Fluids and Electrolytes Flashcards
how much of the body is composed of water?
60%
How is the TBW value different in infants and older adults?
TBW is higher in infants and lower in older adults
What is total body water composed of?
67% Intracellular fluid
25% Interstitial fluid
8 % plasma volume
Where is Intravascular Fluid?
Inside Blood vessels
Where is Extravascular Fluid?
Outside the blood vessels
(lymph, cerebrospinal fluid)
Breakdown the distribution of TBW
TBW = 60%
ICF = 2/3 of TBW
ECF = 1/3 of TBW
ISF = 2/3 of ECF
PV = 1/3 of ECF
_____ + _____ = ECF
Interstitial fluid + Plasma = ECF
Define Tonicity
is the measurement of concentration when referring to IV solutions
define Osmolarity
is the measurement of concentration when referring to body fluids
What is COP
COP stands for Colloid osmotic pressure and is when colloids that can not leave the blood stream due to their size cause fluid to be pulled into the blood vessels. is normally 24 mm Hg
Where dose fluid move in a hypertonic solution?
Out of the cell because the osmolarity is higher outside the cell. Cell shrinkage
Where dose fluid move in a hypotonic solution?
Into the cell because the osmolarity is higher in the cell. Cell bursting
Where dose fluid move in a isotonic solution
No net movement because the osmolarity is the same inside and outside the cell
Define Edema
When there is an accumulation of fluid in the Extravascular space
Define dehydration
When fluid lost exceeds fluid gained
What are Crystalloids?
solutions containing fluids and electrolytes
they contain no proteins
No risk for anaphylaxis, viral transition, or altered coagulation
What are the 4 reasons to use Crystalloids?
Compensate for insensible fluid loss
Replacement of fluids
Manage fluid and electrolyte disturbances
Promote urinary flow
List the Crystalloids you need to know for the exam
Normal saline: 0.9 % sodium chloride
3.3 Dextrose and 0.3 NS
Hypertonic saline
Lactated ringer solution (Iso)
Dextrose 5% in H20 (Iso)
D5W and 0.45 NS (Hyp)
What are the indications of Crystalloids?
Compensate for insensible fluid loss
Replace fluids
manage fluid and electrolyte disturbance
promote urinary flow
DVT
hemodiaysis
shock
burns
What are the AE of Crystalloids?
May cause edema
may dilute plasma proteins = decreased COP
short therapeutic life
long infusions may impact acidosis or alkalosis
What are Colloids?
Protein substances
Increase COP = move ISF to PV when needed
Name the Colloid drugs you need to know for the exam
Albumin 5% & 25%
Dextran 40 or 70
Hetastarch
What are the AE of Colloids?
May alter coagulation
Have no clotting or oxygen carrying capacity
Rarely causes kidney issues or allergic reaction
Where is Albumin produced?
Liver
____ is responsible for creating 70% of COP
Albumin
Where is Albumin obtained from?
Human donors
_____ is the only fluid that can carry oxygen
Blood products
What do Blood products do?
Increase oxygenation and PV
Increase COP
What are the indications of blood products
To manage bleeding (cryoprecipitate)
Increase clotting factors (Fresh frozen plasma)
Increase oxygen carrying capacity (RBC, Whole blood)
Help bring fluid back into PV compartment (Whole blood)
What are the AE of Blood products?
Not Compatible for everyone (immune response)
Transfusion reaction
Anaphylaxis
pathogen transmission
What are the principle ECF electrolytes?
Sodium cations
Chloride anions
What are the principle ICF electrolytes?
Potassium
Where is most of the bodies Potassium?
95% in cells
What is the most abundant cationic electrolyte in the body?
Potassium
What is a healthy range of Potassium in the body?
3.5-5 mmol/L
Name 5 foods high in Potassium
Bananas, oranges, broccoli, potatoes, wheat bread, etc.
Where is extra potassium exdcreted?
The kidneys
What can cause to Hyperkalemia?
Potassium supplements
Kidney failure
ACEs
Burns/trauma/infections
Metabolic acidosis
potassium sparing diuretics
What can cause Hypokalemia?
Alkalosis
Corticosteroids
Diarrhea/vomiting
Burns
Thiazide and Thiazide like diuretics
Hyper aldosterone
What can cause digoxin toxicity?
Hypokalemia when taken with digoxin resulting in Ventricular dysrythmias
What are the 6 things Potassium is responsible for in the body?
Muscle contraction
Nerve impulse transmitting
Heart beating
balancing acid-base
Isotonicity
Electrodynamic characteristics of the cell
What is the Indications of Potassium?
treat/ prevent potassium depletion
Stop irregular heart beats
Manage tachydysrhythmias
What are the AE of Potassium?
PO: NVD, GI bleeding, ulceration
IV: pain at injection site, phlebitis (inflammation of vein near site)
Too much: hyperkalemia, toxicity, cardiac arrest
How dose Hyperkalemia manifest?
Muscle weakness, paresthesia (numbness/tingling) , paralysis, cardia irregularities
How do you treat Hyperkalemia?
hemodialysis to remove excess K+
IV sodium bicarbonate
Sodium Polystyrene sulphonate
What is the normal concentration of Na+ out of the cell?
135-145 mmol/L
How dose hyponatremia present?
lethargy, stomach cramps, hypotension, vomiting and diarrhea, seizures
What causes Hyponatremia?
Excessive diarrhea, vomiting, perspiration, kidneys disorder, adrenocortical impairment
How dose hypernatremia present?
Edema, hypertension, red, flushed, dry, sticky mucous membranes, thirst, increased temp, little or no urine output
What causes Hypernatremia?
Poor excretion of Na+, inadequate H20 intake, dehydration
What is Na+ responsible for in the body?
Control of water reabsorption
fluid and electrolyte balance
Osmotic pressure of Body fluids
Participation of acid-base balance
What are the indications of Na+?
Na+ depletion
in mild cases treat with oral NaCl or fluid restriction
In severe cases use IV NS or lactated Ringer solution
What are the AE of Na+?
PO: Nausea, vomiting, cramps
IV: vein inflamation
What needs to be assessed when pt is taking Fluid and electrolyte drugs?
baseline fluids
electrolyte status
VS
weights
mucous membrane
I/O
Electrocardiogram (K+)
contraindications
Transfusion Hx
What needs to be monitored when pt is on Fluid and electrolyte drugs?
Serum electrolyte levels
Infusion rates and sites
appearance of fluid or solution
other IV complications
What is the max infusion rate for IV K+?
10mmol/hr when pt is not on cardiac monitor
20mmol/L when critical pt is on cardiac monitor
How should you NEVER give K+?
IV bolus or undiluted
______ should always be taken with 100-250mL of fluid and food to avoid upset GI, and avoid rapid absorption
potassium
How should colloids be admintred?
slowly
