Module 3 Week 6 Flashcards
What is the goal of pre-operative fluid management
It is to provide the appropriate amount of parental fluid to maintain intravascular volume and cardiac preload, oxygen carrying capacity, coagulation status, acid-base hemostasis, and electrolyte balance.
What can make the pre-operative period a challenge
Blood loss, evaporation loss, third spacing, preoperative fluid volume status, and pre-existing disease states
What is the major component of all fluid compartments with in the body
Water
Total body water can be divided into two basic components ______ and _____?
Intracellular and extracellular
What are the major components of the extracellular compartment
Blood volume and interstitial fluid volume
What is the non-cellular component of the blood?
The plasma volume
What is the major difference between plasma and interstitial fluid
Plasma has a higher concentration of protein
What can influence electrolyte balance
Parental fluid administration
What can lead can happen in the perioperative period that can lead to shift in fluid balance
Physiologic changes
What is the recommended period of time for preoperative fasting from clear liquids
2 hours
Balanced salt Solutions have an electrolyte composition similar to what
Extracellular fluid
What is considered extracellular fluid and what classification of fluid do they fall in?
These are hypotonic solutions such as Lactated ringer‘s, Plasma-Lyte, normosol
In vivo ( in the body) what does lactate ringers Metabolize into
It becomes bicarbonate
What kind of solution is normal Saline
It is slightly hypertonic
Why is normal Celine preferred to dilute pack red blood cells
Because it is nearly isotonic
Osmolality of iso tonic solution’s can cause what at the point of injection
Hemolysis
Why does dextrose Function as free water
Because the dextrose is metabolized
In what circumstances is dextrose IV solution used
To correct hyper natremia and to prevent Hypoglycemia and diabetic patients
What are Colloids And why are they used
A colloid is albumin And it is used because it is a larger molecule in weight and remains in the intravascular space longer than a crystalloid
Does albumin affect coagulation?
A minimal effect
Hydroxyethyl starches (HES) interferes with what
With von Willebrand factor, factor VIII, And platelet function
Administration of what after acute blood loss may lead to more rapid improvement of filling pressures, arterial blood pressure, and heart rate
Colloid (albumin)
Postoperatively what rapidly subsides when administration of anesthetics are stopped
Venodilation in my cardinal depression
What is the fluid deficit equation
(Maintained fluid requirement) x (hours since last intake (Npo deficit)) + (unreplaced preoperative external and interstitial) / (third space loss(eg. vomiting, diarrhea))