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Fluids and Electrolytes > Fluid Types > Flashcards

Fluid Types Flashcards

1
Q

What is osmolarity?

A

describes the concentration of dissolved particles (or solutes)

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2
Q

Hypotonic solutes have a (higher, lower, same) osmolarity than the blood.

A

lower

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3
Q

With hypotonic solutions, Osmosis causes water to move from _________ space to __________ space.

A

extracellular, intracellular (cell swells)

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4
Q

What do hypotonic fluids do in relation to cells?

A

They dilute extracellular space and replenish the inside of the cell.

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5
Q

A patient has hypernatremia. What type of fluids should you give and why?

A

Hypotonic because it will dilute the concentration of solutes.

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6
Q

Hypotonic fluids can provide free water to help the _________ excrete waste and prevent ______________.

A

kidneys, dehydration

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7
Q

Examples of hypotonic fluids

A

half normal saline
anything less than half normal saline
D5W

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8
Q

What is special about D5W?

A

It starts out as an isotonic fluid but will become hypotonic within the body.

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9
Q

Hypotonic fluids can lead to brain swelling. Why?

A

Because fluid is moving from the ECF to the ICF which leads to cell swelling.

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10
Q

What should you monitor for when giving hypotonic fluids?

A

mental status changes
hypotension
hypovolemia
hyponatremia

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11
Q

What type of patients are most sensitive to hypotonic fluids and why?

A

Patients who are fluid sensitive (like heart or renal failure patients) because they cannot handle the extra water.

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12
Q

Hypertonic solutions have a (higher, lower, same) osmolarity than the blood.

A

higher

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13
Q

With hypertonic fluids, osmosis will cause water to leave ___________ space.

A

intracellular (cell shrinks)

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14
Q

Hypertonic fluids will (expand, shrink) extracellular space.

A

expand

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15
Q

What kind of patients would benefit from hypertonic fluids?

A

hyponatremic
cerebral edema (brain swelling)

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16
Q

Examples of hypertonic solutions

A

3% saline
D10W
D5NS
D5 1/2 NS

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17
Q

What are 2 big reasons why should I use caution when administering hypertonic fluids?

A

can overload the extracellular space leading to pulmonary edema
can cause hypernatremia

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18
Q

Isotonic solutes have a (higher, lower, same) osmolarity than the blood.

A

same

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19
Q

Do isotonic solutions affect the size of the cell? Why or why not?

A

No because there is an equal transfer of water between the ECF and ICF.

20
Q

What will isotonic solutions expand?

A

the extracellular fluid volume (plasma)

21
Q

What are some reasons why you would want to administer isotonic fluids?

A

fluid loss in extracellular space
vomiting
diarrhea (need Na and Cl back)
hypovolemic shock
burns
prior surgery (will lose ECF)

22
Q

Examples of isotonic fluids

A

normal saline
LR
D5W (starts as isotonic but will change to hypotonic in the body)

23
Q

What does NS replace?

A

water, sodium, and chloride

24
Q

What is the only solution that can be administered with blood?

A

NS

25
Q

What should I monitor for when giving isotonic fluids?

A
  • fluid overload (esp in those with heart or kidney failure)
  • BP
  • breathing/lung sounds
  • edema in extremities
26
Q

What does D5W replace?

A

water and dextrose

27
Q

What fluid would help with hypernatremia but would NOT be used for fluid resuscitation?

A

D5W

28
Q

What fluid starts out as isotonic but changes to hypotonic and why?

A

D5W because the dextrose is metabolized, so only water is left. This is hypotonic (has low osmolarity).

29
Q

What is in LR?

A

water, K, Na, Cl, Cal, and Lactate

30
Q

What does the lactate in LR help to increase blood pH?

A

lactate will convert to bicarb thus increasing your blood pH

31
Q

Who would you not want to give LR to?

A

a patient with liver disease (liver convert lactate to bicarb) or lactic acidosis (already has a high amount of lactate present)

32
Q

Name some colloid solutions

A

Natural - albumin, FFP (Frash Frozen Plasma)
Synthetic - dextran, hydroxyethyl starches (HES), and gelatin

33
Q

Describe colloid solutions

A
  • large molecules that stay in intravascular space longer
  • fast at expanding the intravascular space by pulling water into intravascular space
  • amount administered = amount lost
34
Q

What type of patient would you want to have colloid solutions?

A

patients with hypovolemic shock, severe burns, or severe bleeding, or low albumin levels

35
Q

Name crystalloid solutions

A

hypotonic, hypertonic, and isotonic solutions

36
Q

Describe crystalloid solutions

A
  • small molecules that don’t stay long in intravascular space
  • high amount of fluids needed = amount lost
37
Q

Risks of colloid solutions

A
  • allergic reaction
  • coagulation problems
  • high cost
38
Q

Risks of crystalloid solutions

A
  • edema/fluid overload
39
Q

__________ pressure pulls water through the capillary wall

A

Oncotic

40
Q

___________ pressure pushes water across the capillary wall.

A

Hydrostatic

41
Q

Hydrostatic pressure is created by the _________ _________.

A

heart’s contractions

42
Q

Hydrostatic pressure is __________ at the arterial end of the capillary

A

highest

43
Q

Hydrostatic pressure is __________ at the venous end of the capillary

A

lowest

44
Q

What is ANP - Atrial Natriuretic Peptide?

A

a hormone released by heart cells due to atrial wall stretching

45
Q

What is BNP - Brain Natriuretic Peptide?

A

A hormone released by heart cells due to ventricle wall stretching

46
Q

What do ANP and BNP do in relation to the RAAS?

A

they work against angiotensin II and stop the effects of aldosterone, ADH, and renin. Which helps to prevent fluid volume overload

47
Q
A

Fluids and Electrolytes (4 decks)

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