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WHOLE PT > Fluids/Acid Base > Flashcards

Fluids/Acid Base Flashcards

1
Q

What is the distribution of water in the human body?

A

intracellular - 2/3 of TBW

extra: 1/3 of TBW

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2
Q

What is the normal urine output in infants? adults?

A

infants: 1mL/kg/hr
adults: 0.5-1mL/kg/hr

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3
Q

What are 3 reasons for oliguria?

A

low blood flow to kidney -check heart
kidney prob
post renal obstruciton

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4
Q

What is the distribution for extra?

A

plasma: 1/12 of TBW
interstitial: 1/4 of TBW

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5
Q

What is the distribution of plasma?

A

85% is venous

15% is arterial

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6
Q

What are the 4 diff types of fluid replacement?

A

normal saline
d51/2NS
D5W
lactated ringers

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7
Q

What is used to increase intravascular vol?

A

normal saline

lactated ringers

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8
Q

When is lactated ringers contraindicated w/increasing intravascular vol?

A

NOT maintenance

pt has hyperkalemia

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9
Q

What is used to dilute med?

A

D5W

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10
Q

What can used to correct hypernatremia?

A

D5W

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11
Q

Pt has mental status changes, poor turgor, and oliguria? What other sx? Cx?

A

hypovolemic

sx: apathy, orhtostatic hypotension, tachycardia, hypothermia
cx: internal/external bleeding, V/D, sepsis, polyuria (DKA), third spacing

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12
Q

How to dx hypovolemia?

A

monitor urine output and wt

labs: HIGH serum Na, LOW urine Na
kidneys: BUN/Cr >20:1

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13
Q

How to tx hypovolemia?

A

increase intravascular vol

maintain urine output: 0.5-1mL/kg/hr

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14
Q

What PE to expect from hypovolemia?

A 
wt gain
edema
JVD
INCREASE CVP AND PCWP
RALES
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15
Q

What can cause hypervolemia?

A

CHF
nephrotic sx
cirrhosis
ESRD

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16
Q

Tx hypervolemia?

A

restrict fluids

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17
Q

What does aldosterone do? ADH?

A

aldosterone increases reuptake of Na

ADH increases reuptake of H20

18
Q

Where is Na -ECF or ICF?

A

ECF

19
Q

What haps when there is a high intake of Na consumption?

A

increase in ECF

20
Q

Where is Na reabsorbed in the nephron?

A

proximal tubule

21
Q

Aldosterone increases Na reabsorption and ___ secretion from ____?

A

potassium secretion

form teh late distal tubules

22
Q

Hypothalamus has __ to control H20?

A

osmoreceptors

23
Q

Hypo/hyper natremia is caused by?

A

too much or too little water

24
Q

Hypo/hyper volemia is caused by?

A

too much or too little Na

25
Q

What is the value of hyponatremia?

A
26
Q

What to do w/ head trauma pts - na levels? Why?

A

normal or hypernatremic b/c if hyponatremic the water will move INTO brain cells –> increased ICP

27
Q

How can hyponatremia be classified?

A

hypotonic
euvolemic
isotonic
hypertonic

28
Q

How can hypotonic hyponatramia be classified?

A

hypovolemic
euvoemic
hypervolemic

29
Q

What is hypovolemic hypotonic hyponatremia?

A

low fluids and low Na

low urine Na output 20 - no Na but on top of that body is forcing water out (diuretic) + Na

30
Q

What is euvolemic hypotonic hyponatremia?

A

ECF is ok but low Na

  • SIADH
  • drinking too much water
31
Q

What is hypervolemic hypotonic hyponatremia?

A

too much water but OK Na

  • CHF
  • nephrotic sx
32
Q

What is isotonic hyponatremia?

A

increase in plasma that lowers plasma Na concentration but the amt of sodium in plasma is NORM -> d/t elevated protein or lipis

33
Q

What is hypertonic hyponatremia?

A

osmotic shift of water OUT of cells –> hyperglycemia increase osmotic pressure so water shifts from cells INTO ECT –> diluting Na

34
Q

What sx to look for if suspecting hypotnatremia?

A

NEUROLOGICAL DEFECTS - brain cell swelling

  • HA
  • muscle twitching
  • hyperactive deep tendon reflexes
35
Q

Hyponatremia -Pt has high serum osmolality?

A

hypertonic hyponatremia

  • hyperglycemia
  • mannitol
36
Q

Hypontaremia - pt has normal serum osmolality?

A

pseudohyponatremia

-check for high lipids

37
Q

Hyponatremia - pt has “true hypontremia” + low Na in body?

A

measure urine Na

-20: diuretic, low aldosterone

38
Q

Hyponatremia - pt has true hyponatremia and normal Na?

A

SIADH

39
Q

Hyponatremia - pt has true hyponatremia and high Na?

A

CHF

nephrotic dz

40
Q

How to tx isotonic an dhypertonic hyponatremias?

A

tx underlying disorder

41
Q

How to tx hypotonic hyponatremia?

A

mild-no water

mod: loop diuretics
severe: hypertonic saline - not too fast to avoid central pontine dmyelination

42
Q

What number is hypernatremia?

A

> 145

WHOLE PT (19 decks)

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