Fluids

Question 1

Body weight %

Answer 1

60% of total body weight is water
40% is intracelluar (2/3)
20% is extraceullar (1/3)

Question 2

how much fluid is lost daily through urine?
stool?
lungs/skin?

Answer 2

up to 1500 ml
up to 250 ml
up to 900 ml
roughly 2500 p/day

Question 3

standard Na
K
Cl
HCO3

Answer 3

135-150
3.5-5.0
98-106
22-30

Question 4

standard maintenance fluid volumes

Answer 4

4-2-1 p/hr
4 ml/kg/hr for first 10 kg
2 ml/kg/hr for second 10 kg
1 ml/kg/hr for remainder

Question 5

examples of hypotonic solutions

Answer 5

1/2 normal saline

D5W

Question 6

examples of isotonic solutions

Answer 6

normal saline

LR

Question 7

examples of hypertonic solutions

Answer 7

NS + HCO3

3% saline

Question 8

gold standard for surgical resusitation

Answer 8

LR

Question 9

for fluid loss, how much should you give back?

Answer 9

determine the deficit, replace 1/2 over first 8 hours then then remainder over next 16 hours

Question 10

what are the main cations and anions extracellularly?

Answer 10

Na+, Cl-

Question 11

what are the main cations and anions intracellularly?

Answer 11

K+, phosphate-

Question 12

what determines the osmolality of ECF?

Answer 12

Na

Question 13

hypo/hypernatremia can cause…

Answer 13

coma, muscle weakness

Question 14

hyponatremia is usually dilutional needs to be corrected slowly (<0.5 mEqhr)
Caution for Central Pontine Myelinolysis if given too quickly

Answer 14

hypernatremia needs to be corrected slowly (<0.7 mEqhr)

caution for cerebral edema

Question 15

signs of hypokalemia

Answer 15

Muscle fatigue, Paralysis, Cardiac Arrhythmia

Rhabdomyolysis, EKG Changes (ST depressions)

Question 16

signs of hyperkalemia

Answer 16

Cardiac Changes (peaked T waves), Flaccid Paralysis
dialysis

Question 17

magnesium behaves like…

Answer 17

K

Question 18

pH of tissues is regulated by…

Answer 18

chemical buffers
respiratory compensation
renal compensation

Question 19

Respiratory Acidosis
Respiratory Alkalosis
Metabolic Acidosis
Metabolic Alkalosis

Answer 19

(pCO2 > 45 mm Hg)
(pCO2 > 45 mm Hg)
(HCO3- < 23 me/l)
(HCO3- > 26 me/l)

Question 20

shock

Answer 20

Acute circulatory failure with inadequate or inappropriately distributed tissue perfusion resulting in generalized cellular hypoxia

Question 21

class II shock

Answer 21

tachycardia begins (>100bpm), normal BP

Question 22

class III shock

Answer 22

BP drops