Fluid And Blood Flashcards
What respiratory acidosis does to cv system, tx
Dec myo contractility, inc PVR, dec SVR. Vent, bicarb, improve pulm func
Respiratory alkalosis: d/t what, results in what, tx
Inc minute vent from pain/anxiety/hypoxemia/cns disease/sepsis. Tx cause. Hypokalemia, hypocalcemia, dysrhythmias, bronchoconstriction, hypotension
Metab acidosis: due to what, results in what, tc
Uremia, ketoacidosis, lactic acidosis, diarrhea, renal fail, saline admin. Results in reduced myo contractility, inc PVR, dec SVR. IV fluid and na hco3
Metab alkalosis: d/t what
Diuretics, renal hypoperfusion, hypokalemia, hypochloremia, hypovolemia.
Metab alkalosis results in what
Leads to hypokalemia/hypocalcemia/arrhythmias/hypoventilation/hypercarbia.
Metabolic alkalosis tx
Expand IV volume, admin K, Carbonic anhydrase inhibitor
Body fluid: % weight tbw, intracellular, extracellular
60%, 40%,
20% (plasma 4% isf 16%)
Main determinant of extracellular osmotic p, intracellular osmotic p
Na, k
Physical signs for assessing fluid vol
Turgor, MM, edema, lung sounds, VS, UOP, HCT, urine specific gravity, BUN/creat
Maintenance fluid calc
4 cc/kg/hr for 1st 10kg. 2cc for 2nd 10 kg. 1 cc for each kg after that
Fluid deficit
Maintenance req x hrs NPO.
Fluid should be used to replace what beyond NPO deficit
MAP, HR, filling pressures prior to induction. Also to maintain UOP
Fluid deficit replacement timing in or
1/2 first hr. 1/4 2nd and 3rd hrs
Other sources of fluid loss in OR
GI prep, NGT drainage, vomit, diarrhea, fever
Visual estimation of blood loss
Floor, surgical drapes, soaked gauze (4x4=10cc), laparotomy pad (100-150cc), suction container
EBV: premies, term neonate, infants
- 80
EBV: kids, men, women
- 65
ABL calc
EBV (starting hct- allowable hct) / starting hct
3rd space loss due to what
Trauma, sepsis, burns, ascites
Replacement for evaporative loss in minimal cases, moderate, severe, and emergency. And cases under each category
Min (eye, lap Chloe, hernia, knee scope) 0-2 ml/kg/hr. Mod (open Chloe, appendec) 3-5, severe (bowel sx, thr) 6-9, emergency (gun shot, MVA) 10-15
What eras goal directed fluid tx about
Avoidance of na and h20 overload. Questions 3rd space loss. Monitoring of hr, bp, peripheral perfusion and temp, UOP, CVP and markers like lactate
Goal directed fluid therapy uses what to estimate volume
Stroke volume variation, pulse pressure variation, systolic pressure variation
Hypotonic solutions
- D5W. Water loss
Isotonic solutions
- Replaces water and lyte loss. Replacement fluids, LR and NS
