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Therapeutics > Fluids & Electrolytes > Flashcards

Fluids & Electrolytes Flashcards

1
Q

Osmolarity

A

number of particles per LITER of solvent (mOsmoles/L)

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2
Q

Osmolality

A

number of particles per KG of solvent (mOsmoles/kg)

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3
Q

Tonicity

A

effective Osmoles in soln

i.e. solutes that don’t freely cross the mem & determine osmotic pressure gradients

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4
Q

Plasma

A

aq portion of blood WITH clotting factors (not RBC & WBC)

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5
Q

Serum

A

plasma WITHOUT clotting factors

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6
Q

Serum osmolality calculation

A

mOsm/kg = 2 Na + Glucose/18 + BUN/2.8

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7
Q

Serum osmolality normal range

A

275-295 mOsm/kg

reflects tonicity of serum

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8
Q

Hypovolemic presentation

A
  • hypotension/orthostasis
  • tachycardia
  • poor skin tugor/dry mucus mem
  • slow capillary refill
  • cool extremities
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9
Q

Hypervolemic presentation

A
  • hypertension
  • edema
  • weight gain
  • jugular venous distention
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10
Q

Part(s) of kidney that secrete water

A

collecting duct via aquaporins

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11
Q

Part(s) of kidney that reabsorb water

A

prox tubule, ascending loop, distal tubule (Na reabs, water follows)

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12
Q

Causes of hypovolemia

A
  • poor PO intake
  • infection/fever
  • hypermetabolic states (burn/trauma)
  • blood loss
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13
Q

Maintenance fluids for adults

A

30-35 mL/kg

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14
Q

Maintenance fluids in peds

A

1st 10 kg -> 100 mL/kg/day
2nd 10 kg -> 50 mL/kg/day
> 20 kg -> 20 mL/kg/day

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15
Q

Adjustment for maintenance fluids in CKD, chronic liver disease, and mild HF

A

x 0.75

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16
Q

Adjustment for maintenance fluids in severe HF, and ESRD

A

x 0.5

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17
Q

Use normal maintenance fluids for..

A
  • NPO for procedure
  • CKD w/ mild dehydration
  • HF w/ mod dehydration
  • ESRD w/ severe dehydration
18
Q

Adjustment for maintenance fluids in mild dehydration

A

x 1.25

19
Q
A
20
Q

Adjustment for maintenance fluids in mod dehydration

A

x 1.5

21
Q

Adjustment for maintenance fluids in severe dehydration

A

x 2

22
Q

Adjustment for maintenance fluids in hemodynamic shock

A

use a large vol bolus

23
Q

Hypotonic fluid loss

A

insensible, sweat, urine

24
Q

Isotonic fluid loss

A

blood, vomiting, diarrhea

25
Q

D5W

A
  • hypotonic
  • no electrolytes
  • 1000 mL free water
  • shifts water intracell
26
Q

1/2 NS

A
  • hypotonic
  • 77 mEq/L Na & Cl
  • 500 mL free water
  • shifts water intracell
27
Q

3% NaCl

A
  • hypertonic
  • 513 mEq/L Na & Cl
  • (-)2133 mL free water
  • shifts water extracell
28
Q

NS

A
  • isotonic
  • 154 mEq/L Na & Cl
  • stays in extracell
29
Q

Lactated ringers

A
  • isotonic
  • 130 mEq/L Na & 105 mEq/L Cl
  • stays in extracell
30
Q

5% albumin

A
  • isotonic
  • no electrolytes
  • stays in extracell
31
Q

Balanced crystalloids

A

mimic plasma electrolyte conc
- lactated ringers (acidotic)
- plasma-lyte A (neutral expensive)

32
Q

N5 D5W

A
  • isotonic
  • stays in extracell
33
Q

N5 D5W w/ 20mEq KCl

A
  • hypertonic
  • (-)125 mL free water
  • shifts water extracell
34
Q

1/2 NS D5W

A
  • hypotonic
  • 500 mL free water
  • shifts water intracell
35
Q

1/2 NS D5W w/ 20mEq KCl

A
  • hypotonic
  • 370 mL free water
  • shifts water intracell
36
Q

1/2 NS D5W w/ 40mEq KCl

A
  • hypotonic
  • 240 mL free water
  • shifts water intracell
37
Q

Hyponatremia labs

A

Na < 135

38
Q

Drug-induced hyponatremia

A

syndrome of inappropriate anti diuretic hormone
- SSRI
- carbemazepine
- thiazides
- opiates

39
Q

Cause of isotonic hyponatremia

A

page 8

40
Q
A

Therapeutics (17 decks)

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