Fluids Flashcards
Who is at most risk for dehydration?
new borns and elderly
Intracellular Fluid
70% of total fluid and 40% of total body weight
Extracellular Fluid
30% of total fluid and 20% of total body weight
Interstitial Space
space between structures such as cells, organs and muscles
Serum
obtained by spinning after clotting
Plasma
obtained by spinning before clotting 55% of blood
WBC, RBC and platelets
45% of blood
Osmosis
movement of H2O from low to high concentration
Diffusion
movement of solutes from high concentration to disperse out
Active Transport
requires energy for movement of substances through cell membrane
ex sodium potassium pump
Capillary Filtration
passage of fluid through permeable membrane from high to low pressure
Hydrostatic Pressure
force exerted by fluid present with in blood capillaries against capillary wall, push fluid out of capillaries, occurs at arterial end
Oncotic Pressure
exerted by proteins in blood plasma, pushes fluid into blood capillaries, occurs at venous end
ANP and BNP
peptides that have diuretic effect for fluid overload
Angiotensin 2
vasoconstrictor to increase BP
Retention of Sodium and Water
kidney secretes renin–> adrenal glands secrete aldosterone
Normal Serum Osmolality
200-300
Normal Urine Osmolality
200-800
What happens to osmolality and osmolarity when there isnt enough fluid?
increases
Urine Specific Gravity
1.010-1.020; higher when dehydrated
Sensible Fluid Loss
observable; urine, feces, perspiration
Insensible Fluid Loss
not observable; expired breath, cutaneous transpiration
Isotonic Fluids
adds fluid volume outside the cell; used to replace in case of fluid volume deficit; increases BP
Types of Isotonic Fluids
0.9% sodium chloride
lactated ringers
D5W
D5NS
Caution with isotonic fluids
high BP, heart and kidney failure
What is the only fluid used when giving blood products
Normal Saline
Hypotonic Fluid
water shifts from extracellular to intracellular: used to bring down high sodium levels and hypertonic dehydration ! WATCH FOR BRAIN SWELLING!
Types of Hypotonic Fluids
0.5% normal saline (0.45% sodium chloride)
0.3% sodium chloride
Dextrose 5%
Hypotonic Cautions
not for renal or heart failure
Hypertonic Fluid
pulls water out of cell; decreases cellular swelling; can be used for cerebral edema
Hypertonic Fluid types
3% sodium chloride
5% sodium chloride
Hypertonic Considerations
give SLOWLY and closely monitor
Colloids
large molecule that do not cross over membrane out of vessels, shifts water back into vasculature; used for hypotension and plasma extension
Albumin
colloid, from liver so if liver isnt working properly it can cause ascites, can be given to get fluid back into vessels; expensive!
Normal Intake
2600 mL per day
liquids- 1300
food- 1000
Metabolic oxidation- 300
Normal Output
around 1-2 L
should balance with intake
Urine- 1500-2500
insensible- 350
Feces- 2000 ml
Hypovolemia
BUN and hematocrit will increase; caused by decreased intake or increased loss; treated with isotonic
Hypervolemia
Listen to lungs; caused by HF, kidney failure, cirrhosis, increased salt intake; treatment is diuretics and restricting sodium and fluid intake
