Fluids And Electrolytes (45) Flashcards

1
Q

___% of adult human body is water

A

60

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2
Q

Three main components of TBW

A

Intracellular fluid, interstitial fluid, plasma volume

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3
Q

Percentage of Intracellular fluid

A

67%

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4
Q

Percentage of Extracellular fluid

A

33%

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5
Q

Make up of Extracellular fluid in percentages

A

Interstitial fluid 25%

Plasma volume 8%

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6
Q

Distribution of fluid in ECF is determined by

A

Bulk flow
(Startling forces)

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7
Q

What are the two main pressures

A

-hydrostatic pressure
-colloid osmotic pressure

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8
Q

Hydrostatic pressure

A

Pushing fluid OUT
-blood pressure

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9
Q

Colloid osmotic pressure

A

Pushing fluid IN
-plasma proteins

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10
Q

Water intake should equal

A

Water loss

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11
Q

Examples of fluid out of balance

A

-edema (increased fluid and blood pressure)
-dehydration and fluid loss

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12
Q

When are some people meant to receive IV fluid administration

A

-dehydration
-electrolyte imbalances
-blood component deficiencies
-nutrition

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13
Q

Crystalloids contain water plus…

A

Electrolytes and small molecules

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14
Q

Crystalloids do NOT contain

A

Proteins/large molecules

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15
Q

0.9% sodium chloride

A

Normal saline or NS
-isotonic solution

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16
Q

The 0.9% in NS stands for

A

0.9g of NaCl in 100mL

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17
Q

What are the most abundant particles in ECF

A

Na and Cl

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18
Q

0.45% of sodium chloride

A

Half NS
-hypotonic solution

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19
Q

Osmolarity of normal saline (Na/Cl)

A

Na- 154 Cl-154

ISOTONIC

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20
Q

Hypertonic saline osmolarity (Na/Cl)

A

Na- 513 Cl-513

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21
Q

Lactated ringer osmolarity

A

Na- 130 Cl-109 K-4

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22
Q

D5W osmolarity

A

K- 1

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23
Q

Examples of Crystalloids

A

-normal saline
-half normal saline
-hypertonic saline
-lactated ringers
-d5w
-normosol/plasmalyte

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24
Q

Crystalloids are used to treat

A

Dehydration
-volume loss or maintenance

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25
Q

Crystalloids are used as

A

Replacement or maintenance of fluids

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26
Q

Examples of use for crystalloids in replacement and maintenance of fluids

A

-compensate for insensible fluid losses
-replace fluids
-manage specific fluids and electrolyte disturbances
-promote urinary flow
-expand plasma volume

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27
Q

Compensating for insensible fluid losses example

A

NS

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28
Q

To replace fluids example

A

NS

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29
Q

To manage specific fluid and electrolyte disturbances example

A

Ringers lactate

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30
Q

Promote urinary flow example

A

NS

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31
Q

Expand plasma volume example

A

3% NaCl

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32
Q

Example of vomiting and diarrhea

A

Removing a chunk of ECF not affecting the overall toxicity

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33
Q

Example of sweating

A

The body sweats out more water than ECF
-body is left hypertonic as there are more salts left

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34
Q

How would one treat intense sweating

A

Treatment with water, to even out the hypertonic solution

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35
Q

How would someone treat intense diarrhea and vomiting

A

Since its a loss of volume, and leaves the solution at the same tonicity
-would give NS as it is isotonic

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36
Q

Indications of crystalloids

A

-acute liver failure
-acute nephrosis
-burns
-hypovolemic shock
-renal dialysis

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37
Q

What is the only fluid used with administration of blood cell products

A

NS

38
Q

Adverse effects of crystalloids

A

Edema, dilute plasma proteins, short lived effects

39
Q

Colloids

A

Move fluid from interstitial compartment to plasma compartment
-expand plasma volume

40
Q

Plasma volume increasing due to colloids equals

A

BP increasing

41
Q

Colloids increase

A

Colloid osmotic pressure

42
Q

In colloids particles are

A

Large
-too big to leave

43
Q

Examples of colloids

A

-dextran
-hetastarch
-modified gelatin
-albumin

44
Q

Albumin as a colloids

A

Only comes from human donors
-donated and separated then suspended in water

45
Q

Indications of colloids

A

Generally a fall in blood pressure
-trauma
-burns
-sepsis
-hypovolaemic shock

46
Q

Colloids vs crystalloids

A

Colloids - more expensive and difficult to prepare

Both increase plasma and blood pressure

47
Q

Adverse effects of colloids

A

Usually safe
-altered coagulation
-no oxygen carrying capacity

48
Q

Colloids need to be given

A

Slowly
-dont want bounding BP

49
Q

What are the most expensive fluid/electrolytes

A

Blood and blood products
-least available bc they require human donors

50
Q

Examples of blood and blood products

A

-whole blood
-RBC products carry oxygen
-inc supply of various products
-platelets

51
Q

Whole blood

A

Nothing is changes
-in situations of intense bleeds

52
Q

RBC products carrying oxygen

A

Just separate RBC
-cancer chemo like bone marrow anaemia

53
Q

Indications of blood products

A

-packed RBCs
-fresh frozen plasma
-cryoprecipitate and plasma protein factors

54
Q

Packed RBCs and whole blood

A

Increase oxygen carrying capacity
-anemia
-substantial hemoglobin deficits

55
Q

What percentage of blood loss are packed RBCs and whole blood used for

A

Blood loss greater than 25% of total blood volume

56
Q

Fresh frozen plasma

A

Increase the clotting factor levels in clients with demonstrated deficiency creating COAGULATION

57
Q

Example of fresh frozen plasma

A

Disseminated intramuscular coagulation

58
Q

Cryoprecipiate and plasma protein factors example

A

Fibrinogen, factor VIII, prothrombin complex concentrates

59
Q

Adverse effects of blood products

A

-transfusion reaction
-transmission of pathogens to recipient

60
Q

Client care: administer colloids

A

Slowly

61
Q

Client care: monitor for ___ overload and possible __ failure

A

Fluid overload, heart failure

62
Q

Client care: monitor closely for signs of ___ reactions

A

Transfusion

63
Q

Advantages of crystalloids

A

Few side effects, low cost, wide availability

64
Q

Disadvantages of crystalloids

A

Short duration of action, may cause edema

65
Q

Advantages of colloids

A

Longer duration of action, less fluid required to correct hypovolaemia

66
Q

Disadvantages of colloids

A

Higher cost, may cause volume overload, could interfere with clotting, risk of anaphylactic reactions

67
Q

Principal ECF electrolytes

A

Sodium and chloride

68
Q

Principal ICF electrolyte

A

Potassium

69
Q

What is the most abundant postively charged electrolyte inside cells

A

Potassium

70
Q

Potassium is responsible for

A

-skeletal muscle contraction
-transmission of nerve impulses
-regulation of heartbeat
-maintenance of acid base balance

71
Q

Normal ECF levels of potassium

A

3.5 to 5 mmol/L

72
Q

Hypokalemia causes

A

-loop and thiazide diuretics
-vomiting
-diarrhea

73
Q

Symptoms of hypokalemia

A

Muscle weakness, cardiac dyrthmnias, irregular pulse

74
Q

Parenteral infusions of potassium must be

A

Monitored closely

75
Q

Rate o potassium should never exceed

A

10 mmol/hour

76
Q

Potassium should NEVER be given as an

A

IV bonus or undiluted

77
Q

Sodium is the most abundant ___ charged electrolyte outside cells

A

Postively

78
Q

Normal concentration outside cells is

A

135 to 145 mmol/L

79
Q

Dietary intake of sodium chloride

A

Salt, fish, meats

80
Q

Sodium is responsible for

A

-control of water distribution
-fluid and electrolyte balance
-osmotic pressure of body fluids
-participates in acid base balance

81
Q

Hypo stream is

A

Sodium loss of deficiency
<135 mmol/L

82
Q

Symptoms of hyponatremia

A

Lethargy, stomach cramps, hypotension, vomiting

83
Q

What causes hyponatremia

A

Prolonged diarrhea or vomiting, renal disorders

84
Q

Hypernatremia

A

Sodium excess
>145 mmol/L

85
Q

Symptoms of hypernatremia

A

Edema, hypertension, red flushed skin, sticky mucous

86
Q

Hypernatremia causes

A

Kidney malfunction

87
Q

Mild treatment of sodium depletion

A

Treated with oral sodium chloride or fluid restriction

88
Q

Severe treatment fo prevention of sodium depletion

A

If normal saline or lactated ringers solution

89
Q

Oral administration of Sodium

A

Nausea, vomiting, cramps

90
Q

IV administration of sodium

A

Venous phlebitis

91
Q

Client care: monitor what during therapy

A

Serum electrolyte levels