Fluid Balance And Blood Products Flashcards
Fluid balance =
Intake-outtake
Total body weight=
Body weight x 0.6
What is fundamental for homeostasis?
The movement of solutes to help move water
Osmosis causes …
Water to shift, aiming for equal solute concentration
What do plasma proteins (albumin, fibrigin,globulins) produce?
Oncotic pressure
During inflammation …
Proteins leak out due to blood vessel
changes
The arterial end of the capillary has …
High hydrostatic pressure and low oncotic pressure
Fluid leaves the capillary
The venous end of the capillary has …
Low hydrostatic pressure and high oncotic pressure
Waste products enter the capillary
The biochemical signs of dehydration:
Raised urea and normal createnin
The biochemical signs of AKI:
Raised urea and raised createnin
What are the ranges of mean arterial pressure (MAP)
Normal = 70-110mmHg
Poor perfusion =
Mean arterial pressure (MAP) =
Cardiac output (CO) x systolic vascular resistance (SVR) + central venous pressure (CVP)
What is the normal value for central venous pressure?
3-8 mmHg
What must be considered for pts who are NBM?
Does the pt require fluids as they can become dehydrated very quickly
What are the problems with pts who have oedemas?
Increased capillary permeability can lead to sepsis and cellulitis
Increased venous pressure can lead to heart failure
Decreased oncotic pressure and albumin can lead to liver disease
What are the symptoms of pulmonary oedema?
Crackling noise Decreased SpO2 Increased respiratory rate Shortness of breath Pink frowfy sputum
What is the treatment for pulmonary oedema?
Respiratory assessment Supplementary O2
Change of position
Supportive cough
Diuretics
Covert compensated =
Reduced intravascular volume
Overt compensated =
Tachy and wide pulse pressure
Decompensated =
Shock
How to manage pts with fluid deficits?
Treat cause
Provide fluids - best route, type of fluid, quantity, how quickly
Crystalloid fluids (solutes of lower molecular weight)
Colloid fluids (large molecules which are artificial)
Fluid challenge
What are the risks of IV therapy?
Infection Sepsis Pain Bruising Site tissuing Air embolus leading to a PE Fluid going into the tissue instead of the blood vessel Fluids being given too fast
What are some examples of Crystalloid fluids?
0.9% Nacl
Hartmanns
5% dextrose
What are some examples of colloid fluids?
Frozen plasma
Blood
Albumin
Why do pts require red blood cell transfusions?
Blood loss and to enhance O2 carrying capacity of blood
Why do pts with AKI become anaemic?
Due to a decrease in decreased erythropoietin
The life span of blood is …
35 days
What is important to remember for women of child bearing age?
The blood needs to be cross matched, be Rhesus matched and be Kell-
Who is the universal donor and universal recipient for red blood transfusion?
Universal donor = O
Universal recipient = AB
Who is the universal donor and universal recipient for blood plasma transfusion?
Universal donor = AB
Universal recipient = O
What are the adverse effects of a blood transfusion?
Acute haemolysis due to mismatch
Anaphylaxis due to preservatives in blood
Transfusion associated lung injury (breathless, SOB - can happen hrs after, immediate CXR required)
Urticaria
What to look for if a pt is having a reaction to a blood transfusion?
Itch and rash Broncho spasm Compromised circulation Fever/chills Back pain Brown urine Sudden anxiety
What is the life span of platelets?
5-7 days
How long does it take to transfuse platelets?
30 minutes
Why would a pt require a platelet transfusion?
For enhancement of coagulation of blood
Why would a pt require a fresh frozen plasma (FFP) transfusion?
For replacement of coagulation factors
How long does it take to transfuse fresh frozen plasma (FFP)?
30 minutes
What is important to remember about a fresh frozen plasma transfusion?
Pts can have drastic reactions
