Intravenous Fluid Administration and Blood Transfusion

Question 1

State factors of water output and how much water is lost by each per day.

Answer 1

Urine - 1400 ml 
Insensible: Skin - 350 ml 
Insensible: Lungs - 350ml 
Sweat: 100 ml 
Feces: 100ml

Question 2

How many liters of water are in each body fluid compartment?

Answer 2

Total=42
ECF (14L) ; ICF (28L)
Interstitial (11L); Plasma (3L); Transcellular (1-2L)
Blood (5L)

Question 3

Name 3 water balance mechanisms in the body.

Answer 3

ADH/Vasopressin
Renin-Angiotensin System
Aldosterone

Question 4

Where is vasopressin produced?

Answer 4

Posterior pituitary gland

Question 5

What is the mechanism of the Renin-Angiotensin system?

Answer 5

Osmoreceptors sense high osmolarity; stimulate release of renin into blood
Renin stimulates cleavage of angiotensinogen into angiotensin 1
Angiotensin 1 converted into angiotensin 2 by ACE

Question 6

Define osmoreceptor.

Answer 6

A sensory receptor that detects changes in plasma osmolarity contributing to water balance regulation

Question 7

From where is aldosterone released?

Answer 7

Adrenal cortex

Question 8

Define cardiac output.

Answer 8

The amount of blood pumped by the heart in one minute

Question 9

Give the formula for cardiac output.

Answer 9

CO = SV(stroke volume) x HR (heart rate)

-where stroke volume =amount of blood pumped in one beat; heart rate = beats per minute

Question 10

A patient has low cardiac output. What can we infer about their blood pressure?

Answer 10

They have a low blood pressure.

Question 11

Venous return is ________________________.

Answer 11

the amount of blood returning back from systematic circulation back to the heart for oxygenation .

Question 12

If a person has low blood pressure, then their venous return must be _______________

Answer 12

If a person has low blood pressure, their their venous return must be low.

Question 13

What is PERIPHERAL BLOOD RESISTANCE?

Answer 13

resistance of arteries to blood flow

Question 14

State 3 factors affecting peripheral blood resistance.

Answer 14

1. Pharmacological agents/Drugs
2. Blood viscocity
3. Activity of PNS (sympathetic and parasympathetic activity); sympathetic activity causes both vasoconstriction

Question 15

List 5 signs of dehydration.

Answer 15

1. Dry mucous membranes
2. Reduced skin turgor
3. Increase capillary refill time (it if takes more than 3-4 seconds to fill nail bed)
4. Increased thirst
5. Altered level of consciousness

Question 16

State the stages of consciousness.

Answer 16

1. Alert
2. Automatism; unable to remember actions later, abnormal mood
3. Confusion; unable to speak in logical coherent manner, disorientation of time and space
4. Delirium; hallucinations, restless, incapable of rational thought, unable to follow simple commands, possibly violent
5. Stupor; glazed expession, quiet and uncommunicative, no control of bladder/rectum
6. Obtunded; slow response, sleepy, decreased alertness
7. Semi-Coma; aroused to stupor only by vigorous stimulation
8. Coma; cannot be roused even with vigorous stimulation

Question 17

The terms oliguria, anuria, and polyuria mean?

Answer 17

Oliguria - reduced amount of urine
Anuria - no urine
Polynuria - excessive urination

Question 18

What is the fluid requirement for an adult?

Answer 18

25-30 ml per KG in 24 hours

Question 19

What are the normal hematocrit levels in men and women?

Answer 19

Women; 0.37 - 0.48

Men; 0.45 - 0.52

Question 20

What is gtts/ml?

Answer 20

It’s the way drip/drop factor is measured; gtts means drops; gtts/ml refers to the size of a drop used to deliver medication

Question 21

Name 2 solutions used for resuscitation.

Answer 21

0.9% saline

Lactated Ringer’s

Question 22

How do you deal with blood transfusion complications?

Answer 22

1. Stop transfusion and assess vital signs
2. Give patients with dyspnoea (difficulty breathing) oxygen
3. Keep line open; get new IV tube for normal saline solution