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URN Biweekly 2 > Fluid Therapy- Almalouf > Flashcards

Fluid Therapy- Almalouf Flashcards

1
Q

IV fluid that is water + electrolytes or small solutes that pass the capillary wall freely

A

crystalloid

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2
Q

IV fluid that is water + macromolecules that are mostly confined to the vascular space

A

colloid

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3
Q

osmolarity near that of normal plasma

A

isotonic

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4
Q

osmolarity less than that of normal plasma

A

hypotonic

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5
Q

osmolarity more than that of normal plasma

A

hypertonic

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6
Q

albumin is an example of colloid or crystalloid

A

colloid

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7
Q

starch is an example of colloid or crystalloid

A

colloid

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8
Q

what pressure maintains fluid in vascular space

A

oncotic pressure

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9
Q

deficiency of body water (identified by hypernatremia)

A

dehydration

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10
Q

a deficiency of ECF volume (saline) identified by changes in hemodynamic function

A

volume depletion

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11
Q

to treat dehydration

A

hypotonic fluid

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12
Q

if you lose water, what do you replace it with

A

hypotonic fluid

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13
Q

to treat volume depletion—deficiency of ECF volume

A

Isotonic fluid

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14
Q

if you lose salt and water, what do you replace it with

A

isotonic fluid (salt and water)

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15
Q

3 main types of isotonic crystalloids used to treat volume depletion

A

Normal Saline
Lactated Ringer’s
Plasma-Lyte

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16
Q

majority of the crystalloid fluid infused actually gets distributed where when equilibrated

A

interstitial space

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17
Q

normal saline=

A

0.9% NaCl

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18
Q

this crystalloid fluid does NOT contain a buffer so large amounts can acidify body fluids

A

normal saline

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19
Q

this is specifically used for ECF volume repletion to sustain blood pressure and CO

A

normal saline

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20
Q

repletes ECF space
increases vascular volume (increases CO and BP)

A

normal saline

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21
Q

disadvantage to this crystalloid is that it contains no buffer so can lead to metabolic acidosis

A

normal saline

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22
Q

what body fluid compartment is affected with the infusion of normal saline

A

ECF compartment

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23
Q

NaCl + KCl + CaCl2 + NaLactate

A

lactated ringer’s solution

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24
Q

what does lactated ringer’s solution involve

A

NaCl
KCl
CaCl2
Nalactate

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25
Q

this crystalloid contains a lactate anion (a buffer) to liberate HCO3-

A

lactated ringers solution

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26
Q

buffer used in lactated ringers solution

A

lactate anion

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27
Q

used to replace blood loss; increasing blood volume in vascular space

A

lactated ringers solution

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28
Q

Resuscitation from Blood Loss – infusion of banked blood
products are Ca++ poor; calcium in LR maintains serum [Ca++] which is vital for neuro-muscular activity

A

lactated ringers solution function

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29
Q

using this crystalloid won’t lead to metabolic acidosis unlike normal saline

A

lactated ringers solution

30
Q

what crystalloid can cause hyperkalemia if pt already has high K+

A

lactated ringers solution

31
Q

this crystalloid is also slightly hypotonic so can lead to water excess

A

lactated ringers solution

32
Q

this crystalloid contains
NaCl
KCl
MgCl2
NaAcetate
Glucose

A

plasma-lyte solution

33
Q

plasma-lyte solution contains what

A

NaCl
KCl
MgCl2
NaAcetate
Glucose

34
Q

buffer for plasma-lyte solution

A

acetate

35
Q

primary use of this crystalloid is for physiologic maintenance fluid

A

plasma-lyte solution

36
Q

this crystalloid is hypotonic and used for treatment of dehydration (replacing water)

A

dextrose 5% in water (D5W)

37
Q

this crystalloid is equivalent to giving pure water

A

D5W

38
Q

necessary to provide initial [Osm] near plasma so as not to swell RBC’s and cause hemolysis

A

D5W

39
Q

appropriate fluid for hypernatremic (hyper-osmolar) state; true dehydration

A

D5W

40
Q

crystalloid that distributes to all body water spaces (ICF and ECF)

A

D5W

41
Q

a near isotonic fluid at time of infusion which can introduce drugs into vascular space without causing hemolysis of RBC by hypotonic swelling

A

D5W

42
Q

do not resuscitate with this crystalloid

A

D5W

43
Q

a half and half crystalloid fluid

A

1/2 normal saline + 1/2 D5W

44
Q

final effect of this half and half crystalloid is an infusate that has half the tonicity of NS (154)

A

1/2 NS + 1/2 D5W

45
Q

this crystalloid is slightly hypertonic to protect RBC’s from hemolysis

A

1/2 Normal Saline

46
Q

the net osmolarity of this crystalloid is hypotonic due to metabolism of glucose leaving water component to distribute in all body fluids

A

1/2 normal saline

47
Q

this crystalloid inappropriate use is “Gentle” hydration when one is ignorant of precise need for volume and/or water repletion and hopes the kidney will help the body select the component to retain or excrete

A

1/2 normal saline

48
Q

this crystalloid is used for hypertonic (hypernatremic) ECF volume depletion

A

1/2 normal saline

49
Q

This is equivalent to infusing D5W in one arm for the hypernatremia plus infusing NS in the other arm for the ECF volume deficiency

A

1/2 normal saline

50
Q

disadvantage of this crystalloid is a fixed ratio of NS to water regardless of severity of each individual need

A

1/2 normal saline

51
Q

Macro-molecules (albumin and manufactured starches) are mostly confined to the vascular space and exert a colloid-osmotic (oncotic) pressure across the capillary wall

A

the colloids

52
Q

when to give colloids

A

in a patient who is in an edematous state

53
Q

give this in edematous state with low serum [Albumin] and vascular volume deficiency despite total ECF volume excess

A

colloids

54
Q

this causes an increase in Vascular oncotic pressure pulls fluid from interstitium, expanding VS (does nothing to ICF)

A

albumin infusion

55
Q

advantage of this colloid is it can be manufactured and has long half-life

A

hydroxyl-ethyl starches (HES)

56
Q

a disadvantage to this colloid is it can cause osmotic swelling in PCT and AKI gets filtered in glomeruli and reabsorbed in PCT

A

hydroxyl-ethyl starches

57
Q

special solution used for metabolic acidosis

A

bicarbonate solution

58
Q

infusion of undiluted _______ solution can cause dangerous, iatrogenic hypernatremia

A

bicarbonate

59
Q

this special solution is incompatible with Ca2+

A

HCO3-

60
Q

____amps NaHCO3 added to 1 L D5W ≡ NS

A

3

61
Q

______amp NaHCO3 added to 1 L D5W ≡ 1/3 NS

A

1

61
Q

Level of [HCO3-] determines ______ of NaHCO3 to infuse

A

quantity

61
Q

_____amps NaHCO3 added to 1 L D5W ≡ 2/3 NS

A

2

62
Q

Level of [Na+] determines _____ of NaHCO3 solution

A

concentration

63
Q

Serum [HCO3-] 15 mEq/L requires larger _______of infusion

A

quantity

64
Q

Serum [Na+] 140 mEq/L would use an _______ solution

A

isotonic (3 amps)

65
Q

Serum [Na+] 148 mEq/L would use a ______solution

A

hypotonic (1 amp)

66
Q

to fulfill all nutritional needs with an IV solution when the GI tract is non-functional or not available for enteral feeding

A

parenteral nutrition solution (TPN)

67
Q

components of this= 70% glucose solution + 10% AA solution

A

parenteral nutrition solution (TPN)

68
Q

Water - Amino Acid - Glucose

A

basic TPN solution

URN Biweekly 2 (15 decks)

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