fluid balance

Question 1

how does fluid loss by excretion occur

Answer 1

through urine and stool

Question 2

average fluid loss- urine

Answer 2

500 ml

Question 3

average fluid loss- stool

Answer 3

200 ml

Question 4

average fluid loss- respiration

Answer 4

400ml

Question 5

how does body balance fluid loss

Answer 5

by activating thirst and hunger

Question 6

homeostasis happens when

Answer 6

normal fluid replacement occurs

Question 7

why cant someone replace fluid losses

Answer 7

bc of disease or trauma

Question 8

IV therapy is used when

Answer 8

someone cant replace fluid loss due to disease or trauma

Question 9

basic fluid requirements for “maintenance “ of homeostasis

Answer 9

35ml/kg/day

Question 10

how to calculate patients fluid requirements per hour to maintain adequate intake

Answer 10

4x10 + 2x10 + 1x (x)

Question 11

normal serum osmolality

Answer 11

around 280 mOsm/kg

Question 12

major determinant of osmolarity

Answer 12

sodium

Question 13

how do fluids move between circulation and cells

Answer 13

osmosis

Question 14

when to asses fluid therapy

Answer 14

during patient physical assessment

Question 15

when is iv therapy used

Answer 15

when fluid loss isnt replaced adequately due to disease or trauma

Question 16

reasons IV fluids are used

Answer 16

maintenance & resuscitation

Question 17

when are maintenance IV fluids used

Answer 17

when a patient is not eating drinking but otherwise has stable vital signs

Question 18

when are resuscitation IV fluids used

Answer 18

when a patient has a major trauma/acute illness creating body fluid shifts within ICF and ECF

Question 19

hypertonic fluids

Answer 19

fluids high in sodium and/or glucose

Question 20

IV fluid restriction patients

Answer 20

patients with pounding pulses, high BP, edema

Question 21

how to choose fluid type

Answer 21

according to BP and electrolyte results (sodium)

Question 22

2 types of IV therapy

Answer 22

maintenance and resuscitation

Question 23

maintenance IV therapy

Answer 23

replaces normal losses via osmosis

Question 24

resuscitation IV therapy

Answer 24

replaces deficits

Question 25

fluid restriction

Answer 25

no iv therapy required, restrict fluid intake

Question 26

reasons a patient is NPO (not by mouth)

Answer 26

acute severe illness & unable to eat, awaiting surgery, ventilated patients

Question 27

osmolality

Answer 27

concentration of an osmotic solution. high osmolality= more solute than solvent low osmolality= more solvent than solute

Question 28

IV fluids are categorized based on

Answer 28

based on tonicity

Question 29

tonicity of fluids with high protein content in the body

Answer 29

hypertonic

Question 30

fluids with high dextrose in the body

Answer 30

dextrose is quickly used so the other half of the solution determines tonicity in the body

Question 31

fluid maintenance: water, electrolyte & glucose requirements

Answer 31

water: 35 ml/kg/day electrolytes: potassium, sodium and chloride glucose: 500-100g/day

Question 32

colloids

Answer 32

supply proteins to ECF, stay in circulation

Question 33

crystalloids

Answer 33

supply h20 & electrolytes, can move between ECF & ICF

Question 34

colloids tx

Answer 34

hypovolemic shock, not used in other cases due to no passing via capillaries

Question 35

isotonic fluids ex

Answer 35

lactated ringers, NS (0.9%)

Question 36

NS (0.9%) contents, category & s/e

Answer 36

contents- 154 na, 154 cl category- isotonic, #1 maintenance fluid in adults s/e- hypokalemia if long term use

Question 37

Lactated ringers LR contents, category, & s/e

Answer 37

contents- more electrolytes than NS include potassium and calcium category- isotonic s/e- hyperkalemia, not used in children bc too many electrolytes

Question 38

isotonic fluids fx

Answer 38

ecf=icf, no fluid movement

Question 39

hypertonic fluids fx

Answer 39

icf-->ecf, draws fluid from cells into ecf

Question 40

hypertonic fluids ex

Answer 40

D51/2NS, 25% albumin

Question 41

D51/2NS contents, category, s/e

Answer 41

contents: dextrose + 1/2 NS (na&cl) category: hypertonic (in the bag), draws fluid from cells, dextrose is used up fast so becomes hypotonic s/e: cellular dehydration, hyponatremia

Question 42

best IV fluid for children

Answer 42

D5+1/2NS, check K+

Question 43

25% albumin contents, category, s/e, when is it used

Answer 43

contents: 25% albumin + Na category: hypertonic, colloid stays in circulation s/e: intravenous volume expander uses: for patients who are on fluid and sodium restriction

Question 44

when is hypertonic Iv used

Answer 44

when a patient is in fluid overload and needs electrolytes. patients with heart failure or severe edema

Question 45

when is hypotonic IV used

Answer 45

when a patients cells are dehydrated and fluid needs to go back into ICF

Question 46

hypotonic IV fluid fx

Answer 46

draws ECF fluid into ICF

Question 47

resuscitation fluid tx's

Answer 47

hypovolemic shock, dehydration, trauma (hemorrhage)

Question 48

1st choice resuscitation fluid

Answer 48

NS normal saline (0.9%) (isotonic)

Question 49

monitoring NS

Answer 49

check VS and circulation

Question 50

NS s/e

Answer 50

high amounts cause fluid overload & edema

Question 51

2nd choice resuscitation

Answer 51

colloids

Question 52

colloids fx monitoring & s/e

Answer 52

increase BP faster to avoid peripheral edema plasma expander, stays in circulation monitor for fluid overload

Question 53

why are electrolytes essential

Answer 53

nerve conduction, membrane permeability, water balance

Question 54

electrolyte issues ex

Answer 54

sodium and potassium imbalances

Question 55

hyponatremia causes and tx

Answer 55

diuretic use | D5NS

Question 56

hypernatremia causes and tx

Answer 56

kidney failure, high sodium intake | restrict salt intake, diuretic use

Question 57

hypokalemia causes and tx

Answer 57

loop diuretics, N&V | KCL

Question 58

hyperkalemia causes and tx

Answer 58

potassium sparing diuretics or renal disease | kayexalate

Question 59

iv for dehydrated pt dt vomiting and diarrhea

Answer 59

isotonic: lactated ringers

Question 60

maintenance fluid in children

Answer 60

require electrolytes and dextrose: D51/2NS with KCL