Fluid disorders Flashcards
What is the total body water for males, females, pediatrics, elderly males and elderly females
60%, 50%, 60%-70%, 50% and 45%
How is the total body water found in obese individuals
Decrease by 5% if they are 130% over ideal body weight
How is total body water spread out
1/3 extracellular fluid, 2/3 intracellular fluid
how is extracellular fluid spread out
3/4 interstitial fluid, 1/4 intravascular fluid
What is the extracellular cation
Na+
What is the intracelluar cation
K+
What is the plasma osmolality range
280-295
What does it mean if plasma osmolarity is high, low plasma osmolarity
high solute/low solvent (lack of water), low solute/high solvent (excess of water)
T/F: Osmolality is calculated, osmolarity is measured
False: osmolarity is calculated, osmolality is measured
what is the equation to calculate osmolarity
mOsm/LH2O= 2 x {Na+} + glucose/18 + BUN/2.8
T/F: Na+/K+ pumps maintain concentrations
True
T/F: Water freely moves along gradient between membranes
True
Stimulants that cause the release of Arginine Vasopressin
high plasma osmolarity, nausea, pain/anxiety
Medications that stimulate relase of Arginine Vasopressin
carbamazepine, tricylic antidepressants,SSRIs,opiates
Symptoms of hypovolemia
weakness, lethargy tachycardia, thirst, low urine output, dry clammy skin/low skin turgor, flushed skin
Symptoms of hypervolemia
anxiety, hypertension, wheezing, diarrhea, pitting edema, crackles
T/F: Diabetes insipidus causes hypervolemia
False: AVP is not released correctly causing loss of water therefore hypovolemia
What are the two types of Diabetes Insipidus
Central: brain, Nephrogenic: kidney
What are the 3 goals of volume therapy
Resuscitation, Replacement, Maintenance
Characteristics of crystalloids
can replace water and electrolyes, readily available, better tolerated, first line
Characteristics of colloids
for intravascular expansion, less readily available, risky
T/F: Hypertonic solutions move extracellular to intracellular
False: Move intracellular space to extracellular space
T/F: Hypotonic solutions move extracelluar to intracellular
True
What is an example of isotonic fluid replacement
0.9% NaCl, Lactated Ringers
What is an example of a hypertonic fluid replacement
3% NaCl
What is an example of hypotonic fluid replacement
0.2% NaCl
What are the four crystalloids commonly used in fluid replacement
0.45% NaCl, 0.9%NaCl, Lactated Ringers (LR), Dextrose 5% Water (D5W)
What is the order for crystalloids when it comes to Na+
0.9%NaCl, LRs, 0.45%NaCl, D5W (no Na+ at all)
What is the order for crystalloids when it comes to highest osmolarity to lowest osmolarity
0.9%NaCl, Lactated Ringers, D5W, 0.45%NaCl
What is the order for crystalloids when it comes to movement into the intracellular fluid
D5W, 0.45%NaCl. 0.9%NaCl and Lactated Ringers do not go into the intracellular fluid
What is the order for crystalloids when it comes to movement into the interstitial fluid
0.9%NaCl/Lactated Ringers at the same percentage, 0.45%NaCl, D5W
What is the order for crystalloids when it comes to movement into the intravascular fluid
0.9%NaCl/Lactated Ringers at the same percentage, 0.45%NaCl, D5W
Which crystalloid distributes itself in the exact same way water/fluid distributes itself in the body
D5W
T/F: 0.9%NaCl and Lactated Ringers strictly go in to extracellular fluid and move in the exact same way interstitial fluid and intravascular fluid divide
True
In order to raise blood pressure which crystalloids will raise blood pressure in a hypovolemic patient
.09%NaCl and Lactated Ringers
What are the two colloids used for fluid replacement
5% albumin and 25% albumin
T/F: Colloids stay mostly intracellular, pulling water to the cells
False: Colloids stay in extracellular and 25% albumin will actually pull water from the interstitial fluid
What are the daily fluid requirements (maintenance) in dehydration, post-operative, euvolemia, elderly or CHF
45 ml/kg/day, 40ml/kg/day, 35ml/kg/day, 30ml/kg/day
