fluid and electrolytes Flashcards
what do third space losses depend on?
location, duration of surgical procedure, amount of tissue trauma, temp, ventilation
How much third spacing losses do you get with a superficial surgical trauma and what is an example of this procedure?
1-2 ml/kg/hr
knee arthroscopic surgery
How much third spacing losses do you get with a minimal surgical trauma and what is an example of this procedure?
2-3 ml/kg/hr
head and neck surgery
hernia
knee surgery
How much third spacing losses do you get with a moderate surgical trauma and what is an example of this procedure?
5-6 ml/kg/hr
open hysterectomy
chest surgery
How much third spacing losses do you get with a severe surgical trauma? what is an example?
8-10 ml/kg/hr
AAA repair
nephrectomy
dissecting aortic aneurism
what is the osmolarity of:
0.9% NaCl
0.45% NaCl
glucose 5%
308
154
278
what are the formulas for calculating osmolarity with and w/o K+?
2 (Na +K+) + (BUN/0.8)+(glucose/16)
2(Na) +(BUN/0.8)+ (glucose/18)
what are the 5 things that volume regulation depend on?
ADH renin/angiotensin/aldosterone baroreceptors stretch receptors in the atrium-juxtaglomerular apparatus cortisol-mineralocorticoid activity
what is the rule for maintenance fluid?
4-2-1 rule
4 ml/kg/hr for the first 10 kg
2 ml/kg/hr for the next 10 kg
1 ml/kg/hr for the remaining kg
what is a standard order for fluid in the ICU?
I L of 0.45 NaCl 20 KCl at 125 mL/hour
(takes about 8 hours)- 3L in 24 hours
what is the maintenance replacement for Na? K?
2-3 mm/kg/day
0.5-1 mm/kg/day
How do you calculate resuscitation for for NPO losses?
of hours NPO X maintenance fluid requirement
how much fluid is lost for bowel prep?
up to 1 L
how much is in 1 unit of packed RBC’s?
how much does one unit raise the hemoglobin?
1 unit = 250 mL
Hct = 70-80%
raises the hgb 1 gm/DL
-infuse is with NS
what are the indications for giving platelets?
thrombocytopenia
in surgery when plt count is <50,000
