Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > Exam 3- IV Fluid > Flashcards

Exam 3- IV Fluid Flashcards

1
Q

Does overnight fasting have a significant reduce IV volume?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anesthesia related factors causing IV volume derangements (2)

A
  1. Anesthetics

2. Sympathetic blockade during neuralgia anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Surgery related factors causing IV volume derangements (6)

A
  1. Hemorrhage
  2. Coagulopathy due to hemodilution and hypothermia
  3. Decrease venous return
  4. Mechanical ventilation maneuvers
  5. Prolonged operative time, open abdominal cavity, bowel edema
  6. Reasons preventing transition from IV to oral fluid therapy within 24 hrs of surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tissue edema effects, increase extra vascular fluid

A

Hypervolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Can hypovolemia and hypervolemia lead to tissue perfusion?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3 limitations for monitoring IV volume status:

A
  1. CVP
  2. Urine output
  3. Mixed venous and oxygen saturation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is tonicity:

A

Effective osmolality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does serum sodium reflect?

A

Total body water status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does sodium content in intravenous fluid dictate?

A

Fluid distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can all crystalloids be viewed as?

A

Water and saline equivalents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

More or less water as we age?

A

Less water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Increased ECF or ICF with malnutrition?

A

ECF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Water represents how much of weight?

A

50-60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ICF:ECF ratio?

A

2:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ECF is comprised of:

A 
Interstitial fluid (3 parts)
Plasma (IV) (1 part)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ISF:plasma ratio

A

3:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cellular membrane permeable to what?

A

Water but not ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Principle ions of ECF:

A

Na+ Cl-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Principle ions of ICF:

A

K+ PO42-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fluid components of blood within vessels maintained by the inward pull of…

A

Colloid osmotic pressure (oncotic pressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fluid components of blood within vessels maintained by the outward pull of…

A

Hydrostatic pressure which pushes plasma out of vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is endothelial glycocalyx?

A

Endothelium coated on luminal side with fragile glycocalyx layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Web of membrane bound glycoproteins and proteoglycans

A

Glycocalyx layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does endothelial glycocalyx do?

A

First barrier to regulating cellular and macromolecule transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What kind of pressure does endothelial glycocalyx produce?
Colloid oncotic pressure which is important to transcapillary flow
26
4 factors that degrade endothelium?
1. Ischemia/reperfusion 2. Hypoxia 3. Inflammatory cytokines 4. Atrial natriuretic peptide
27
3 protective factors of endothelium
1. Sevo 2. Hydrocortisone 3. Antithrombin
28
Which ion is the primary determinant of osmolality?
Sodium
29
What governs IV fluid distribution within the body?
Sodium content of intravenous fluids
30
Represent particles which are confined to one side of the membrane thereby influencing distribution of fluids within the body
Effective osmoles
31
Does effective osmoles influence distribution of fluids within body?
YES
32
What are the 4 effective osmoles?
Glucose Sodium Mannitol Glycerin
33
Represent particles which readily cross the membrane reaching equilibrium
Ineffective osmoles
34
Do ineffective influence the distribution of fluids within the body?
NO
35
3 examples of ineffective osmoles?
Urea Ethanol Methanol
36
Total body osmolality equation (2)
(Extracellular solute+intracellular solute)/total body water ((Nax2)+(Kx2))/total body water
37
Aqueous solutions of low molecular salts
Crystalloids
38
What dictates how crystalloids distribute?
Sodium content
39
Plasma sodium?
140
40
0.9% NaCl is?
154 mEq/L
41
What is normal saline?
.9% NaCl
42
What does each liter of .45% NaCl provide?
500ml of .9% NaCl | 500ml free water
43
Hypertonic saline solution
3% and 5%
44
Provides significant salt load in a small water volume
Hypertonic saline solution
45
Decrease cell volume
Hypertonic saline
46
What does LR contain?
Sodium; isotonic
47
3 main types of colloids:
1. Albumin 2. Hetastarch 3. Dextrans
48
What are colloids prepared in?
.9% NaCl
49
Albumin is an important source of what pressure?
Capillary oncotic pressure
50
Effectively draws interstitial fluid, if available, into vascular space
Hyperoncotic albumin
51
Not a protein so contribution to capillary oncotic pressure is difficult to measure and derived from amylopectin and is a synthetic glycogen like compound
Hydroxyethyl starches (HES)
52
What are products with high ratios expected to be?
Degraded more slowly
53
Does osmotic effectiveness depend on number of particles or molecular size?
Number of particles, NOT SIZE
54
4 adverse effects with HES:
1. Increased amylase 2. ESR 3. Renal function 4. Prolonged PT, aPTT
55
Moderate platelet function and are anti-thrombotic
Rheological properties
56
What has rheological properties?
Dextrans
57
How does water distribute?
From vascular compartment into interstitial space and then across cell membrane
58
How does sodium distribute?
Readily across capillary membrane into interstitial fluid, but it is pumped out of the cell
59
How do colloids distribute?
Don’t readily cross the capillary membrane. Normally confined to vascular compartment early on
60
3 reasons for crystalloids:
1. Provide maintenance requirements 2. Replacement of losses (water, blood, secretions, suction) 3. Treatment of excess or deficit of fluid or electrolytes
61
2 things about colloids:
1. Add to oncotic pressure | 2. Rheological properties
62
Body is able to maintain water and electrolyte balance through where?
Kidneys and GI tract
63
What is sensible water losses?
Measurable | -kidney, GI
64
What are insensible water losses?
Not measurable | -respiration, fever, evaporation
65
Maintenance for adult?
2-2.5 L/day
66
Maintenance fluid rule?
4-2-1 | Add 40ml to their weight (kg) if above 20kg
67
5 situations for increases loss:
1. Fever 2. Sweat 3. Gastric losses (NG tube) 4. Small intestine, biliary, pancreatic 5. Colon (diarrhea)
68
Intra-op IV electrolyte crystalloid solution management and administration rate?
LR | 1.5:1 volume basis until transfusion threshold met
69
What to avoid in intra-op IV volume management:
Dextrose | Large amount of NS .9%NaCl
70
What are large amounts of NS .9%NaCl associated with:
1. Hyperchloremic acidosis | 2. Risk of acute kidney injury
71
Minimal evaporative fluid losses:
0-2 ml/kg
72
Moderate evaporative fluid losses:
2-4 ml/kg
73
Severe evaporative fluid losses:
4-8 ml/kg
74
When is zero balance approach used?
Only fluid lost is replaced
75
What is recommended in major invasive surgeries?
Restrictive, zero balance approach
76
5 restrictive favored outcome:
1. Pneumonia 2. Pulmonary edema 3. First bowel activity 4. LOS 5. Morality
77
3 goal directed tools:
1. Pulmonary artery catheter 2. Esophageal Doppler 3. Preload responsiveness

Pharmacology (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions