Fluids and electrolytes Flashcards
What are crystalloids? Do they have proteins?
These are solutions that have fluids and electrolytes that are typically in the body. They do not contain proteins in them.
What are the seven types of crystalloids, and are they isotonic, hypertonic, or hypotonic?
Normal saline, hypertonic saline, 3.3%dextrose and 0.3% NS, lactated ringer solution, dextrose 5% in water, D5W, and 0.45% NS.
What are the most significant indications for crystalloids?
Burns, shock, DVT, liver failure, liver disease, anaphylaxis
What are the main adverse effects of crystalloids?
They can cause edema, dilute plasma protein, and worsen alkalosis or acidosis.
What are colloids?
These are protein substances that increase colloid oncotic pressure,
What are the adverse effects for colloids?
May alter coagulation, causing an increased risk of bleeding.
What is the primary type of colloid? \
Albumin is the primary example of colloid and it is a natural protein made by the liver and makes up most of the colloid oncotic pressure. It is harvested by pooling blood.
What are blood products?
This is donated blood that is used to carry oxygen within the patient. it is the most expensive.
What effect do blood products have on colloid osmotic pressure, and what are the four examples?
They increase colloid osmotic pressure and plasma volume. Cryoprecipitate and plasma protein, and fresh frozen plasma, PRBC, whole blood
What is the indication for cryoprecipitate plasma protein factors?
They are used to manage acute bleeding
What is an indication of fresh frozen plasma?
It increases the clotting factors in patients with deficiencies in clotting factors.
What are the indications for a giving packed red blood cells?
This could be given to increase the oxygen-carrying capacity in a patient with anemia, hemoglobin deficit, or huge loss of blood
What is the indication for giving whole blood and what is the difference with this and packed RBCs
For anemia, hemoglobin deficit, and really huge blood loss. Its main difference is it can be used for blood loss greater than 25%.
What are the main adverse effects of blood products
Anaphylaxis, transmission of pathogen
What is the principle ECF and ICF electrolyte?
The main ECF electrolyte is sodium and the main ICF electrolyte is potassium.
What is the measure for potassium outside the cell?
The range is 3.5 to 5 mmol/L
What food sources are potassium derived from, and what does excess potassium cause?
Food sources are bananas, oranges, apricots, dates, raisins, broccoli, potatoes. High levels of potassium can impair the kidney
What is a serious drug interaction for potassium?
Low levels of potassium (hypokalemia) can cause digoxin toxicity causing really low pulse and ventricular dysrhythmias
What does potassium do in the body?
Muscle contraction, nerve impulses, heart contractions, acid-base balance,
What is the main indication for potassium?
Treatment of hypokalemia or low potassium due to inadequate diet
What is the main adverse effect of potassium?
Cardiac arrest if the dose is too high
What is the treatment for severe hyperkalemia?
IV sodium bicarbonate, sodium polystyrene sulphonate, and hemodialysis.
What is the normal concentration for sodium outside the cells?
135-145 mmol/L
What is low levels of sodium called and what causes it?
Low levels is called hyponatremia. Burns, excessive perspiration, severe vomiting, and diarrhea cause it.
What are the symptoms of hypernatremia, and what causes it?
Symptoms are edema, hypertension. It is caused by dehydration, and kidney malfunction
What is the main indication for sodium?
Sodium depletion
Do infants or adults have more body water
Infants have more body water, and this is significant because if they don’t have enough, they can become dehydrated much easier
What is the biggest colloid within the blood?
Albumin is the biggest colloid in the blood and causes the most colloid oncotic pressure so it is important to have it so that we don’t have fluid seeping out of the blood vessels
What are the differences between hypertonic, isotonic, and hypotonic?
Hypertonic means there is not a lot of sodium within the blood vessels so blood vessels shrivel up, hypotonic is when there is a loss of salt, and isotonic
What are examples of colloids and what is the main reason for using it?
Albumin 5% or 25%, dextran 40 or 70, and hetastarch. The main reason for using this is for malnourishment.
What are the main adverse effects for sodium?
It may cause convulsions and issues with the CNS.
Which solution should the nurse administer with packed red blood cell
They should be given with 90% normal saline.
