IV fluids Flashcards
1
Q
where is body water
A
1/3 ECF
2/3 ICF
2
Q
where is water in ECF
A
1/4 plasma (8% total)
3/4 ISF (25% total)
3
Q
how much fluid and lytes are needed per day
A
4-2-1 rule
4 ml/kg/h for 1st 10kg
2 for next 10
1 for rest
4
Q
def. effective osmole
A
particle that doesn’t cross cell membrane
- Na, K, glucose
- NOT ethanol and urea
5
Q
what are 2 types of losses
A
sensible - those you feel - urine
insensible - those you don’t - sweat, resp
6
Q
what is “free water” in 1 L of 70mmol/L fluid
A
500 ml is isotonic (140)
so 500ml is free
7
Q
4 types of fluid loss
A
- pure water loss
- hypotonic
- isotonic
- blood
8
Q
2 ways to lose free water
A
- . skin - insensible
- urine
- diabetes insipidus
- urea induced osmotic diuresis
9
Q
3 ways to lose hypotonic
A
- skin
- sweat (20-50 Na) - urine
- most diuretics
- glucose or mannitol induced - GI
- vomiit
- diarrhea if due to osmotic laxative
10
Q
4 ways to lose isotonic
A
- skin
- burns - GI
- most diarrhea
- ileus - urine
- thazides - third space losses
11
Q
3 consequences of fluid loss
A
- hypovolemia
- less CO > hypotens> activate SNS - possible hypernatremia
- brain cells shrink> confusion - possibly lose other lytes
12
Q
magnitude of blood volume lost for a liter loss of each type
A
- pure water loss - 80ml
- hypotonic - 80-250
- isotonic - 250-333
- blood- 1000ml
13
Q
3 hormonal responses to hypovolemia
A
- SNS activation
- RAS activations
- ADH
14
Q
effects of hormones (3)
A
- incr. CO
- vasoconstrict
- reduce urine loss and NaCl
15
Q
4 Hx ways to assess loss
A
- urine (output, color)
- thirst/intake
- dizzy when standing
- direct evidence of loss
- blood, surg, GI etc
