Fluid Therapy- Almalouf

Question 1

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

Answer 1

crystalloid

Question 2

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

Answer 2

colloid

Question 3

osmolarity near that of normal plasma

Answer 3

isotonic

Question 4

osmolarity less than that of normal plasma

Answer 4

hypotonic

Question 5

osmolarity more than that of normal plasma

Answer 5

hypertonic

Question 6

albumin is an example of colloid or crystalloid

Answer 6

colloid

Question 7

starch is an example of colloid or crystalloid

Answer 7

colloid

Question 8

what pressure maintains fluid in vascular space

Answer 8

oncotic pressure

Question 9

deficiency of body water (identified by hypernatremia)

Answer 9

dehydration

Question 10

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

Answer 10

volume depletion

Question 11

to treat dehydration

Answer 11

hypotonic fluid

Question 12

if you lose water, what do you replace it with

Answer 12

hypotonic fluid

Question 13

to treat volume depletion—deficiency of ECF volume

Answer 13

Isotonic fluid

Question 14

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

Answer 14

isotonic fluid (salt and water)

Question 15

3 main types of isotonic crystalloids used to treat volume depletion

Answer 15

Normal Saline
Lactated Ringer’s
Plasma-Lyte

Question 16

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

Answer 16

interstitial space

Question 17

normal saline=

Answer 17

0.9% NaCl

Question 18

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

Answer 18

normal saline

Question 19

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

Answer 19

normal saline

Question 20

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

Answer 20

normal saline

Question 21

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

Answer 21

normal saline

Question 22

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

Answer 22

ECF compartment

Question 23

NaCl + KCl + CaCl2 + NaLactate

Answer 23

lactated ringer’s solution

Question 24

what does lactated ringer’s solution involve

Answer 24

NaCl
KCl
CaCl2
Nalactate

Question 25

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

Answer 25

lactated ringers solution

Question 26

buffer used in lactated ringers solution

Answer 26

lactate anion

Question 27

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

Answer 27

lactated ringers solution

Question 28

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

Answer 28

lactated ringers solution function

Question 29

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

Answer 29

lactated ringers solution

Question 30

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

Answer 30

lactated ringers solution

Question 31

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

Answer 31

lactated ringers solution

Question 32

this crystalloid contains NaCl KCl MgCl2 NaAcetate Glucose

Answer 32

plasma-lyte solution

Question 33

plasma-lyte solution contains what

Answer 33

NaCl KCl MgCl2 NaAcetate Glucose

Question 34

buffer for plasma-lyte solution

Answer 34

acetate

Question 35

primary use of this crystalloid is for physiologic maintenance fluid

Answer 35

plasma-lyte solution

Question 36

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

Answer 36

dextrose 5% in water (D5W)

Question 37

this crystalloid is equivalent to giving pure water

Answer 37

D5W

Question 38

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

Answer 38

D5W

Question 39

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

Answer 39

D5W

Question 40

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

Answer 40

D5W

Question 41

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

Answer 41

D5W

Question 42

do not resuscitate with this crystalloid

Answer 42

D5W

Question 43

a half and half crystalloid fluid

Answer 43

1/2 normal saline + 1/2 D5W

Question 44

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

Answer 44

1/2 NS + 1/2 D5W

Question 45

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

Answer 45

1/2 Normal Saline

Question 46

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

Answer 46

1/2 normal saline

Question 47

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

Answer 47

1/2 normal saline

Question 48

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

Answer 48

1/2 normal saline

Question 49

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

Answer 49

1/2 normal saline

Question 50

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

Answer 50

1/2 normal saline

Question 51

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

Answer 51

the colloids

Question 52

when to give colloids

Answer 52

in a patient who is in an edematous state

Question 53

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

Answer 53

colloids

Question 54

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

Answer 54

albumin infusion

Question 55

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

Answer 55

hydroxyl-ethyl starches (HES)

Question 56

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

Answer 56

hydroxyl-ethyl starches

Question 57

special solution used for metabolic acidosis

Answer 57

bicarbonate solution

Question 58

infusion of undiluted _______ solution can cause dangerous, iatrogenic hypernatremia

Answer 58

bicarbonate

Question 59

this special solution is incompatible with Ca2+

Answer 59

HCO3-

Question 60

____amps NaHCO3 added to 1 L D5W ≡ NS

Answer 60

3

Question 61

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

Answer 61

1

Question 61

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

Answer 61

quantity

Question 61

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

Answer 61

2

Question 62

Level of [Na+] determines _____ of NaHCO3 solution

Answer 62

concentration

Question 63

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

Answer 63

quantity

Question 64

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

Answer 64

isotonic (3 amps)

Question 65

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

Answer 65

hypotonic (1 amp)

Question 66

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

Answer 66

parenteral nutrition solution (TPN)

Question 67

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

Answer 67

parenteral nutrition solution (TPN)

Question 68

Water - Amino Acid - Glucose

Answer 68

basic TPN solution