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PathoPharm > lilley ch 29 (fluid and electrolytes) > Flashcards

lilley ch 29 (fluid and electrolytes) Flashcards

1
Q

normal urine osmolality range

A

100-1300 mOsm/kg

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2
Q

normal plasma osmolality range

A

280-295 mOsm/kg

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3
Q

3 types of crystalloids

A

isotonic
hypotonic
hypertonic

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4
Q

Fluids with the same osmolality as the surrounding cells

A

isotonic

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5
Q

examples of isotonic crystalloids (3)

A

LR
D5W
0.9% NS

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6
Q

Solutions that are less concentrated than in the cells (less electrolytes)
-fluid moves out of vein and into tissues and cells

A

hypotonic

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7
Q

examples of hypotonic crystalloids (2)

A
  1. 45% NaCl

0. 33% NaCl

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8
Q

Fluids that are more concentrated than in the cells

-fluid moves from interstitial spaces into cells

A

hypertonic

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9
Q

examples of hypertonic crystalloids (2)

A

3% NaCl

D10W

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10
Q

“stays where I put it”

A

isotonic

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11
Q

“enters the vessel”

A

hypertonic

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12
Q

“into the cell”

A

hypotonic

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13
Q

-Solutions containing fluids and electrolytes that are normally found in the body
-don’t contain proteins
-less expensive
-No risk for viral transmission,
anaphylaxis, or alteration in
coagulation profile

A

crystalloids

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14
Q

what is the best indicated use for crystalloids

A

dehydration and maintenance fluids

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15
Q

contraindications of crystalloids (2)

A

drug allergy

hypervolemia

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16
Q

adverse effects of crystalloids (5)

A
  • may cause edema
  • may dilute plasma proteins
  • large volumes required to be effective
  • effects may be short-lived
  • prolonged infusions may worsen alkalosis/acidosis
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17
Q

what is the only solution that can be given with blood

A

0.9% NS

18
Q

in which patients should you use NS with caution (2)

A

cardiac disease

renal disease

19
Q

isotonic crystalloid:

  • does not provide free water or calories
  • used to treat hypovolemia, burns, GI fluid losses
A

LR

20
Q

in which patients would the use of LR be contraindicated (4)

A
  • alkalosis
  • lactic acidosis
  • liver disease
  • caution with renal patients
21
Q

isotonic crystalloid:

  • initially isotonic then hypotonic
  • does not provide electrolytes, but provides some calories
  • great for treating hypernatremia
A

D5W

22
Q

when should you not use D5W (2)

A
  • cerebral edema

- resuscitation

23
Q

what patients would benefit from hypotonic crystalloids (2)

A
  • diabetic ketoacidosis

- hyperglycemia

24
Q

when should you not use hypotonic crystalloids (4)

A
  • cerebral edema
  • liver disease
  • trauma
  • burns
25
Q

what is D50W used for

A

hypoglycemia (rapid IV bolus)

26
Q

when would hypertonic crystalloids be useful (3)

A
  • severe hyponatremia
  • head injuries
  • when calories are needed with TPN
27
Q 
type of fluid: 
-contain molecules too large to pass through 
capillary walls ("volume expanders")
-require less volume
-longer duration of action
A

colloids

28
Q

5 types colloids

A
  • albumin 5% and 25%
  • dextran 40, 70, 75
  • whole blood
  • packed red blood cells
  • fresh frozen plasma
29
Q

when are colloids useful (2)

A

shock

burns

30
Q

adverse effects colloids (2)

A
  • may alter coagulation

- dextran therapy may cause anaphylaxis or renal failure

31
Q

4 contraindications of dextran

A
  • hypersensitivity
  • heart failure
  • renal insufficiency
  • extreme dehydration
32
Q

type of fluid:

  • improves oxygenation
  • increases colloid osmotic pressure and plasma volume
  • expensive
  • least available
A

blood

33
Q

blood product:

Increase clotting factor levels in patients with demonstrated deficiency

A

fresh frozen plasma

34
Q

blood product:
used to increase oxygen-carrying capacity in patients with anemia, in patients with substantial hemoglobin deficits, and in patients who have lost up to 25% of their
total blood volume

A

packed red blood cells

35
Q

blood product:
more beneficial in cases of extreme (greater than 25%) loss of blood volume because whole blood also contains plasma proteins

A

whole blood

36
Q

disadvantages of using blood products (3)

A
  • possible anaphylaxis
  • possible transfusion reaction
  • possible transmission of pathogens to pt
37
Q

when is the most likely time for a blood transfusion reaction to occur

A

first 15 minutes of transfusion

38
Q

4 important S+S of blood transfusion reactions

A
  • temp rise of 1C above baseline
  • hives
  • chills
  • pruritis
39
Q

what is the order of operations if you suspect a blood transfusion reaction (4 steps)

A
  • stop transfusion and switch to normal saline
  • assess and stabilize patient
  • tell doctor
  • tell blood bank
40
Q

3 types of blood transfusion reactions

A
  1. allergic: hives, itching
  2. febrile: fever, chills, fast heartrate and breathing
  3. hemolytic: chest pain, chills, fever, low bp, increased resp rate

PathoPharm (42 decks)

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