IVF

Question 1

3 types of IVF…

Answer 1

crystalloids, colloids, blood and blood products

Question 2

What type of IVF?

contain sodium as main osmotically active particle

Answer 2

crystalloids

Question 3

What type of IVF?

contain high-molecular weight substances that don’t migrate easily across capillaries

more likely to stay in vascular compartment

Answer 3

colloids

Question 4

What type of IVF?

similar to colloids because they stay in the vascular space

Answer 4

blood/blood products

Question 5

3 types of isotonic crystalloids…

Answer 5

0.9 NS, LR, plasmalyte

Question 6

These crystalloids have same salt concentration as normal cells of body and blood…

Answer 6

isotonic crystalloids

Question 7

These crystalloids have higher salt concentration than normal cells…

Answer 7

hypertonic crystalloid

Question 8

What IVF is a hypertonic crystalloid?

Answer 8

3% NS

Question 9

This type of crystalloid has a lower salt concentration than normal cells

Answer 9

hypotonic crystalloids

Question 10

What are two types of hypotonic crystalloids?

Answer 10

0.5 NS, 0.25 NS

Question 11

D5W is what type of IVF?

Answer 11

crystalloid

Question 12

Which isotonic crystalloid?

contains lactate, potassium, calcium and NaCl

Answer 12

lactated ringers

Question 13

isotonic crystalloids distribute in a _____ pattern throughout ECF space

Answer 13

uniform

Question 14

This type of IVF is used for tx of dehydration, hypovolemia. They can be used for IV bolus

Answer 14

isotonic crystalloids

Question 15

This type of IVF should be used cautiously

can be used with life-threatening hyponatremia with significant water excess

replacement rate must be calculated.

Answer 15

hypertonic crystalloids (3% NS)

Question 16

what could occur with overly rapid correction of hyponatremia?

Answer 16

CPM

Question 17

This type of IVF is used for maintenance fluids, and is distributed throughout the TBW.

It isn’t adequate for replacing intravascular volume deficit (hypovolemia/dehydration)

Answer 17

hypotonic crystalloids

Question 18

This IVF has similar TBW distribution to hypotonic crystalloids

can be used to treat hypoglycemia

Answer 18

D5W

Question 19

This type of IVF can be considered when crystalloids fail to sustain plasma volume due to low osmotic pressure

Answer 19

colloids

Question 20

burn patients or peritonitis patients with considerable protein loss can be repleted with…

Answer 20

colloids

Question 21

Colloids are more likely to expand which compartment?

Answer 21

vascular

Question 22

is there evidence to support use of colloids in severe hypovolemia?

Answer 22

no

Question 23

What are the 3 main categories of colloids?

Answer 23

albumin, dextran, hetastarch

Question 24

Albumin comes in what preparations?

Answer 24

5%, 25%

Question 25

Dextran comes in what two preparations?

Answer 25

40, 70

Question 26

what colloid is used in edematous patients to mobilize interstitial fluid to vascular space?

Answer 26

albumin

Question 27

This colloid can be helpful patients experiencing third spacing...

Answer 27

albumin

Question 28

This is a synthetic glucose polymer that is a colloid IVF

Answer 28

dextran

Question 29

What is dextran's intravascular expansion equal to?

Answer 29

amount infused

Question 30

This is a glyocogen like molecule that is less expansive than albumin, and therefore can be used as an alternative

Answer 30

hetastarch

Question 31

hetastarch is more frequently used in what setting?

Answer 31

intra-operatively

Question 32

hetastarch increases vascular volume to an amount _____ than the volume infused

Answer 32

greater or equal to

Question 33

Three types of blood products are...

Answer 33

PRBCs, platelets, fresh frozen plasma

Question 34

PRBCs can be used with crystalloids for what reason?

Answer 34

expand intravascular volume

Question 35

Before transfusion with PRBCs, what must be done?

Answer 35

blood type screen/cross

Question 36

When can platelets be considered?

Answer 36

thrombocytopenia or impaired function

Question 37

This is used to correct major bleeding complications in patients on wararin or with a vitamin K deficiency

Answer 37

FFP

Question 38

Which 4 IVF can be given as bolus?

Answer 38

NS, LR, plasmalyte, PRBCs

Question 39

bolus can be given ___mL to ____ L

Answer 39

250 ml - 1L

Question 40

Bolus should be considered in what two situations?

Answer 40

hypovolemia due to dehydration or acute blood loss

Question 41

What is the commonly used preparation of maintenance IVF?

Answer 41

D5W/0.5NS with 20mEq KCl

Question 42

When is maintenance IVF considered?

Answer 42

NPO patients

Question 43

Can potassium-containing IVF be given as a bolus?

Answer 43

no, NEVER

Question 44

potassium is as osmotically active as...

Answer 44

sodium

Question 45

When can potassium be added to IVF?

Answer 45

maintenance if NPO or hypokalemia

Question 46

What type of IVF therapy can be given to correct existing water/electrolyte deficit from GI, GU, Skin, blood loss or third spacing?

Answer 46

replacement IVF

Question 47

what can be used as a guide for post-op fluid repletion?

Answer 47

urine output and vitals

Question 48

Parkland formula...

Answer 48

percent burned x body weight (kg) x 4 ml

Question 49

The following are indications for... ``` small bowel resection bowel obstruction IBD bowel rest can't tolerate enteral inadequate energy intake PO multisystem dx ```

Answer 49

TPN

Question 50

what type of parenteral nutrition? - central line - MC - > 7 days

Answer 50

TPN

Question 51

Which type of parenteral nutrition? - infrequently used - uses IV/peripheral access - short term < 7 days

Answer 51

PPN

Question 52

What should be monitored while on TPN?

Answer 52

Is and Os daily weights CMP, LFTs, TGs

Question 53

How often should monitoring occur on TPN while inpatient?

Answer 53

daily to weekly

Question 54

How often should monitoring occur on TPN while outpatient?

Answer 54

weekly to monthly

Question 55

The following TPN complications are related to what? ``` air embolism PTX DVT infx thrombophlebitis ```

Answer 55

catheter