Fluids Flashcards
What is the ideal body weight equation for a male?
Male= 50kg + (2.3 x in over 60”)
What is the ideal body weight equation for a female?
Female= 45.5kg + (2.3 x in over 60”)
What is the equation for dosing body weight (DBW)?
DBW= IBW + 0.4(wt-IBW)
At what percentage of ABW should determine if using DBW?
If ABW>130% of IBW, use DBW
Which applies for dosing certain drugs such as antibiotics?
A. IBW
B. DBW
C. NBW
D. ABW
B. DBW (Dosing body weight)
What is the equation for NBW?
NBW= IBW + 0.25(wt-IBW)
At what percentage of ABW should NBW be used?
Use NBW if ABW>130% of IBW
Which applies for calculating fluid, electrolyte, and nutrition (FEN) parameters?
A. IBW
B. DBW
C. NBW
D. ABW
C. NBW (Nutrition Body Weight)
Which fluid distribution accounts for 40% of body weight in adults?
A. Intracellular
B. Extracellular
C. Intravascular
D. Transcellular
A. Intracellular
Which fluid distribution accounts for 20% of body weight in adults?
A. Intracellular
B. Extracellular
C. Intravascular
D. Transcellular
B. Extracellular
Which fluid distribution accounts for 3/4th of body weight in adults?
A. Intracellular
B. Extracellular
C. Intravascular
D. Interstitial
D. Interstitial
Which fluid distribution accounts for 1/4th of body weight in adults?
A. Intracellular
B. Extracellular
C. Intravascular
D. Interstitial
C. Intravascular
Which of the following are not subject to daily gains/losses in fluid distribution?
A. Intracellular
B. Transcellular
C. Extracellular
B. Transcellular
What three organs in the body are responsible for maintaining body temp, cell shape, transport of nutrients, gases and wastes?
Skin, lungs and kidneys
The measurable form of fluid loss is (sensible/insensible), which the immeasurable portion is (sensible/insensible)
The measurable form of fluid loss is sensible, which the immeasurable portion is insensible.
What are two major forms of sensible fluid loss?
Urination and defecation
What are two major forms of insensible fluid loss?
Skin and lungs
Which hormone reduces diuresis and increases water retention?
A. ADH
B. RAAS
C. ANP
A. ADH
Which hormone regulates renin secretion and sodium/water regulation?
A. ADH
B. RAAS
C. ANP
B. RAAS
Which hormone decreases ADH release and counteracts effects of RAAS?
A. ADH
B. RAAS
C. ANP
C. ANP
What is the tonicity value of isotonic fluids?
275-290 mOsm/L
What is the tonicity value of hypotonic fluids?
<275 mOsm/L
(Hypotonic/Hypertonic) fluid is less concentrated than extracellular fluid, therefore fluid moves into the cell increasing cellular volume
Hypotonic
(Hypotonic/Hypertonic) is more highly concentrated than extracellular fluid, therefore fluid is pulled into bloodstream from cells
Hypertonic
What is the tonicity value of hypertonic fluids?
> 290 mOsm/L
Calculate the osmolarity of 1L of 0.45% NaCl (154 mOsm/L) with 20 mEq KCl (2 mOsm/mEq)
(0.45% NaCl + KCl)
150 mOsm/L + (2mOsm/mEq /20 mEg/L) = 194 mOsm/L
What is the clinical estimate for adults for MIVF over 24hrs?
A. 10-20 mL/kg/day
B. 30-40 mL/kg/day
C. 60-80 mL/kg/day
B. 30-40 mL/kg/day
KD is a 34 yom admitted today s/p appendectomy
Ht= 70” Wt=91kg
What are his total MIVF needs per day?
At what rate should his fluids run (mL/hr)?
What fluids should be started?
What are his total MIVF needs per day?
(30-40 mL/kg) x 91kg= 2730-3640 mL/day
At what rate should his fluids run (mL/hr)?
(2730-3640)/24hrs= (115-150 mL/hr)
Fluids started: 125 mL/hr
Which type of fluid has isotonic, hypotonic, and hypertonic tonicity?
(Crystalloids/Colloids)
Crystalloids
NS, 1/2 NS, D5W, LR and balances salt solutions are examples of what fluid type? (Crystalloid/Colloid)
Crystalloid
Albumin (5% or 25%), Hetastarch (Hespan), Tetrastarch (Voluven), Blood and Plaasmanate are examples of what fluid type?
(Crystalloid/Colloid)
Colloid
(Crystalloids/Colloids) provide water and/or sodium while maintaining the osmotic gradient between intravascular and extravascular compartments
Crystalloids
Which of the following is used for intravascular fluid replacement with sodium and/or chloride replacement?
A. NS
B. 1/2 NS
C. Lactated Ringer
D. D5W
A.
Normal Saline (NS) is an example of a (resuscitation/maintenance) fluid
Normal Saline (NS) is an example of a resuscitation fluid
1/2 Normal Saline (1/2 NS) is an example of a (resuscitation/maintenance) fluid
1/2 Normal Saline (1/2 NS) is an example of a maintenance fluid
T/F: 1/2 NS is used as a combination product only
True
Which of the following is used for replacement of blood loss by approximating human plasma?
A. NS
B. 1/2 NS
C. Lactated Ringer
D. D5W
C. Lactated Ringer
Lactated Ringers (LR) are used as (maintenance/resuscitation) fluids
Lactated Ringers (LR) are used as resuscitation fluids
Which of the following is used for free water replacement?
A. NS
B. 1/2 NS
C. Lactated Ringer
D. D5W
D. D5W
Dextrose 5% (D5W) is used as a (maintenance/resuscitative) fluid?
Dextrose 5% (D5W) is used as a resuscitative fluid
T/F: Dextrose 5% is a MIVF by itself
False: D5W is NOT a MIVF by itself
Crystalloid solutions contain physiologic levels of what two balanced salt solutions?
chloride and buffer solution
What are the three major NS complications?
Increased mortality, Increased acidosis, Increased renal injury
(Crystalloids/Colloids) are used to increase plasma oncotic pressure by moving fluid from the interstitial compartment to the intravascular (plasma) compartment
Colloids are used to increase plasma oncotic pressure by moving fluid from the interstitial compartment to the intravascular (plasma) compartment
(Crystalloids/Colloids) are plasma expanders that may be used in hemorrhagic shock (lower BP, blood loss)
Colloids
What are the two adverse effects of albumin?
Hypervolemia and Azotemia
(Albumin 5%/Albumin 25%) is used for treating paracentesis, while (Albumin 5%/Albumin 25%) is for treating hypovolemia
Albumin 25% is used for treating paracentesis, while Albumin 5% is for treating hypovolemia
A (low/high) molecular weight and a (low/high) substitution ratio are associated with increased mortality and toxicity
A high molecular weight and a high substitution ratio are associated with increased mortality and toxicity
What are the three safety concerns with the use of Hespan and Voluven in severe sepsis?
- Increased risk of death at day 90
- Increased risk of requiring renal replacement therapy
- Increased association with bleeding
How many mL is in 1 Unit of RBCs?
A. 130-250
B. 230-350
C. 330-450
B. 230-350
What value (in g/dL) is considered low hemoglobin?
A. < 7-8
B. < 9-10
C. < 12-13
D. < 13-14
A. < 7-8
1 unit of RBCs increases hemoglobin by how many g/dL?
1 unit of RBCs increases hemoglobin by 1 g/dL
What is the most common MIVF used to increase plasma oncotic pressure and is similar composition to urine?
D5W + 1/2 NS + 20 mEg KCl/L
What happens to heart rate, blood pressure, urine output, and BUN/SCr ratio in dehydration?
HR: Tachycardic (increased)
BP: hypotension (decreased)
Urine output: < 0.5 mL/kg/hr
BUN/SCr: >20
Extracellular fluid is higher in (Na/K), while intracellular fluid is higher in (Na/K)
Extracellular fluid is higher in Na, while intracellular fluid is higher in K
