Fluid disorders

Question 1

What is the total body water for males, females, pediatrics, elderly males and elderly females

Answer 1

60%, 50%, 60%-70%, 50% and 45%

Question 2

How is the total body water found in obese individuals

Answer 2

Decrease by 5% if they are 130% over ideal body weight

Question 3

How is total body water spread out

Answer 3

1/3 extracellular fluid, 2/3 intracellular fluid

Question 4

how is extracellular fluid spread out

Answer 4

3/4 interstitial fluid, 1/4 intravascular fluid

Question 5

What is the extracellular cation

Answer 5

Na+

Question 6

What is the intracelluar cation

Answer 6

K+

Question 7

What is the plasma osmolality range

Answer 7

280-295

Question 8

What does it mean if plasma osmolarity is high, low plasma osmolarity

Answer 8

high solute/low solvent (lack of water), low solute/high solvent (excess of water)

Question 9

T/F: Osmolality is calculated, osmolarity is measured

Answer 9

False: osmolarity is calculated, osmolality is measured

Question 10

what is the equation to calculate osmolarity

Answer 10

mOsm/LH2O= 2 x {Na+} + glucose/18 + BUN/2.8

Question 11

T/F: Na+/K+ pumps maintain concentrations

Answer 11

True

Question 12

T/F: Water freely moves along gradient between membranes

Answer 12

True

Question 13

Stimulants that cause the release of Arginine Vasopressin

Answer 13

high plasma osmolarity, nausea, pain/anxiety

Question 14

Medications that stimulate relase of Arginine Vasopressin

Answer 14

carbamazepine, tricylic antidepressants,SSRIs,opiates

Question 15

Symptoms of hypovolemia

Answer 15

weakness, lethargy tachycardia, thirst, low urine output, dry clammy skin/low skin turgor, flushed skin

Question 16

Symptoms of hypervolemia

Answer 16

anxiety, hypertension, wheezing, diarrhea, pitting edema, crackles

Question 17

T/F: Diabetes insipidus causes hypervolemia

Answer 17

False: AVP is not released correctly causing loss of water therefore hypovolemia

Question 18

What are the two types of Diabetes Insipidus

Answer 18

Central: brain, Nephrogenic: kidney

Question 19

What are the 3 goals of volume therapy

Answer 19

Resuscitation, Replacement, Maintenance

Question 20

Characteristics of crystalloids

Answer 20

can replace water and electrolyes, readily available, better tolerated, first line

Question 21

Characteristics of colloids

Answer 21

for intravascular expansion, less readily available, risky

Question 22

T/F: Hypertonic solutions move extracellular to intracellular

Answer 22

False: Move intracellular space to extracellular space

Question 23

T/F: Hypotonic solutions move extracelluar to intracellular

Answer 23

True

Question 24

What is an example of isotonic fluid replacement

Answer 24

0.9% NaCl, Lactated Ringers

Question 25

What is an example of a hypertonic fluid replacement

Answer 25

3% NaCl

Question 26

What is an example of hypotonic fluid replacement

Answer 26

0.2% NaCl

Question 27

What are the four crystalloids commonly used in fluid replacement

Answer 27

0.45% NaCl, 0.9%NaCl, Lactated Ringers (LR), Dextrose 5% Water (D5W)

Question 28

What is the order for crystalloids when it comes to Na+

Answer 28

0.9%NaCl, LRs, 0.45%NaCl, D5W (no Na+ at all)

Question 29

What is the order for crystalloids when it comes to highest osmolarity to lowest osmolarity

Answer 29

0.9%NaCl, Lactated Ringers, D5W, 0.45%NaCl

Question 30

What is the order for crystalloids when it comes to movement into the intracellular fluid

Answer 30

D5W, 0.45%NaCl. 0.9%NaCl and Lactated Ringers do not go into the intracellular fluid

Question 31

What is the order for crystalloids when it comes to movement into the interstitial fluid

Answer 31

0.9%NaCl/Lactated Ringers at the same percentage, 0.45%NaCl, D5W

Question 32

What is the order for crystalloids when it comes to movement into the intravascular fluid

Answer 32

0.9%NaCl/Lactated Ringers at the same percentage, 0.45%NaCl, D5W

Question 33

Which crystalloid distributes itself in the exact same way water/fluid distributes itself in the body

Answer 33

D5W

Question 34

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

Answer 34

True

Question 35

In order to raise blood pressure which crystalloids will raise blood pressure in a hypovolemic patient

Answer 35

.09%NaCl and Lactated Ringers

Question 36

What are the two colloids used for fluid replacement

Answer 36

5% albumin and 25% albumin

Question 37

T/F: Colloids stay mostly intracellular, pulling water to the cells

Answer 37

False: Colloids stay in extracellular and 25% albumin will actually pull water from the interstitial fluid

Question 38

What are the daily fluid requirements (maintenance) in dehydration, post-operative, euvolemia, elderly or CHF

Answer 38

45 ml/kg/day, 40ml/kg/day, 35ml/kg/day, 30ml/kg/day