fluid, electrolytes, acid-base Flashcards
Total body water accounts for ____% body wt?
60%
Of the total body water, how much is located intracellularly? Extracellularly?
2/3 and 1/3 (#mental math)
Extracellular fluid is composed of _________ and __________________
plasma, interstitial fluid
What is a normal fluid intake/day
1500mL
What is a normal urine output/day
800-1500mL
there are 4 types of fluid replacement. What 2 increase intravascular fluid? What 2 increase intercellular fluid?
Intravascular: NS and Lactated Ringer’s
Intracellular: D51/2NS and D5W
Loss of fluid through sweat and respiration is called?
Insensible loss
What do labs look like in a dehydrate patient?
high serum Na with BUN/Cr ration >20:1 (hypoperfusion of kidneys) high hct, high osmolarity of blood
What is the goal urine output for an adult? Child?
Adult: 0.5 mL/kg/hr
Child: 1mL/kg/hr
When giving bolus fluids, should you include dextrose or potassium?
No, this can lead to hyperglycemia or hyperkalemia (Lactated Ringer’s). Give NS bolus and do mixture for maintenance dose
How do you calculate maintenance fluids?
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
If you increase Na, where do you see an increase in fluid volume?
Extracellular fluid
High Na = increased/decreased GFR?
increased
Hyponatremia is caused by too much _________ and hypovolemia is caused by too little __________
water, sodium
What is the major concern for hypernatremia?
osmotic effects on the brain, water leaves brain cells leaving them dehydrated