Fluids

Question 1

Fluids containing larger molecular weight particles with plasma oncotic pressures similar to normal plasma proteins

Answer 1

colloids

Question 2

Examples of colloids

Answer 2

albumin, FFP, hetastarch, dextran

Question 3

noting or pertaining to a solution containing the same salt concentration as blood

Answer 3

isotonic fluids

Question 4

Examples of isotonic solutions

Answer 4

0.9% NS or lactated ringers

Question 5

a solution of lower osmotic pressure than blood

Answer 5

hypotonic fluids

Question 6

examples of hypotonic fluids

Answer 6

0.45% NaCl and D5 0.45% in NaCl

Question 7

most osmotically active electrolyte in the body

Answer 7

sodium

Question 8

easiest way to monitor net gain/loss of fluids

Answer 8

daily weights

Question 9

tells you the patient has adequate water balance

Answer 9

normal serum sodium

Question 10

obligate fluid loss of normal adults

Answer 10

1600 ml/day

Question 11

Ideal fluid to use for maintenance therapy since the kidneys will regulate Na, K, and H20 retention

Answer 11

0.45% NaCl + 20 mEq KCl

Question 12

Estimate of daily fluid requirements (from ALL sources) in adults without fever/sweats

Answer 12

1500ml + 20ml/kg for each kg >20

Question 13

How much does water requirement increase for each degree of fever > 37C?

Answer 13

100-150 ml/day for each degree above 37C

Question 14

Earliest sign of hypovolemia due to the kidneys conserving sodium and water

Answer 14

decreased urine Na (<25 mEq/L)

Question 15

What is the BUN/Cr ratio with hypovolemia?

Answer 15

> 20:1

Question 16

Treatment for hypovolemia due to decreased intake or excess excretion while waiting for labs

Answer 16

0.45% NaCl

Question 17

Treatment for hypovolemia due to decreased intake or excess excretion if serum Na > 145

Answer 17

0.25% NaCl

Question 18

Treatment for hypovolemia due to decreased intake of excess excretion if serum Na < 138

Answer 18

0.9% NaCl (NS)

Question 19

Minimum amount of urine that should be made per hr

Answer 19

30cc

Question 20

Treatment for hypovolemia due to vomiting or diarrhea until labs are back

Answer 20

0.9% NaCl (NS)

Question 21

Treatment for hypovolemia due to vomiting or diarrhea if serum Na > 145

Answer 21

0.45% NaCl

Question 22

handled like free water…will diffuse thru body water

Answer 22

1L 5% dextrose

Question 23

isotonic…distributed in ECF since cell membrane not permeable to sodium

Answer 23

1L 0.9% NS

Question 24

remains in intravascular space…shock

Answer 24

1L 5% albumin

Question 25

Acute sequestration in a body compartment that is not in equilibrium with ECF (Isotonic). Examples include: intestinal obstruction, severe pancreatitis, peritonitis, major venous obstruction, burns. Will need IV fluids to preven extracellular volume depletion

Answer 25

third spacing

Question 26

What is the fluid therapy of choice for acute hypernatremia?

Answer 26

5% dextrose

Question 27

What is the fluid therapy of choice for chronic (> 48 hrs) of hypernatremia?

Answer 27

5% dextrose in water

Question 28

What is the fluid therapy of choice for emergent hyponatremia?

Answer 28

100ml bolus of hypertonic saline given over 10 to 15 minutes

Question 29

What is the fluid therapy of choice for nonemergent hyponatremia?

Answer 29

Hypertonic saline (50ml bolus or slow continuous infusion)

Question 30

What is the fluid therapy of choice for chronic severe hyponatremia?

Answer 30

Hypertonic saline as a slow infusion at 15 to 30ml/hour. 50ml bolus can be used