lecture 4 - polzin2 - even more fluids

Question 1

Question 2

(Composition of “Fluids Out”)

1. urine
2. sweat
3. Gi secretions
4. diarrhea
5. vomiting
6. respiratory

Answer 2

1. hypo–>hyper (use isotonic)
2. isotonic
3. isotonic
4. isotonic (LRS)
5. isotonic (but use saline - need the Cl- to balance acid)
6. electrolyte free water (rare)

Question 3

(isotonic losses)

1. loss of water and electrolytes equal
2. typical of what systems?
3. can be replaced with what

Answer 3

2. Gi and renala
3. isotonic balanced electrolyte solutions

Question 4

(types of fluids)

1. how are crystalloids different from colloids?

Answer 4

1. crystalloids - small mol wt that can go through ECF and ICF

colloids - restricted to plasma component

Question 5

(tonicity)

1. what is it?
2. hyper?

hypo?

iso?

normal plasma osmolality?

Answer 5

1. power to draw out fluid
2. << 300mOsm/L: draws out fluid
   hypo: >> 300

iso ~300

~290

Question 6

1-5. What are 5 reasons to use an isotonic fluid?

Answer 6

1. similar to plasma osmolality
2. less likely to disrupt cells than hyper or hypo
3. minimally disrupts ECF composition
4. give large amounts rapidly and safely
5. ideal for peripheral vein or other parenteral routes of administration

Question 7

(where does each fluid go)

1. LRS?
2. dextrose in water (D5W)
3. how will LRS affect Na conc?
4. D5W?
5. what do you need to give to expand ECF?

Answer 7

1. stays in ECF (Na based)
2. diffuse into total body water

(dextrose metabolized leaving just water)

3. won’t
4. lower
5. Na

Question 8

(Replacement Fluids)

1. similar to ECF or ICF?
2. used to replace what kind of fluid loss?

Answer 8

1. ECF
2. isotonic

Question 9

(hypotonic fluids)

1. when do you use this?
2. rarely used… why?

Answer 9

1. to provide electrolyte-free water
2. may cause cell lysis

Question 10

(hypertonic fluids)

1. given when?

Answer 10

1. when you need to expand ECF quickly

Question 11

LAST WORD ON FLUID SELECTION - IF NOT SURE USE WHAT

Answer 11

LRS

then 0.9% NaCl

Question 12

(generalities on rate of fluid administration)

1. usually try to correct by when?
2. slower when?
3. more rapidly when?

Answer 12

1. 24 hours
2. when electrolyte and acid-base deviations from normal are great
3. when renal perfusion is impaired

Question 13

Question 14

Question 15

Question 16

Answer 16

Question 17

barely do this one