Perfusion Part 2 - Fluids Flashcards
__% of body fluid is H2O
60
__% of H2O is stored in the ICF meanwhile __% of H2O is stored in the ECF
40, 20
Out of the H2O in the ECF, __% is in the interstitial fluid while __% is in plasma
16, 4
What organ is the primary regulator of fluid output?
Kidneys
What are some examples of fluid balance issues/losses?
- Vomiting
- GI bleeding
Upper GI bleeding results in bloody ____ while lower GI bleeding results in bloody ____
vomit, stool
What are 4 meds that can contribute to GI bleed?
- Antiplatelets
- Anticoagulants
- Thrombolytics
- NSAIDs
What is osmolality?
Concentration of solute in an osmotic solution
What is the expected osmolality?
275-295 mOsm/kgH2O
Dehydration ____ osmolality meanwhile overhydration ____ osmolality
increases, decreases
What are the 3 types of tonicity for IV fluids?
- Isotonic
- Hypertonic
- Hypotonic
Rank [isotonic], [hypertonic] & [hypotonic] in terms of concentration:
____ < plasma = ____ < ____
hypotonic, isotonic, hypertonic
RBCs in a hypertonic solution will ____ versus in hypotonic solutions, where they will ____
shrink, swell
If a fluid has high protein content, it will be __tonic in the bag but __tonic in the body
iso, hyper
If a fluid has high dextrose content, it will be __tonic in the bag but __tonic in the body
hyper, iso
The estimated amount of water an adult needs is: __ mL/kg/day
35
An adult need 50-100g/day of ____ to limit starvation ketosis
glucose
Explain the 4/2/1 rule and which patient group its most often used for
Pediatric patients:
4ml/kg/hr for 1st 10kg of body weight
2ml/kg/hr for 2nd 10kg of body weight
1ml/kg/hr for remaining 10kg of body weight
Define resuscitation
Replenishing deficits
Colloids are ____ based meanwhile crystalloids are ____ based
protein, water
What does NPO mean?
Nothing by mouth
What are 4 examples of isotonic fluids?
- Lactated Ringer’s
- Normal Saline (0.9%)
- Albumin (5%) [colloid]
- Dextran 40 [colloid]
What type of fluid is used to treat hypovolemic shock?
Colloid
Describe the movement of colloids when in circulation
Stay in circulation (proteins are too big to cross membrane)
Describe the movement of crystaloids when in circulation
Move between ICF & ECF easily
What is the best resuscitation fluid choice for adults?
NS (0.9%)
What are 2 side effects of long term use of NS (0.9%)
- Hypokalemia
- No dextrose
NS (0.9%) is composed of:
154 mEq __
154 mEq __
Na
Cl
LR contains ____ electrolytes compared to NS
more
LR is composed of:
4 mEq __
2.7 mEq __
Na, Cl & lactate
K
Ca
What are 3 side effects of LR?
- Hyperkalemia
- No dextrose
- High lactate
What are 6 examples of hypertonic fluids?
- D5NS
- D5LR
- D10W
- D5 1/2NS
- NaCl (3%)
- Albumin (25%) [colloid]
NaCl (3%) is used to treat ____ injury by lowering ____ pressure
head, intracranial
D5 1/2NS is __tonic but becomes __tonic in the body
hyper, iso
__% albumin is hypertonic meanwhile __% albumin is isotonic
25, 5
D5 means:
50 mEq of dextrose
What are 2 side effects of D5 1/2NS?
- Cellular dehydration
- Hyponatremia
What is the 1st choice maintenance fluid for pediatrics?
D5 1/2NS
Caution is needed with albumin (25%) because it adds . times its volume of additional fluid
3.5
What are 4 examples of hypotonic fluids?
- 0.45 NaCl
- D5W
- 3.3% dextrose, 0.3% sodium (2/3 1/3)
- D5 0.2% NaCl
What is hypernatremic dehydration?
Increased sodium and decreased water
What type of fluid is used to treat hypernatremic dehydration?
Hypotonic, without sodium (ex: D5W)
