Fluid and Body Therapy - Quiz 4 Flashcards
How much of Total Body Weight is Water?
Water is 60% of TBW
40% Intracellular
20% Extracellular
What makes up the Extracellular Compartment?
75% Interstitial Volume
25% Plasma
What is the Total Body Water for Man, Woman, Baby?
Man: 55%
Woman: 45%
Baby: 80%
What is found in the Intracellular Fluid Compartment?
Potassium (K+), Phosphate (PO43-), & Magnesium (Mg)
What elements are found in the Extracellular Fluid Compartment?
Sodium (Na+) & Chloride (Cl)
What affects Fluid movement accross Compartments?
Membrane & Osmotic Properties
What is the main determinant of Osmotic Pressure?
Albumin
What is the difference between Osmolarity and Osmolality?
Osmolarity = # of osmoles in a Liter of Solution
Osmolality = # osmoles in a Kg of Solvent
Whats the difference between Hypovolemia and Dehydration?
Hypovolemia deals with actual fluid loss.
Dehydration deals with concentration in relation to water
What is Hypervolemia?
Excess fluid in an isotonic concentration
EX: CHF, Renal Failure
All gain/loss of sodium is accompanied by the gain/loss of what?
Water
What is the amount of Sodium in the ECV vs ICV?
Extraceullar: 140 mEq
Intracellular: 25 mEq (NaKATPase)
What are some causes of Hyponatremia?
Adrenal Insufficiancy
SIADH
CHF
Liver Failure
Renal Failure
Nephrotic Syndrome
Diuretics
What are some symptoms of Hyponatremia?
Neuro problems
Anorexia
N/V
Cramps & Weakness
How do you treat Hyponatremia
Restrict Fluids
Give 3% Hypertonic Fluid
Osmotic/Loop Diuretic
Correct Slowly or Brain Explodes (1-2 mEq/L per hour)
What is the most common cause of Hypernatremia?
Water Deficiency: Excessive loss or Inadequate Intake
What diseases can cause Hypernatremia?
Hyperaldosteronism
Diabetes Insipidus
Renal Dysfunction
Salt Intake
What are some symptoms of Hypernatremia?
Neuro Problems
Thirst
Hypervolemia
Polyuria or Oliguria
Renal Insufficiency
How do you treat Hypernatremia?
Replace Water Deficit
Correct Slowly (1-2 mEq/hr)
What is largely reponsible for Resting Membrane Potential?
Potassium
How is the amount of Potassium balanced by the body?
Potassium absorbed through GI and excreted by Kidneys
What are some things that cause Hypokalemia?
GI Loss
DKA
Diuretics
Poor Diet
Systemic Alkalosis
What are the CV effects of Hypokalemia?
ST Depression & U Wave
Flat T Waves
Ventricular Ectopy
What are the Neuromuscular effects of Hypokalemia?
Weakness
Decreased Reflexes
Confusion
How do you treat Hypokalemia in the OR?
Slow IV Potassium
Avoid Hyperventilation & Glucose
What are some causes of Hyperkalemia?
Renal Failure
Potassium-Sparing Diuretics
Giving Too Much K+ & Salt Substitutes
What are factors that alter Potassium Distribution?
Acidosis
Digoxin Toxicity
Insulin Deficiency
Tissue/Muscle Damage
Succinylcholine
Ace Inhbitors, ARBs, B-Blockers
How would Hyperkalemia look on an EKG?
Tall, Peaked T-Waves
Wide QRS
Prolonged PR Interval
Flat/Absent P-Wave
ST Depression
Cardiac Arrest
How do you treat Hyperkalemia?
Give Insulin + Glucose to shift K+ into cells
IV Calcium
Upper Limit of K+ is 5.5 mEq/L
Where is Magnesium stored in the body?
Muscle and Bones: 40-60%
Cells: 30%
Serum: 1%
Which organs regulate Magnesium?
Intestines & Kidney
What role does Magnesium play in the body?
Enzyme Reactions
Protein Synthesis
Neuromuscles
Na-K-ATPase
What causes Hypomagnesemia?
Poor Intake of Mag
TPN w/o Mag
Starvation
GI Losses
Chronic Alcoholism
What would Hypomagnesemia look like on an EKG?
Flat T-Waves
U-Waves
Prolonged QT Interval
Wide QRS
Atrial & Ventricular PVCs
How is Hypomagnesemia treated?
Give 1-2g Mag over 5 minutes
then
Continuous Infusion 1-2g/hr
What causes Hypermagnesemia?
(>2.5 mEq/L)
Giving too much Mag: Preeclampsia, Antacids, Laxatives
Renal Failure
Adrenal Insufficiency