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Surgery Test 1 > Fluid and Electrolytes > Flashcards

Fluid and Electrolytes Flashcards

1
Q

Which has more water, the intracellular space or the extracellular space?

A 
Intracellular volume (40%)
-Extracellular volume has 20%
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2
Q

What is extracellular volume (ECV) made up of?

A

Interstitial fluid
Plasma
3:1 ratio of IF to plasma

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3
Q

What electrolytes are in ECV?

A

Na
Cl
HCO3

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4
Q

What electrolytes are in ICV?

A

K, PO4, SO4

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5
Q

What is the most important osmotically active colloid in ECV?

A

Albumin

4 g/L in serum vs. 1 g/L in serum

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6
Q

What is the target concentration of Na in the body?

A

140 mg/dL

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7
Q

What is the target concentration of Cl in the body?

A

100 mg/dL

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8
Q

What is the target concentration of K in the body?

A

4 mg/dL

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9
Q

What is the target concentration of Alb in the body?

A

4 g/L

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10
Q

What is the 4-2-1 rule?

A
  1. First 10 kg: 40 cc
  2. Next 10 kg: 20 cc
  3. I cc for every kg after that
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11
Q

What does D5 mean as it pertains to fluids?

A

5 g of dextrose per 100 ml of fluid

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12
Q

What does normal mean as it pertains to fluids?

A
  • Refers to osmolarity

- We want same in fluid as in body

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13
Q

What is third spacing?

A

Leaking of fluid into interstitial space between skin and fascia; normally this area is not filled with fluid.

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14
Q

What is ideal urinary output?

A

1 cc/kg/hr

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15
Q

Hemolysis can cause false high readings of what electrolyte?

A

K

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16
Q

What situations can cause hypernatremia?

A

When we lose water without salt:

  • Burns
  • Fever
  • Hyperventilation
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17
Q

What situations can cause hyponatremia?

A

When we lose water with salt:

  • Diuretics
  • NGT
  • Hypoproteinism (cirrhosis, nephrotic syndrome, malnutrition)
18
Q

What conditions can cause hypokalemia?

A

Vomiting, diarrhea
NGT
Renal losses
Prolonged NPO

19
Q

Why is vomiting so bad for potassium losses?

A

While we are losing K from vomiting, our kidneys excrete extra K to hold on to H+ and Na+

20
Q

What is the primary danger of having low potassium?

A

Cardiac arrhythmias

21
Q

What are usual signs if hypokalemia?

A

Weakness

Ileus

22
Q

What will an EKG show in hypokalemia?

A

Flattened T waves

23
Q

Low magnesium can cause what other electrolyte change?

A

Hypokalemia

24
Q

Most important electrolyte imbalance to consider in surgery patients?

A

Hypokalemia

25
Q

What are some effects of hyperkalemia?

A

Spiked T-waves
Arrhythmias
Sudden death!

26
Q

What are four treatments for hyperkalemia?

A

IV calcium gluconate
Glucose, insulin, sodium bicarbonate
Potassium-binding resins
Dialysis

27
Q

How does calcium gluconate treat hyperkalemia?

A

Antagonizes effects at cell membrane

Works in seconds to minutes

28
Q

How do glucose, insulin, and sodium bicarbonate treat hyperkalemia?

A

Move K back into cells

Works in 30-60 mins

29
Q

How do potassium binding resins work?

A

Bind and hasten excretion of K into colon

Works in 1-6 hours (faster rectally)

30
Q

Where is most calcium found?

A

Bones

31
Q

Where is calcium that’s not in bones found?

A

Bound to albumin

32
Q

Where is calcium absorbed?

A

Duodenum

33
Q

What does calcium do?

A
  • Muscle contractions
  • Nerve conduction
  • Coagulation
34
Q

What are the usual causes of hypercalcemia?

A

Parathyroid problem

Malignancy

35
Q

What are the symptoms of hypercalcemia?

A
  • Muscle weakness
  • Fatigue
  • Depression
  • Anorexia
  • Arrhythmias
36
Q

Treatment for hypercalcemia?

A

Lasix
Vigorous NS
Calcitonin
Bisphosphonates

37
Q

What are symptoms of hypocalcemia?

A
  • Paresthesias
  • Muscle spasms
  • Tetany
38
Q

What are usual causes of hypocalcemia?

A

Parathyroid surgery
Pancreatitis
Low albumin

39
Q

What is often the hidden reason why other electrolytes can’t be normalized?

A

Low Mg

-Target is 2.0

40
Q

When is PO4 often high?

A

In renal failure

41
Q

What are indications for dialysis?

A
  • Acidosis
  • Uremia w/ symptoms
  • Hyperkalemia
  • Volume

Surgery Test 1 (7 decks)

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