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Y3R4 - BMS 🏥 > L6: Fluid Balance > Flashcards

L6: Fluid Balance Flashcards

1
Q

Introduction to fluid balance

A
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2
Q

Body fluid composition

A
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3
Q

“Being able to assess the hydration status of a patient is an important skill that you’ll regularly use in clinical practice”

The patient may be:

A
  • Hypovolemic (dehydrated).
  • Euvolemic.
  • Hypervolemic (Fluid overloaded). See poge
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3
Q

IV distribution to body fluid compartments

A
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4
Q

Def of Hypovolemia

A

Refers to an overall deficit of fluid in the body.

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4
Q

Causes of Hypovolemia

A
  • Poor intake.
  • Excessive loss: Vomiting - Diarrhea - Hemorrhage.
  • Third Space loss
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5
Q

what is Third space loss?

A
  • Fluid remains within the body.
  • But has shifted from the intravascular space to another compartment within the body.
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6
Q

Pure water loss

  • Lost through ….
  • Electrolyte concentration loss / L …..
A
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7
Q

Intestinal content loss

  • Lost through ….
  • Electrolyte concentration loss / L …..
A
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7
Q

Gastric fluid loss

  • Lost through ….
  • Electrolyte concentration loss / L …..
A
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8
Q

Urinary losses

  • Lost through ….
  • Electrolyte concentration loss / L …..
A
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9
Q

Vital signs in Hypovolemia

A
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9
Q

Physiological response to hypovolemia

A
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10
Q

Assessment Of Hypovolemia

A
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11
Q

Uses of Capillary Refill Time

A

useful way of assessing peripheral perfusion.

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12
Q

Steps of Capillary Refill Time

A
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13
Q

Results in Capillary Refill Time

A
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14
Q

Results in Skin Turgor

A
14
Q

Steps of Skin Turgor

A
15
Q

Inspection of hands color in Hypovolemia

A
16
Q

steps of Temperature assessment in hypovolemia

A
17
Q

Results in Temperature assessment in hypovolemia

A
18
Q

What are indications that the patient needs fluid resuscitation?

A
19
Q

TTT of hypovolemia in obese or thin patients

A

Adjust the IV fluid prescription to their ideal body weight.

19
Q

TTT of Hypovolemia

A

IV fluid prescription

20
Q

Dose in TTT of hypovolemia

A

20-25 ml/kg/day fluid

21
Q

Why should we use lower range volumes per kg in TTT of hypovolemia?

A

As patients rarely need more than a total of 3 litres of fluid per day.

22
Q

Cautions during TTT of hypovolrmia

A
  • Large volume resuscitation promotes endothelial injury, fluid extravasation & tissue edema.
  • Increasing interstitial fluid & extravascular lung water are associated with progressive organ dysfunction & death.
23
Q

Percent of water in human bodies

A
23
Q

Def of Hypervolemia

A
  • Refers to an excess of fluid in the body.
24
Q

Causes of Hypervolemia

A
  • Excessive fluid intake.
  • Inappropriate fluid retention.
25
Q

Clinical features in Hypervolemia

A
26
Q

Methods of assessment of hypervolemia

A
  • JVP
  • CVP
26
Q

Uses of Jagular venous pressure

A

Provides an indirect measure of central venous pressure (CVP).

27
Q

where is Jagular venous pressure measured?

A
  • Internal jugular vein (UV), As UV connects to the right atrium without any intervening valves, resulting in a continuous column of blood.
28
Q

The external jugular vein (EJV) is better visualized, but less reliable

why?

A
29
Q

Method of measuring of Jagular venous pressure

A

Assessing the vertical distance between the sternal angle & the top of the pulsation point of the UV.

30
Q

Results in measuring of Jagular venous pressure

A

healthy individuals —-> less than or equal 3 cm.

30
Q

Definition of Central Venous Pressure (MVP)

A
  • Pressure of blood in the thoracic vena cava, near the right atrium of the heart.
31
Q

Uses of Central Venous Pressure (MVP)

A
  • Reflects the amount of blood returning to the heart.
  • Reflects the ability of the heart to pump the blood into the arterial system.
  • Used as a surrogate for preload.
  • Predict volume responsiveness (le. whether more fluid will improve COP), By using changes in CVP in response to infusions of intravenous fluid.
32
Q

Results of Central Venous Pressure (MVP)

A

Normal values: 5 - 10 cm H,O.

32
Q

Steps of Central Venous Pressure (MVP)

A
33
Q

Factors that increase Central Venous Pressure (MVP)

A

Y3R4 - BMS 🏥 (18 decks)

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