fluid, electrolytes, acid-base Flashcards

1
Q

Total body water accounts for ____% body wt?

A

60%

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2
Q

Of the total body water, how much is located intracellularly? Extracellularly?

A

2/3 and 1/3 (#mental math)

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3
Q

Extracellular fluid is composed of _________ and __________________

A

plasma, interstitial fluid

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4
Q

What is a normal fluid intake/day

A

1500mL

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5
Q

What is a normal urine output/day

A

800-1500mL

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6
Q

there are 4 types of fluid replacement. What 2 increase intravascular fluid? What 2 increase intercellular fluid?

A

Intravascular: NS and Lactated Ringer’s
Intracellular: D51/2NS and D5W

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7
Q

Loss of fluid through sweat and respiration is called?

A

Insensible loss

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8
Q

What do labs look like in a dehydrate patient?

A

high serum Na with BUN/Cr ration >20:1 (hypoperfusion of kidneys) high hct, high osmolarity of blood

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9
Q

What is the goal urine output for an adult? Child?

A

Adult: 0.5 mL/kg/hr
Child: 1mL/kg/hr

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10
Q

When giving bolus fluids, should you include dextrose or potassium?

A

No, this can lead to hyperglycemia or hyperkalemia (Lactated Ringer’s). Give NS bolus and do mixture for maintenance dose

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11
Q

How do you calculate maintenance fluids?

A

Give 4mL/kg for first 10kg, 2mL/kg for next 10kg, and then 1 mL/kg for remainder of weight per hour.
4/2/1 Rule

Ex: 70kg man. 4mL x 10kg + 2mL x 10kg + 1mL x 50kg = 110mL/hour

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12
Q

If you increase Na, where do you see an increase in fluid volume?

A

Extracellular fluid

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13
Q

High Na = increased/decreased GFR?

A

increased

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14
Q

Hyponatremia is caused by too much _________ and hypovolemia is caused by too little __________

A

water, sodium

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15
Q

What is the major concern for hypernatremia?

A

osmotic effects on the brain, water leaves brain cells leaving them dehydrated

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16
Q

What factors are involved in balancing calcium?

A

PTH, calcitonin, vit D, albumin, pH

17
Q

What is the normal Ca+ range?

A

8.5-10.5mg/dL

18
Q

calcium exists in what 2 forms?

A

Protein bound (albumin controlled) and Free ionized (PTH controlled)

19
Q

Increased/decreased pH increases the binding of Ca to albumin?

A

Increased

20
Q

What organs are involved in calcium regulation?

A

Bone (breakdown, remodeling)
Kidney (Ca reabsoprtion vs phosphate reabsorption)
Gut (activation of vit D)

21
Q

Low calcium results in __________ deep tendon reflexes?

A

Hyperactive (chvostek and trousseau signs)

22
Q

HYPERcalcemia will __________QT interval and

HYPOcalcemia will _____________QT interval.

A
hyper = shorten
hypo = lengthen
23
Q

Too much calcium results in what generic nmeumonic?

A

stones, bones, groans, moans

24
Q

What is the normal K+ range?

A

3.5 - 5.0

25
Q

T/F. Potassium level is greatly affected by pH

A

true

alkalosis moves K into cells.
acidosis moves K out of cells

26
Q

What are some causes of potassium loss?

A

GI, Renal, insufficient diet, sweating, bactrim

27
Q

How do you treat low K? how important is it?

A

KCl, treat right away to avoid cardiac arrhythmia

28
Q

How do you treat high K?

A

IV Ca to stabilize membrane potential (immediately)

29
Q

What electrolyte imbalance is the most dangerous and rapidly fatal?

A

hyperkalemia

30
Q

What are normal Mg levels?

A

1.8-2.5mg/dL

31
Q

Where is most of the body’s Mg?

A

bones

32
Q

What other electrolytes are related to Mg levels?

A

hypomagnesemia makes hypokalemia and hypocalcemia more difficult to tx

33
Q

What complications occur with too much Mg?

A

arrhythmia, coma, resp failure

34
Q

How do you treat too much Mg?

A

IV Ca to stabilize heart, intubate, saline+loop

35
Q

What are normal phosphate levels?

A

3-4.5mg/dL

36
Q

Where is your P stored?

A

bones

37
Q

What are the 2 most common causes of low phosphate?

A

ETOH and DKA