of water (solvent) and a electrolytes ( a solute like salt or glucose)

Question 33

What are colloids?

Answer 33

solutions that contain large molecules that stay in vascular space.

Question 34

Common Crystalloids for IV?

Answer 34

Normal Saline 0.9%, Ringers Lactate, Hartmann’s solution, dextrose D5, D25, D50

Question 35

what are DEXTROSE crystalloids?

Answer 35

D5- isotonic (but hypo once absorbed), D25 hyper, D50 Hyper

Question 36

Common colloid?

Answer 36

albumin- (made of plasma proteins)

Question 37

Categories of crystalloids?

Answer 37

hypotonic, isotonic, hypertonic

Question 38

What are common electrolytes?

Answer 38

sodium most common in the blood and interstitial, potassium most common in the cells.( the others are calcium, potassium, magnesium, chloride, phosphate)

Question 39

Diff between colloid and crystalloid?

Answer 39

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.

Question 40

What is ringer’s lactate and how is it diff from saline?

Answer 40

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)

Question 41

What is Hartman’s solution

Answer 41

Same a ringers lactate

Question 42

Common ISOTONIC solutions

Answer 42

0.9%NS, RL, Abumin

Question 43

What causes HYPERKALEMIA

Answer 43

High potassium: Burns, Crush injuries, diabetic ketoacidosis, sepsis, renal failure

Question 44

What gets hidden potassium out of interstitial space and into cells?

Answer 44

D50 and Insulin, Sodium Bicarbonate, Calcium Gluconate,

Question 45

What causes HYPOKALEMIA?

Answer 45

HARD TO DIAGNOSE low potassium intake, medications, diarrhea, vomiting, burns

Question 46

Treat hypokalemia?

Answer 46

Potassium replacement. POTASSIUM CHLORIDE

Question 47

How much isotonic solution for 1 Liter blood loss?

Answer 47

generally about 3:1, so 3 liters crystalloid to replace 1 liter of blood.

Question 48

How much colloid solution for 1 liter blood loss?

Answer 48

1 liter