Exam 1 Lecture 1

Question 1

Formula for IBW

Answer 1

Men: 50+ (2.3 x inches over 60’’)

women: 45.5 + (2.3 x inches over 60’’)

Question 2

Nutritional body weight formula?

Answer 2

IBW+0.25(wt-IBW)

Question 3

When to use NBW when calculating fluid, electrolyte and nutrition parameters?

Answer 3

If actual body weight is >130% of IBW

Question 4

when calculating for electrolyte and nutrition parameters, if ABW is below IBW, what do we use?

Answer 4

Actual

Question 5

isotonic range

Answer 5

275-290 mOsm/L (same concentration of active solute as extracellular fluid)

Question 6

Hypotonic solution range

Answer 6

less than 275

Question 7

Hypertonic range

Answer 7

> 290

Question 8

How to calculate total osmolarity?

Answer 8

Osmolarity of IV solution + osmolarity of added electrolytes

Question 9

Calculate osmolarity of 1 L of 0.45% NaCl with 20 mEq kcl (osmolarity of 0.45 NaCl= 154) (osmolarity of KCl =2)

Answer 9

154+ (20*2)= 194

Question 10

How to calculate MIVF requirements per day

Answer 10

30-40 ml/kg/day (normal amount needed over 24 hours)

Question 11

How to calculate rate of MIVF

Answer 11

divide the MIVF by 24

Question 12

what are the two types of fluid

Answer 12

crystalloids
colloids

Question 13

Difference in the tonicity between crystalloids and colloids

Answer 13

crystalloids- hypotonic, isotonic, hypertonic

colloids- hypertonic

Question 14

Give examples of colloids

Answer 14

Blood, plasmanate, albumin

Question 15

Examples of crystalloids

Answer 15

NS, 1/2 NS, D5W LR

Question 16

What are the use of crystalloids

Answer 16

-Provide water and or sodium
-maintain osmotic gradient between intravascular and extravascular compartments

Question 17

Use of NS (0.9 NaCl) in therapy

Answer 17

Resuscitation fluid (IVF replacement)
Na or Cl replacement

Question 18

place of 1/2 NaCl in therapy

Answer 18

Used for maintenance fluid (combination fluid)

Question 19

Name fluids used for resuscitation

Answer 19

NS, LR, normosol

Question 20

Resuscitation is used for patients that have which characteristics

Answer 20

Hypovolemic
low BP
bleeding

Question 21

What can never be used as maintenance fluid

Answer 21

NS

Question 22

Place of LR (lactated ringer) in therapy

Answer 22

-Replicates blood (used as replacement for blood loss)

-approximates human plasma

-used for resuscitation (low BP and hypovolemia)

Question 23

place of D5W in therapy

Answer 23

Free h20 replacement

Question 24

Can D5W ever be used as a resuscitative fluid?

Answer 24

No

Question 25

Can D5w ever be MIVF by itself?

Answer 25

No

Question 26

What are the uses of balanced salt solutions

Answer 26

They are crystalloid solutions that contain chloride and buffer, helping maintain acid/base status and PH of system

Question 27

examples of balanced salt solutions

Answer 27

Normosol/plasma-lyte LR

Question 28

Normal range of sodium in our body

Answer 28

(usually 140, but 135-145 is normal)

Question 29

normal range of chlorine in body

Answer 29

100

Question 30

Levels of Na and Cl in NS

Answer 30

154 na 154 cL

Question 31

Why does normal saline cause acidosis

Answer 31

Higher content of Na and Cl than blood. Leads to more acidity

Question 32

Use of colloids

Answer 32

Used to increase plasma oncotic pressure

Question 33

how do colloids increase oncotic pressure

Answer 33

By moving fluid from interstitial compartment to intravascular compartment

Question 34

why are colloids called plasma expanders

Answer 34

because they move fluid from interstitial to intravascular (plasma)

Question 35

we use colloids for volume explansion T/F

Answer 35

True

Question 36

what are colloids used in

Answer 36

Hemorrhagic shock (bleeding) Hypovolemic shock

Question 37

1st line and second line of treatment for hypovolemic shock (low BP)

Answer 37

1st line- resuscitative crystalloids (LR, normosol, plasma-lyte) 2nd Colloids

Question 38

What are the two different albumins that we can use

Answer 38

5% and 25%

Question 39

Difference in use between 5% and 25 % albumin

Answer 39

5%- hypovolemic or intravascularly depleted patients (low protein, high fluid content) 25%- fluid and/or sodium restricted patinets (small vial (50 ml) with high protein)

Question 40

When to use blood in theraoy

Answer 40

Acute blood loss inadequate resuscitation from flluids pre-op low hemoglobin

Question 41

Normal range for hemoglobin. Low hemoglubin range

Answer 41

12-14 is normal low range less than 7-8

Question 42

by how much g/dl does hemoglubin increase with 1 unit of blood

Answer 42

1

Question 43

most common MIVF

Answer 43

D5w+ 1/2NS+20meq KCl/l

Question 44

what are some signs of dehydration

Answer 44

Decreased skin turgor delayed capillary refill dry mucus membranes hypotension

Question 45

we consider a person to be dehydrated when U/O (urine output) is

Answer 45

less than 0.5 ml/kg/hr