fluid and blood therapy 1 Flashcards
the body is made up of __ % water
60
intracellular volume makes up __% of total body weight
40
extracellular volume makes up __% of total body weight
20
the interstitial fluid volume is part of the ___ fluid compartment
extracellular
interstitial fluid volume makes up __% of ECV, while plasma volume makes up __% of ECV
75, 25
TBW is __ % of a man’s weight
55
TBW is __ % of a woman’s weight
45
TBW is __ % of a infants weight
80
obese individuals have __ TBW per weight than non-obese
less
which three electrolytes are in the intracellular fluid compartment
potassium, phosphate, mag
sodium-potassium pump maintains the high concentration of __ in the ___
K in the ICF
how does NA +K +ATPase pump work
3NA+ for 2K and 1 ATP
ATP pump maintains high potassium __ the cell, and high sodium __ the cell
inside, outside
there is a high concentration of what two things extracellular
NA(cation) and Cl (anion)
____vascular we have a high concentration of albumin which creates osmotic pressure to hold fluids in this space
intra
normal Ca++
5
4.5-5.5
normal Mg+
3
1.5-2.5
normal Cl-
103
95-107
normal bicarb-
27
20-26
osmolarity
the number os osmoses of a solute in a liter of solution
osmolality
the number of osmoses of a solute in a KILOGRAM of solvent
how to change the osmolality?
change the solutes
isotonic solutions are approx ___ mOsm/L
285
hypovolemia is ___ but dehydration is a ____
fluid loss, concentration disorder
what is the most abundant electrolyte in the ECF
Na
most common electrolyte abnormality in hospitalized patients
hyponatremia
SIADH causes ____natremia
hypo
diuretics cause __natremia
hypo
adrenal insufficiency causes ___ natremia
hypo
vom and diarrhea causes ___ natremia
hypo
biggest risk of hyponatremia
cerebral edema
how to treat hyponatremia
hypertonic saline and an osmotic or loop diuretic
Na should be corrected at what rate
no more than 1-2mEq/L per hr
inadequate intake causes
hypernatremia
Diabetes insipidus causes
hypernatremia
normal K
3.5-5
most common electrolyte abnormality encountered during clinical practice
hypokalemia
Gi losses causes ___kalemia
hypo
systemic alkalosis causes ___kalemia
hypo
DKA causes ___kalemia
hypo
diuretic therapy causes ___kalemia
hypo
SNS stimulation causes ___kalemia
hypo
poor dietary intake causes ___kalemia
hypo
serum K <2.5 will manifest as
paresthesias, depressesed tendon reflexes, , fasciculation’s, muscle weakness
EKG changes with hypokalemia
ST- depression, U wave, flattened or inverted T-waves, ventricular ectopy
hypokalemia has an increased risk of myocardial irritability
2.6
rate for K replacement
10-20 mEq/ hr
potassium sparing diuretics causes ___kalemia
hyper
metabolic or resp acidosis causes ____kalemia
hyper
dig tox causes ___kalemmia
hyper
insulin deficiency causes ___kalemia
hyper
tissue and muscle damage after burns causes ___ kalemia
hyper
succinylcholine causes ___ kalemia
hyper
succs increases K by
.5.. even more in burn patients
EKG changes and hyperkalemia
tall, peaked, and elevated T waves. widened QRS, prolonged PR. flattened or absent P wave, ST depression, cardiac arrest
ace inhibitors, arbs, and BB cause ___ kalemia
hyper
tx for hyperkalemia to shift K into the cells
insulin and glucose
give IV ___ to antagonize cardiac effects of hyperkalemaia
Ca++
upper limit for K for elective procedures
5.5
hypomag is a serum mag less than
1.7 mEq/l
Hypomag is caused by
inadequate dietary intake, TPN without supplementation, starvation, GI losses, chronic ETOH
EKG changes hypomag
flat T waves, U waves, prolonged QT, widened QRS, PACs/PVCs
low mag has an ____ effect on the ATP pump which alters the resting membrane potential
inhibitory
IV mag dose
1-2g over 5min. followed by continuous Invasion 1-2g/hr.
hyper mag is level greater than
2.5
how to treat hypermg, give
Ca
wht is the second messenger that couples cell membrane receptors to cellular responses
ca
Mg ___ resting membrane potentials, CA ___ it.
decreases. increases
hypocalcemia is caused by
hypoparathyroidism, malignancy, chronic renal insufficiency
s/s of hypocalcemia neuromuscular
neurmusclar irritability - cramps, weakness, chvostek, trousseau, sz, numbness, tingling
s/s of hypocalc CV
dysrhythmias, prolonged QT, T wave inversion, hypotension, decreased myocardial contractility
s/s of hypocalc pulm
layngospasm, bronchospasm, hypovent.
advantage of calcium chloride vs calcium gluconate
calcium chloride is more bioavailable and more rapid correctoin
for every gram of calcium chloride, youd need to give how many grams of calc glu
3
causes of hypercalcemia
hyperparathyroidism (>50% cause), tumors/malignancy, calcium mobilization from bone d/t immobility
s/s of hypercalc cv
hypertension, heart block, shortened QT, dysrhythmias
s/s of hypercalc neuromuscular
muscle weakness, decreased deep tendon reflexes, sedation
tx of hypercalcemia
underlying cause, volume expansion with NS, loop diuretics to enhance renal excretion of Ca