Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nayla Foundations Exam 5 > Fluids > Flashcards

Fluids Flashcards

1
Q

Why do we replace fluids

A

to maintain homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is total body water

A

60% of total body weight
2/3 ICF, 1/3 ECF (of the ECF, 3/4 is interstitial, 1/4 is plasma)
Newborns have the most (80%)
In adults, M>W (more adipose= less water)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do we remember fluid levels

A

TIE 60 40 20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What ions are intracellular

A

Potassium
PO4
protein
magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What ions are extracellular

A

Sodium
Chloride
HCO3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do we need to know about daily water balance

A

Input should equal output (Euvolemia)

Output is usual insensible loss (lungs, skin NOT sweat), sweat, feces, urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes hypovolemia

A 
GI loss (vomit, bleeding, diarrhea) 
Renal loss (diuretics, diabetes insipidus) 
Skin loss 
Sequestered w/ loss (rhabdo, pancreatitis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are symptoms of Hypovolemia

A 
thirst 
decreased sweating/skin turgor
DMM
Oliguria (concentrated pee)
CNS depression 
weakness, muscle cramps 
Hypotension
Tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is third spacing

A 
fluid in the interstitium (where it shouldn't be) 
AKA edema (ascites, burns, pleural effusion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is significant about third spacing

A

They can still be hypovolemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the types of fluids

A 
Crystalloid (electrolytes, pass thru endothelial membrane, water follows) 
Colloid (lytes and org. molecules, don't pass endothelium, stay in intravascular space) 
Blood products (like colloids, stay in vascular space)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common fluid used

A

Crystalloid- it’s isotonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are types of crystalloids

A

Isotonic (name Na as normal cells): LR, 0.9% NS, plasma-lyte- distribute evenly thru ECF
Hypertonic (higher salt than our cells): 3% NS
Hypotonic (lower salt): 0.5%, 0.25% NS
Dextrose 5% in water (D5W)/ D5 1/2NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is in isotonic crystalloids

A

LR: lactate, K+, Ca, NaCl

plasma lyte: less Chloride to prevent acidosis (more physiologic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are Isotonic crystalloids used for

A

dehydration
hypovolemia
hypovolemic shock (CAN IV BOLUS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are hypertonic crystalloids used for

A

life threatening hyponatremia (causing seizure)

To decrease cerebral edema in neurosurg patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why do we need to be careful with hypertonic crystalloids

A

If administered too quickly can cause CPM

18
Q

What are hypotonic crystalloids used for

A

maintenance fluid- they distribute thru TBW so not good for replacing INTRAvascular fluid deficit, dehydration, or hypovolemia

19
Q

What is D5W used for

A

hypoglycemia
hypernatremia w/ free water deficit
(distributes like hypotonic- caution in DM patients)

20
Q

Colloids are basically

A

likely to expand vascular compartment- use them when crystalloids fail to sustain plasma volume 2/2 decreased osmotic pressure

21
Q

Who would colloids be beneficial in

A

burn pts
peritonitis (protein loss)
malnourished
(NOT for severe hypovolemia)

22
Q

What are the types of colloids

A

Albumin (5%, 25%)

Dextran and Hetastarch (not used a lot)

23
Q

When is albumin used

A

In edematous patients, to mobilize interstitial fluid (NOT if albumin >2.5 mg)
Liver disease
peritonitis
burns
3rd spacing
–AKA, we want to try to shift fluid to intravascular space from the interstitium

24
Q

What are blood products

A

Packed RBC*
platelets
FFP
cryoprecipitate

25
Q

What are packed RBC and when are they used

A

Made from whole blood, they stay in vascular space
Used for transfusion to increase oxygen to tissues (hemorrhage or severe anemia)
1 PRBC unit will increase Hgb by 1g

26
Q

What do patients need if they get packed RBC

A

Type and screen (blood type)

Type and cross (at time of transfusion to specifically check for a reaction)

27
Q

When are platelets used

A

to prevent or treat bleeding In patients with:
thrombocytopenia
bad platelet function (on ASA/plavix)

28
Q

What is FFP and when is it used

A

Has all factors of soluble coagulation system.
Used to correct major bleeding if patient is on warfarin OR hypokalemic
Also in hereditary angioedema

29
Q

What is the difference between FFP and vitamin K

A

FFP works right away but is only effective for a short time

Vitamin K takes a while to be effective but lasts way longer

30
Q

What is cryoprecipitate and when is it used

A

Thawed FFP and collect precipitate- has higher fibrinogen and factor 8, factor 10, and VWF
Use if low fibrinogen d/t massive hemorrhage, liver failure, or consumptive coagulopathy

31
Q

What is a bolus

A 
1 large amount (250mL-1L) 
isotonic crystalloids (2/2 hypovolemia) 
Packed RBC (2/2 massive hemorrhage)
32
Q

Who do we need to use caution in when giving a bolus

A

Heart Failure patients (may already be fluid overloaded)

33
Q

What are maintenance IV fluids

A

they account for ongoing water and electrolyte loss, under normal physiologic conditions (urine, feces, sweating, respirations)

  • we give them when patients are not eating or drinking normally, to maintain balance
  • NS, plasma lyte, LR, D5 1/2NS +/- 20mEq KCl
34
Q

How do we calculate rate at which to give maintenance fluids (adults)

A

based on the clinical scenario! usually:
1st 10kg= 100 mL/kg
2nd 10kg= 50 mL/kg
rest= 20 mL/kg
divide all by 24 hours and you get your average hourly infusion rate

35
Q

Most hourly infusion rates are

A

75 ml, 100 ml, 125 ml

if you get a weird number thru calculation, ROUND

36
Q

What can you add to maintenance IV fluids

A

K to treat hypokalemia (potassium is osmotically like Na)
BUT, you cant bolus potassium. so if you add K to 0.9% NS, you can no longer bolus
also, use caution with K in renal disease patients

37
Q

How are replacement IV fluids used

A

to correct existing water/electrolyte deficiency d/t pathologic conditions
must monitor vitals, UO, and clinical picture
use CAUTION if very hypo or hypernatremic (correcting too fast can lead to CPM)

38
Q

Who often needs replacement fluids

A

surgical patients (low UO, 3 spacing, blood loss, etc.)

39
Q

What is parkland formula (burn patients)

A 
total fluid needed in first hour= (% of 2-3 degree burn) x (kg) x 4mL
replace with LR! 
first 8 hr: 1/2 of total fluid 
8 hr: 1/4 of total 
8 hr: 1/4 of total
40
Q

What is the rule of 9’s

A 
Head: 9
Arms: 9 each
legs: 18 each
front torso: 18
back: 18
perineum: 1

Nayla Foundations Exam 5 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions