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Renal > Intravenous Fluid > Flashcards

Intravenous Fluid Flashcards

1
Q

Percentage of water in total body weight

A

60%

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2
Q

Factors that affect total body water percentage

A

Âge
Gender
Body habitus

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3
Q

Total water body weight percentage in women

A

50%

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4
Q

Total body water percentage in infants

A

80%

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5
Q

Do obese people have more or less water

A

Less

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6
Q

Intracellular volume is ….. of TBW

A

2/3

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7
Q

Extra cellular volume Is ….. of TBW

A

1/3 ( 1/4 plasma volume and 3/4 interstitial fluid )

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8
Q

How to determine fluid status before operation

A 
Mental status 
Intake and output history 
Blood pressure ( supine and standing ) 
Heart rate 
Skin turgor
Urinary output 
Central venous pressure
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9
Q

What allows movement of water across the plasma membrane

A

osmotic pressure and hydrostatic pressure

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10
Q

Major electrolytes in the blood

A 
Sodium
 magnesium 
potassium 
chloride 
calcium 
bicarbonate
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11
Q

What is required for electrolytes to cross the plasma membrane

A

Active transport

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12
Q

The role of proteins in the plasma

A

To maintain the osmotic gradient and keeping fluid intravascular

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13
Q

2 Types of IV fluids

A

Crystalloids

Colloids

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14
Q

Crystalloids composition

A

Water
electrolytes
Water soluble molecules

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15
Q

Colloids composition

A

Large insoluble molecules

Proteins

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16
Q

One example of a colloid fluid

A

Blood and products

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17
Q

Advantage of using crystalloids fluids

A

Simple
cost effective
different combinations
no immune response

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18
Q

Advantage of colloid fluids

A

Higher osmotic pressure

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19
Q

Disadvantage of colloids fluid

A

More expensive

Immune response possible

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20
Q

3 types of crystalloids based on osmo

A

Isotonic
Hypertonic
Hypotonic

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21
Q

Isotonic fluids

A

Same osmotic concentration than extra cellular plasma (250-375L) so no shift between ECF and ICF

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22
Q

Hypertonic fluids

A

Greater osmotic concentration (more than 375L)

So Fluid goes from ICF to ECF ( dehydration of cells )

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23
Q

Hypotonic fluids

A

Less osmotic concentration ( less than 250L)

So fluids goes from ECF to ICF

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24
Q

Normal plasma composition with concentration

A 
Osmo (280-290) 
Sodium ( 135-145) 
Chloride (96-106)
Potassium ( 35-52) 
Calcium (4.4-5.2) 
Magnesium (1.8-2.4)
HCO3 ( 22-26) 
Lactate (1)
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25
Q

Common isotonic IV fluids

A 
Plasma 
Normal saline (0.90NS)
Lactated ringers (LR)
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26
Q

Normal saline composition

A

Osmo 308
Sodium 154
Chloride 154
All the rest is O

27
Q

Is normal saline balanced or unbalanced

A

Unbalanced

28
Q

Most common used fluids

A

Normal saline

29
Q

Why is the issue with normal saline

A

High chloride level -> hyperchloremic metabolic acidosis

Acute kidney injury due to GFR impacted

Slower renal clearance

30
Q

Lactated ringers composition

A 
Osmo 273
Sodium 130
Chloride 109
Potassium 4 
Calcium 3 
Lactate 28
31
Q

Is lactated ringers balanced or unbalanced

A

Balanced

32
Q

Issues with lactated ringer

A

Slight hypotonic so can lead to intracellular shift
Can cause cerebro edema
Hepatic hypoperfusion can’t métabolisé Lactate rapidly enough so should avoid it for patient with liver issues

33
Q

Plasmalyte composition

A 
Osmo 295
Sodium 140
Chloride 98
Potassium 5
Magnesium 4 
Gluconate 27
34
Q

Is plasmalyte balanced or unbalanced

A

Balanced

35
Q

Hypertonic fluids type

A

3% normal saline

36
Q

3% normal saline composition

A

Osmo 1030

37
Q

Usage of 3% normal saline

A

Treatment of cerebral edema, severe symptomatic hyponatremia

38
Q

Type of hypotonic IV fluids

A

1/2 normal saline (0.45NS)

39
Q

Composition of 0.45NS

A

Osmo 154
Sodium 77
Chloride 77

40
Q

When not to use 0.45 NS

A

If head injury or edema patient

41
Q

Dextrose containing fluids types

A 
5% dextrose water (D5W)
5% dextrose -1/2 NS 
5% dextrose - NS (D5NS) 
5% dextrose -Lactated rangers (D5LR)
10% dextrose -water (D10W)
42
Q

Types of colloids based on albumin volume

A

5% albumin - osmo 309

25% albumin - osmo 312

43
Q

Advantage oh albumin

A

Préserve rénal function in critically ill patient

Low levels albumin patients

44
Q

Orthostatic hypotension

A

Systolic blood pressure decreases by more than 20mmgh when going from supine to standing

45
Q

Osmolality definition and units

A

Osmotic active solute per volume of solution (mOsm/L)

46
Q

Osmolarity

A

mOsm/Kg

47
Q

Indication for intravenous fluid

A

Volume resuscitation
Vehicle for IV drugs
Keep vein open

48
Q

normal saline 0.9% indication

A

Intravascular resuscitation
Replacement of salt loss ( diarrhea and vomiting)

Dilute packed RBC prior to transfusion

Dilute drugs

49
Q

Complications of normal saline

A

Hyperchloremic metabolic acidosis

50
Q

Indication for 3% saline

A

severe hyponatremia coma/ seizure

resuscitate hypovolemic shock

51
Q

How to administer 3% saline

A

Slow

With CV line to prevent phlebitis, necrosis and hemolysis

52
Q

Complication of 3% saline

A

Precaution in CHF
Severe renal insufficiency
Edema with sodium retention

53
Q

5% dextrose Indication

A

Maintain water balance when they can’t take anything by mouth

used post operatively with salt retaining fluid

hypernatremia treatment treatment

54
Q

Indication for ringer lactate

A

Deficit intraoperative fluid loss

Severe hypovolemia

55
Q

RL indication

A

Déficit intra operative fluid loss

Severe hypovolemia

56
Q

RL precautions

A

Severe metabolic acidosis when impaired Lactate conversion

Do not give with blood products can decrease anticoagulant activity

57
Q

DNS indication

A

Maintenance solution
correction of fluids deficits

compatible with blood

58
Q

Isolyte p indication

A

Pediatric maintenance fluid

59
Q

Why are colloid more Dangerous

A

They can cause Platelets dysfunction

interfere with fibrinolysis and coagulation factors

60
Q

Albumin indication

A

Emergency treatment of shock when loss of plasma

acute management of burns fluid

resuscitation in ICU

hypoalbuminemia

61
Q

Albumin side effects

A

Pruritis
Anaphylactoid reactions
Coagulation abnormalities

62
Q

Disadvantage of albumin

A

Cost

Volume overload

63
Q

Ffhhun

A

Bggbbb

Renal (16 decks)

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