Exam 1 Lecture 1 Flashcards
Formula for IBW
Men: 50+ (2.3 x inches over 60’’)
women: 45.5 + (2.3 x inches over 60’’)
Nutritional body weight formula?
IBW+0.25(wt-IBW)
When to use NBW when calculating fluid, electrolyte and nutrition parameters?
If actual body weight is >130% of IBW
when calculating for electrolyte and nutrition parameters, if ABW is below IBW, what do we use?
Actual
isotonic range
275-290 mOsm/L (same concentration of active solute as extracellular fluid)
Hypotonic solution range
less than 275
Hypertonic range
> 290
How to calculate total osmolarity?
Osmolarity of IV solution + osmolarity of added electrolytes
Calculate osmolarity of 1 L of 0.45% NaCl with 20 mEq kcl (osmolarity of 0.45 NaCl= 154) (osmolarity of KCl =2)
154+ (20*2)= 194
How to calculate MIVF requirements per day
30-40 ml/kg/day (normal amount needed over 24 hours)
How to calculate rate of MIVF
divide the MIVF by 24
what are the two types of fluid
crystalloids
colloids
Difference in the tonicity between crystalloids and colloids
crystalloids- hypotonic, isotonic, hypertonic
colloids- hypertonic
Give examples of colloids
Blood, plasmanate, albumin
Examples of crystalloids
NS, 1/2 NS, D5W LR
What are the use of crystalloids
-Provide water and or sodium
-maintain osmotic gradient between intravascular and extravascular compartments
Use of NS (0.9 NaCl) in therapy
Resuscitation fluid (IVF replacement)
Na or Cl replacement
place of 1/2 NaCl in therapy
Used for maintenance fluid (combination fluid)
Name fluids used for resuscitation
NS, LR, normosol
Resuscitation is used for patients that have which characteristics
Hypovolemic
low BP
bleeding
What can never be used as maintenance fluid
NS
Place of LR (lactated ringer) in therapy
-Replicates blood (used as replacement for blood loss)
-approximates human plasma
-used for resuscitation (low BP and hypovolemia)
place of D5W in therapy
Free h20 replacement
Can D5W ever be used as a resuscitative fluid?
No
Can D5w ever be MIVF by itself?
No
What are the uses of balanced salt solutions
They are crystalloid solutions that contain chloride and buffer, helping maintain acid/base status and PH of system
examples of balanced salt solutions
Normosol/plasma-lyte
LR
Normal range of sodium in our body
(usually 140, but 135-145 is normal)
normal range of chlorine in body
100
Levels of Na and Cl in NS
154 na 154 cL
Why does normal saline cause acidosis
Higher content of Na and Cl than blood. Leads to more acidity
Use of colloids
Used to increase plasma oncotic pressure
how do colloids increase oncotic pressure
By moving fluid from interstitial compartment to intravascular compartment
why are colloids called plasma expanders
because they move fluid from interstitial to intravascular (plasma)
we use colloids for volume explansion T/F
True
what are colloids used in
Hemorrhagic shock (bleeding)
Hypovolemic shock
1st line and second line of treatment for hypovolemic shock (low BP)
1st line- resuscitative crystalloids (LR, normosol, plasma-lyte)
2nd Colloids
What are the two different albumins that we can use
5% and 25%
Difference in use between 5% and 25 % albumin
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)
When to use blood in theraoy
Acute blood loss
inadequate resuscitation from flluids
pre-op
low hemoglobin
Normal range for hemoglobin. Low hemoglubin range
12-14 is normal
low range less than 7-8
by how much g/dl does hemoglubin increase with 1 unit of blood
1
most common MIVF
D5w+ 1/2NS+20meq KCl/l
what are some signs of dehydration
Decreased skin turgor
delayed capillary refill
dry mucus membranes
hypotension
we consider a person to be dehydrated when U/O (urine output) is
less than 0.5 ml/kg/hr
