Fluid & Electrolyte Balance - WAE

Question 1

What is the Total Body Water % for males and females?

Answer 1

Males = 60& Body weight
Females = 50% Body weight

Question 2

Where is most of the TBW located: intracellularly or extracellularly?

Answer 2

Intracellularly = 2/3 TBW
Extracellularly = 1/3 TBW

Question 3

True or False: Total water content is directly related to fat content?

Answer 3

True

Question 4

What is tonicity?

Answer 4

measure of the osmotic pressure of two solutions separated by a semipermeable membrane

Question 5

Where is most of potassium excreted from the body?

Answer 5

85% of potassium excreted in urine.

15% excreted in stool.

Question 6

What are the primary cations and anions in the ECF?

Answer 6

Sodium primary cation.

Chloride & bicarbonate primary anions.

Question 7

What are the primary cations and anions in the ICF?

Answer 7

Potassium primary cation.

Phosphates & anionic proteins primary anions.

Question 8

1 liter of fluid equals how many kilograms of body weight?

Answer 8

1 Liter = 1 kg body weight

Question 9

What is the diagnostic value for hyponatremia?

Answer 9

a serum Na+ < 135

Question 10

What are the symptoms of hyponatremia?

Answer 10

• anorexia
• nausea
• malaise
• HA, lethargy , agitation

Question 11

What causes hypertonic hyponatremia?

Answer 11

↑ solutes in plasma such as glucose or mannitol redistribute volume from intracellular space to extracellular space causing hyponatremia

Question 12

What causes hypotonic hyponatremia?

Answer 12

• ↑ in total body water (excessive water intake)
• ↓ in total body solute & h20
• ↑ in total body solute & h20

Question 13

What is central pontine myelinolysis?

Answer 13

-occurs 2-6 days after over correction with hypertonic saline
-irreversible neuro deficit
S/S: dysarthria, dysphagia, incoordination, quadriplegia, coma

Question 14

What is the diagnostic value for hypernatremia?

Answer 14

Na+ > 145 MEQ/L

Question 15

What are causes of hypernatremia?

Answer 15

1) Hypodipsia

2) Solute gain (rare → hypertonic saline infusion)

Question 16

What would be the procedure to replace volume depletion in a patient?

Answer 16

1) Use NSS to stabilize BP
2) Replace remaining deficits with 1/2 NSS
3) After BP stabilized → replace free H20 deficits

Question 17

What is the formula used to estimate volume deficit in a patient?

Answer 17

(0.6 x weight {kg}) x (Na - 140) / 140

Replace half in 24 hours in patients with chronic losses

Question 18

What are the S/S of hypokalemia?

Answer 18

• muscle weakness, cramps
• N/V
• arrhythmias
• Polyuria/Polydipsia
• EKG changes (Flat “T” waves & “U” waves)

Question 19

What are the S/S of hyperkalemia?

Answer 19

• Weakness, flaccid paralysis
• Hyperactive DTR’s
• Peaked “T” waves, widened QRS complex

Question 20

In fluid replacement therapy, what is the indication for NSS/RL?

Answer 20

used for volume expansion/hypotension due to volume loss

Question 21

In fluid replacement therapy, what is the indication for D5 1/2 NS?

Answer 21

Maintenance fluid

Question 22

In fluid replacement therapy, what is the indication for 3% NS?

Answer 22

Severe hypotonic hyponatremia

Question 23

In fluid replacement therapy, what is the indication for D5 1/4 D5W?

Answer 23

excessive sodium problems