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Renal- PA Sp23 > IV Fluid Therapy > Flashcards

IV Fluid Therapy Flashcards

1
Q

What is the goal of maintenance fluid therapy with normal kidney function?

A

maintain volume and electrolyte balance

If NPO= H2O, Na, K, +/- dextrose

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2
Q

What is the best estimator of volume status?

A

weight

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3
Q

How often should you reassess maintenance IVF?

A

daily

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4
Q

What is the goal of replacement fluid therapy?

A

correct volume status or serum electrolytes

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5
Q

What is volume status?

A

weight, JVD, urine output, ht, BP, HR, pulmonary edema, peripheral edema

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6
Q

Remember…

A

LOOK AT YOUR PATIENT

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7
Q

Describe the hypervolemic patient.

A

EXCESS TBNa= Na retention and decreased circulating volume

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8
Q

What are the si/sx of hypervolemic patients?

A

edema, ascites, pleural effusions, pulmonary edema, increased JVP, dyspnea

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9
Q

What are the treatments for hypervolemic patients?

A

treat underlying cause
DIURETICS
limit Na intake

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10
Q

Describe the hypovolemic patient.

A

DEFICIT TBNa= renal and extrarenal

renal- diuresis, MC def
extrarenal- GI, burn, respiratory issues, bleeding

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11
Q

What are the si/sx for hypovolemic patients?

A

thirst, weakness, mm cramps, postural dizziness

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12
Q

What are the treatments for hypovolemic patients?

A

REPLENISH IV VOLUME

MILD= oral rehydration
MOD- SEVERE= isotonic fluids (1-2 bolus)

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13
Q

What are the routes of fluid administration?

A

enteral and parenteral

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14
Q

How to calculate fluid deficit?

A

pre-illness weight - illness weight

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15
Q

Children:
TBW is ___% of weight (kg)

A

60

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16
Q

Infants:
TBW is ___% of weight (kg)

A

75

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17
Q

Oral rehydration therapy in children:
- > ___ mo old
- mild-mod ______
- tolerating ___ intake
- no _____ illness

A

6
dehydration
PO
severe

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18
Q

Oral rehydration therapy table:

A
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19
Q

When should IV rehydration be preferred over oral rehydration?
- ___ tolerating PO
- ___ dehydration
- Shock, _____
- ___glycemia
- ______ abnormalities

A

Not
severe
sepsis
hypo
electrolyte

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20
Q

___-___ mL/kg for mild dehydration

A

30-50

21
Q

___-___ mL/kg for mod. dehydration

A

60-80

22
Q

What are the 2 most common types of IV fluids?

A

crystalloids and colloids

23
Q

Describe crystalloids.

A

pass through the capillary wall easily

Increase INTERSTITIAL volume (EC)

24
Q

Describe colloids.

A

Do NOT pass through the capillary wall easily

Increase PLASMA volume (EC)

25
Q

What are the 3 principal components of crystalloids?

A

water, electrolytes, glucose

isotonic saline, hypertonic saline, hypotonic saline, LR, D5W

26
Q

Cellular Physiology Review

A
27
Q

Isotonic fluid:
ECF and ICF have ___ osmolarity. No ____ movement.

A

Equal
water

28
Q

When should you use isotonic saline?

A

hypovolemic shock, DKA, hyperosmolar hyperglycemic state, correct mild hypoNa, treatment of hyperCa, septic shock

29
Q

Increase Na= ____ plasma osmolarity
Decrease Na= ______ plasma osmolarity

A

Increase
Decrease

30
Q

NS components
Na= ___
Cl= ___
Mildly acidotic

A

154
154

31
Q

LR components
Na= ___
Cl= ___
Lactate= ____
Neutral fluid

A

130
109
28

32
Q

____ can cause a ____ AG metabolic acidosis (hyperchloremic) in large volumes.

A

NaCl
Normal

33
Q

Is there a single resuscitation fluid that is optimal?

A

No

34
Q

When should LR be used?

A

HyerpCl, Metabolic acidosis, renal dysfunction, burns, sepsis, large volume fluid infusion

35
Q

What are the proportions of crystalloids and colloids in the intravascular space?

A

Crystalloids= 1/3
Colloids= 2/3

36
Q

What must be considered for crystalloid infusion rates?

A

CHF, dialysis, volume status

37
Q

How to correct hypoNa?

A

replace Na or restrict H2O

38
Q

What is the max dose of Na you can replace in 24 hours?

A

6-8 mEq/L

39
Q

What is the primary risk when correcting low sodium?

A

osmotic demyelination syndrome

40
Q

What is the max correction rate with hypertonic saline?

A

0.5 mEq/L/hr or 10 mEq/L/24h

41
Q

What is the correction of sodium deficiency dependent on?

A

sex, age, and weight

42
Q

What is the complication associated with rapid Na correction of hypernatremia?

A

cerebral edema

43
Q

What is the MCC of hypernatremia?

A

water deficit or Na gain

44
Q

What is the MCC of hypokalemia?

A

vomiting/ diarrhea

45
Q

What is seen on EKG during hypokalemia?

A

flattened T waves, U waves, QT prolongation, V fib

46
Q

IV treatment of hypokalemia should be done carefully. __-___ mEq/hr. ____ should be corrected as well.

A

10-20
Mg

47
Q

What are some examples of natural colloids?

A

Albumin, packed RBCs, plts, FFP

48
Q

What are some examples of synthetic colloids?

A

dextran, starches

Renal- PA Sp23 (4 decks)

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