Brainscape's Knowledge GenomeTM

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


See full index

PHRM 844 Therapeutics > Fluids and Electrolytes > Flashcards

Fluids and Electrolytes Flashcards

1
Q

IBW equation for males

A

50 kg + 2.3(inches over 60”)

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

IBW equation for females

A

45.5 kg + 2.3(inches over 60”)

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

sensible fluid losses are

a. immeasurable
b. measurable

A

b. measurable

(ex. urine, defecation, wounds)

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

insensible fluid losses are

a. immeasurable
b. measurable

A

b. immeasurable

(ex. sweat, fluid through lungs)

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

ADH, RAAS, and ANP are all regulated by what organ?

A

kidney

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

ADH functions (2 of them)

A

-reduces diuresis
-increases water retention

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

RAAS (renin-angiotensin aldosterone system) functions (2 of them)

A

-renin secretion
-sodium/water regulation (aldosterone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ANP (atrial natriuretic peptide) functions (2 of them)

A

-dec ADH release
-counteracts effects of RAAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

isotonic fluid range

A

275 to 290 mOsm/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

hypotonic fluid range

A

< 275 mOsm/L

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

hypertonic fluid range

A

> 290 mOsm/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

definition of osmolarity

A

measure of solute concentration

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

total osmolarity equation

A

total osmolarity = osmolarity of IV solution + osmolarity of added electrolytes

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

what is the clinical estimate (adults) for calculating MIVF?

A

30-40 mL/kg/day

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

what is MIVF?

A

maintenance of IV fluids (normal amount needed over 24 hours)

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

NS, 1/2 NS, D5W, lactated ringers, and balanced salt solutions are examples of

a. crystalloids
b. colloids

A

a. crystalloids

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

albumin, hetastarch (Hespan), tetrastarch (Voluven), blood, and plasmanate are examples of

a. crystalloids
b. colloids

A

b. colloids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

true or false: colloids can be given as a maintenance fluid

A

false (never give as maintenance fluid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

crystalloid solutions functions (2 of them)

A

-provide water and/or sodium
-maintain osmotic gradient between intravascular and extravascular compartments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

normal saline use in therapy (2 of them; slide 29)

A

-intravascular fluid replacement (resuscitation)
-sodium and/or chloride replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

true or false: normal saline (0.9% NaCl) is never a maintenance fluid

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

1/2 NS use in therapy (1; slide 29)

A

-used for maintenance fluids (combination products)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

lactated ringers use in therapy (3 of them; slide 30)

A

-replacement of blood loss
-approximates human plasma
-resuscitation (trauma, burn, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

D5W use in therapy (3 of them; slide 30)

A

-free water replacement
-NOT a resuscitative fluid
-NOT a MIVF by itself

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

balanced salt solutions are crystalloid solutions containing physiological levels of what 2 things?

A

-chloride
-buffer solutions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

3 examples of balanced salt solutions

A

-lactated ringers
-normosol-R
-plasma-lyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

colloid solutions functions (2 of them; slide 35)

A

-inc plasma oncotic pressure
-move fluid from interstitial compartment to intravascular (plasma) compartment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

colloids are plasma expanders and increase _____ _____

A

molecular weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

colloids are used selectively for volume expansion, intravascular repletion in _____ patients

A

symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

colloid solutions are considered _____ line therapy for hypovolemic shock

A

second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

true or false: blood is a colloid

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

clinical use of albumin 5%

A

hypovolemic or intravascularly-depleted patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

clinical use of albumin 25%

A

fluid and/or sodium restricted patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

1 unit of RBCs = approximately _____-_____ mL

A

230-350 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

low hemoglobin is usually less than or equal to _____-_____ g/dL

A

7-8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

1 unit of RBCs inc hemoglobin by approximately ___ g/dL

A

1 g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

most common MIVF

A

D5W + 1/2 NS + 20 mEq KCl/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

how much urine output is considered dehydration?

A

less than 0.5 mL/kg/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

BUN/SCr ratio > ___ may mean dehydration

A

20

40
Q

normal sodium range

A

135-145 mEq/L

41
Q

what is the most common electrolyte disturbance in hospitalized patients?

A

hyponatremia

(Na < 135)

42
Q

pseudohyponatremia (isotonic) can be seen with __________ or __________

A

hypertriglyceridemia (TG > 1000); hyperproteinemia

43
Q

most common cause of isovolemic hypotonic hyponatremia (highlighted on slide 70)

A

SIADH (syndrome of inappropriate ADH release)

44
Q

3 drug classes that can cause SIADH (highlighted, slide 73)

A

-antipsychotics
-carbamazepine
-SSRIs (fluoxetine, sertraline)

(NSAIDs too but not highlighted)

45
Q

first line treatment of SIADH

A

free water restriction

46
Q

__________ may be beneficial if 24-48 hours of free water restriction fails

A

vaptans

47
Q

for treating hyponatremia, in most cases the goal is to avoid rise in serum sodium > ___ mEq/L/hr or no more than ___-___ mEq/L/day

A

0.5; 8-12

(for ex. if their sodium is at 120, 132 would be highest we would go up to)

48
Q

clinical presentation for hypovolemia and hypervolemia?

A

hypovolemia -> dehydration
hypervolemia -> fluid overload

49
Q

hypovolemic hypotonic natremia treatment options (2 of them)

A

-hypertonic NaCl (3%) if symptomatic
-isotonic NaCl (0.9%) if asymptomatic

50
Q

isovolemic hypotonic hyponatremia treatment options (2 of them)

A

-furosemide and 3% NaCl if symptomatic
-isotonic NaCl (0.9%) if asymptomatic and water restriction

51
Q

hypervolemic hypotonic hyponatremia treatment options (2 of them)

A

-furosemide and judicious 3% NaCl if symptomatic
-furosemide in asymptomatic

52
Q

how many hours is considered acute hyponatremia?

A

< 48 hours

53
Q

how many hours is considered chronic hyponatremia?

A

> 48 hours

54
Q

what can develop in pts with acute symptomatic hyponatremia?

A

metabolic encephalopathy (cerebral edema i.e. brain swelling is common)

55
Q

treatment of acute symptomatic hyponatremia: inc serum Na+ by ___-___ mEq/L/hr until symptoms resolve

A

1-2 mEq/L/hr

(max inc of 8-12 mEq/L in first 24 hours; generally an inc of 4-6 is enough)

56
Q

what can result if sodium is corrected too rapidly in acute symptomatic hyponatremia?

A

central pontine myelinolysis (diffuse demyelinating lesions)

57
Q

rule of 8s

A

replace half of sodium deficit in 8 hours, then remaining deficit w/in 8-16 hours

58
Q

hypernatremia is always associated with _____

A

hypertonicity

59
Q

for hypovolemic hypernatremia, what can we use to restore hemodynamic status?

A

0.9 % NaCl (NS)

60
Q

what do we do for hypovolemic hypernatremia once intravascular volume has been restored?

A

calculate free water deficit

61
Q

two ways to provide free water

A

-D5W continuous infusion
-enteral free water via feeding tube

62
Q

how should free H2O deficit be corrected?

A

-give 1/2 of total deficit over 24 hours
-give remaining 1/2 over next 24-48 hours
-adjust as needed

(goal is 0.5 mEq/L/hr dec in serum Na+)

63
Q

normal potassium levels

A

3.5-5 mEq/L

64
Q

factors affecting potassium (3 of them)

A

-Na/K ATPase pump
-kidneys
-arterial pH/acid-base status

65
Q

hypokalemia cause (in bold, from slide 129)

A

magnesium depletion

(Mg is cofactor for Na/K ATPase, need Mg for it to work)

66
Q

treatment if potassium is 3.5-4 mEq/L

A

no therapy generally recommended

67
Q

treatment if potassium is 3-3.4 mEq/L

A

-treatment debateable
-PO potassium for pts w cardiac conditions

68
Q

treatment if potassium is < 3 mEq/L

A

-PO preferred in asymptomatic
-IV for symptomatic pts or those who can’t take PO

(always treat)

69
Q

what potassium levels would we give IV potassium?

A

K+ < 2.5-3

(arrythmia or cardiac arrest if given too quickly)

70
Q

IV potassium: what is the infusion rate without cardiac monitoring?

A

10 mEq/hr

71
Q

IV potassium: what is the infusion rate w/ continuous cardiac monitoring?

A

-20 mEq/hr
-40-60 mEq/hr if emergent w/ severe hypokalemia (e.g. during cardiac arrest)

72
Q

we may see a peaked T wave within what range of potassium levels?

A

5.5-6 mEq/L

73
Q

acronym for treating severe hyperkalemia (K+ > 7)

A

C A BIG K DROP

74
Q

3 steps for treating severe hyperkalemia (K+ > 7)

A
  1. antagonize the membrane actions
  2. dec extracellular K+ conc
  3. remove K from the body
75
Q

“C A BIG K DROP” stands for

A

Calcium

Albuterol
Bicarb
Insulin + Glucose

Kayexalate/Lokelma
Diuretics (furosemide)
Renal unit for dialysis Of Patient

(antagonize the membrane actions; dec extracellular K+ conc; remove K+ from the body)

76
Q

chronic treatment option for severe hypokalemia

A

patiromer (Valtassa)

77
Q

Patiromer (Valtassa) MOA

A

binds potassium in GI tract and dec its absorption

78
Q

hypomagnesemia is often associated with what other two electrolyte’s metabolisms?

A

calcium and potassium

79
Q

PO treatment of hypomagnesemia in asymptomatic pts with Mg > 1 mg/dL (2 of them)

A

-milk of mag 5-10 mL PO QID
-mag-ox 800 mg PO daily or 400 mg PO TID with meals

80
Q

IV treatment of hypomagnesemia in symptomatic pts (or those who cannot tolerate PO)

A

-Mg 1-2 mg/dL -> 0.5 mEq/kg
-Mg < 1 mg/dL -> 1 mEq/kg

81
Q

how many mEq of Mg are in one gram?

A

8 mEq

82
Q

organs involved in calcium metabolism (3 of them)

A

bone, kidneys, intestine

83
Q

acute treatment of hypocalcemia: ___-___ mg elemental Ca2+ IV over 5-10 minutes

A

100-300

84
Q

1 gram Ca chloride = how many grams of Ca gluconate?

A

3 grams (270 mg elemental Ca)

85
Q

Ca chloride can be administered ___ ___ during code; Ca gluconate is preferred for ___ administration

A

IV push; PIV

86
Q

Ca gluconate vs Ca chloride: Ca gluconate has a _____ percentage of elemental Ca2+, has _____ predictable inc in Ca2+ conc, and _____ risk for extravasation (necrosis)

A

lower; less; less

87
Q

usual administration rate for calcium (acute treatment of hypocalcemia)

A

1 gm/hour

88
Q

chronic treatment for hypocalcemia: how many grams/day of elemental Ca2+?

A

1-3 grams/day

89
Q

chronic treatment of hypocalcemia also includes _____ _____ supplementation

A

vitamin D

90
Q

normal phos range

A

2.5-4.5 mg/dL

91
Q

mild to moderate hypophosphatemia range

A

1-2 mg/dL

92
Q

severe hypophosphatemia is less than ___ mg/dL

A

1 mg/dL

93
Q

oral treatment for mild to moderate (phos 1-2) hypophosphatemia

A

Phos-NaK -> 30-60 mMol/day in 2-3 divided doses

(Fleets Phospho-Soda is another one, but I think it is discontinued)

94
Q

IV phosphorus:
Use KPhos when K+ < ___ mEq/L
Use NaPhos when K+ greater than or equal to ___ mEq/L

A

4; 4

95
Q

Phos replacement:

1 mMol NaPhos = ? + ?
1 mMol KPhos = ? + ?

A

1 mMol NaPhos = 1.33 mEq Na + 1.33 mEq Phos
1 mMol KPhos = 1.47 mEq K + 1.47 mEq Phos

96
Q

for phos replacement, infuse IV doses no faster than ___ mMol/hr

A

7

PHRM 844 Therapeutics (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions