Fluid and Electrolytes

Question 1

Albumin
(Colloid)

Answer 1

Natural protein produced by the liver

Used to treat shocks, burns, or whenever a Pt needs plasma expansion

Increases colloid oncotic pressure which moves fluid from outside of the vessels to the inside

*Contraindicated in HF, severe anemia, renal insufficiency

Adverse Effects: Altered coagulation system, possible bleeding

*RARE SUPPLY- very expensive

Question 2

Dextran
(Colloid)

Answer 2

Solution of Glucose

Used to treat shock, burns, and whenever a Pt needs plasma expansion

Similar molecular weight to albumin

Expands plasma volume by drawing fluid from interstitial space to the intravascular space

Contraindicated in HF, renal insufficiency, and extreme dehydration

Adverse: Possible anaphylaxis and renal failure but is RARE. It may alter coagulation and cause bleeding

Question 3

Fresh Frozen Plasma (FFP)
(Blood Product)

Answer 3

Plasma Expander

Increases clotting factor levels by pulling fluid from the extravascular space to the intravascular

*Ability to carry oxygen

Increases the risk of infectious disease

Adverse: Transfusion reactions, Anaphylaxis, Transmit Pathogens (HIV)

Question 4

Packed Red Blood Cells (PRBCs)
(Blood Product)

Answer 4

Increases oxygen carrying capacity in Pts with anemia, hemoglobin deficits, and Pts who lost 25%+ blood volume

Less likely to cause cardiac fluid overload

Pulls fluid from the extravascular space to the intravascular space

No contraindications

Adverse: Bleeding abnormalities, transmit virus, allergic reactions

*HIGH COST, LIMITED SHELF LIFE

Question 5

Potassium
(Electrolytes)

Answer 5

Prevents or treats potassium depletion

Contracts muscles, transmits nerve impulses, and regulates heartbeats

Contraindicated w/ HYPERkalemia, severe renal disease, acute dehydration, untreated Addisons, hemolytic disease, conditions involving extensive tissue breakdown

Adverse: Diarrhea, GI bleeding, ulcerations, hyperkalemia, toxicity, cardiac arrest

Administer at 10mEq/hr unless on cardiac monitor, then 20mEq/hr

Question 6

Sodium Polystyrene Sulfonate (Kayexalate)
(Electrolytes)

Answer 6

Treats HYPERkalemia

Works in the intestines where potassium ions from the body are exchanged for sodium ions

Contraindicated in Pt who does not have normal bowel function or develop constipation

If used with Sorbitol, may cause colonic necrosis

Adverse: Hypernatremia, Hypokalemia, Hypocalcemia, Hypomagnesia

1g of kayexalate=1mEq of
potassium lost