Pharm week 3 Flashcards by Amanda S.

blood capabilities

 Carrying oxygen  Clotting
 Oncotic pressure
Cleanse plasma of harmful constituents by exchanges

How well did you know this?

Not at all

Perfectly

water in body is made of

Intracellular fluid (ICF) Interstitial fluid (ISF) Plasma volume (PV)

How well did you know this?

Not at all

Perfectly

Fluid inside blood vessels

Intravascular fluid (IVF)

How well did you know this?

Not at all

Perfectly

Extravascular volume

 ISF (interstitial fluid)
 ICF (intracellular fluid)

How well did you know this?

Not at all

Perfectly

Extracellular volume

 Plasma
 Interstitial fluid (ISF): fluid in space between cells, tissues, and organs

How well did you know this?

Not at all

Perfectly

Plasma proteins exert constant osmotic pressure****

 Colloid oncotic pressure (COP)
 Normally 24 mm Hg

How well did you know this?

Not at all

Perfectly

ISF exerts hydrostatic pressure (HP)

Normally 17 mm Hg

How well did you know this?

Not at all

Perfectly

water lost through kidneys

Urine excretion accounts for 50% to 60% of total daily water loss

How well did you know this?

Not at all

Perfectly

blood

Only class of fluids that are able to carry oxygen
Increase plasma volume

How well did you know this?

Not at all

Perfectly

blood products can increase

Increase COP and PV
Pull fluid from extravascular space into intravascular space (plasma expanders)

How well did you know this?

Not at all

Perfectly

we are looking to manage

Management of acute bleeding (greater than 50%
slow blood loss or 20% acutely). THEY would get plasma protein factors (PPF).

How well did you know this?

Not at all

Perfectly

if we need to increase clotting factors, we use

Fresh frozen plasma (FFP)

How well did you know this?

Not at all

Perfectly

adverse affects of transfusions

 Incompatibility with recipient’s immune system
 Transfusion reaction
 Anaphylaxis
 Transmission of pathogens to recipient (hepatitis, HIV)

How well did you know this?

Not at all

Perfectly

PRBCs (packed RBCs)

PRBCs: for blood loss up to 25% of total blood volume

How well did you know this?

Not at all

Perfectly

whole blood

for blood loss over 25% of total blood volume

How well did you know this?

Not at all

Perfectly

colloids

 Albumin 5% and 25% (from human donors)
 Dextran 40, 70, or 75 (a glucose solution)
 Hetastarch (synthetic, derived from cornstarch)

How well did you know this?

Not at all

Perfectly

colloids

Superior to crystalloids in PV expansion, but more
expensive

How well did you know this?

Not at all

Perfectly

colloids disadvantages

 May cause altered coagulation, resulting in bleeding
 Have no clotting factors or oxygen-carrying capacity
 Few others

How well did you know this?

Not at all

Perfectly

types of crystalloids

 Hydrating solutions
 Isotonic solutions
 Maintenance solutions
 Hypertonic solutions

How well did you know this?

Not at all

Perfectly

crystalloids

 Better for treating dehydration rather than
expanding plasma volume

How well did you know this?

Not at all

Perfectly

crystalloids -  Used as maintenance fluids to

 Compensate for insensible fluid losses
 Replace fluids
 Manage specific fluid and electrolyte disturbances
 Promote urinary flow

How well did you know this?

Not at all

Perfectly

types of crytalloids

 Normal saline (0.9% sodium chloride)
 Half normal saline (0.45% sodium chloride)
 Hypertonic saline (3% sodium chloride)
 Lactated Ringer’s solution
 D5W
 Plasma-Lyte

How well did you know this?

Not at all

Perfectly

indications for colloids

 Acute liver failure
 Acute nephrosis
 Burns
 Shock
 Renal dialysis
 Many other conditions

adverse effects of colloids

 May cause edema, especially peripheral or pulmonary
 May dilute plasma proteins, reducing COP
 Effects may be short-lived

crystalloids don't contain

proteins

if we need faster expansion

use colloids

if dehydrated and we need to rehydrate quickly

use crystalloids

sodium polystyrene sulfonate

kayexolate - for hyperkalemia

sodium levels

135 - 145

Hyponatremia symptoms ***

Lethargy, stomach cramps, hypotension, vomiting, diarrhea, seizures

Hypernatremia - symptoms

 Water retention (edema), hypertension  Red, flushed skin; dry, sticky mucous membranes; increased thirst; elevated temperature; decreased urine output

natremia - either way

 Mild  Treated with oral sodium chloride and/or fluid restriction  Severe  Treated with intravenous normal saline or lactated Ringer’s solution

side effect of sodium administration

 Oral administration  Nausea, vomiting, cramps  IV administration  Venous phlebitis

potassium levels

3.5 - 5

foods high in potassium

Fruit and fruit juices (bananas, oranges, apricots, dates, raisins, broccoli, green beans, potatoes, tomatoes), meats, fish, wheat bread, and legumes

K+ is excreted

through kidneys -  Impaired kidney function leads to higher serum levels, possibly toxicity

Metabolic acidosis = you need what?

K+

hypokalemia causes

 Alkalosis  Corticosteroids  Crash diets  Diarrhea  Ketoacidosis  Burns (burn patients can have either hypokalemia or hyperkalemia)  Loop and thiazide diuretics  Vomiting  Malabsorption  Large amounts of licorice consumption!

hypokalemia can lead to

digtoxicity if they're on digoxin

K+ adverse effects

 Oral preparations  Diarrhea, nausea, vomiting, GI bleeding, ulceration  IV administration  Pain at injection site  Phlebitis  Excessive administration  Hyperkalemia toxic effects

 Hyperkalemia

Muscle weakness, paresthesia, paralysis, cardiac rhythm irregularities (leading to possible ventricular fibrillation and cardiac arrest)

Treatment of severe hyperkalemia

 IV sodium bicarbonate, calcium salts, dextrose with insulin kayexolate

Ca normal range

4.5 to 5.5 mEq/L; 9 to 11 mg/dl;

mag range

1.5 to 2.5 mEq/L or 1.8 to 3 mg/dl

treatmetn for hypomagnesium ***

 IV magnesium, calcium gluconate

chloride range

95 to 108 mEq/L

phosphorus

1.7 to 2.6 mEq/L

Before giving potassium

assess ECG

DO the fluid electroylte

match worksheet WILL BE ON EXAM

very important - Parenteral infusions of potassium must be monitored***

closely  Rate should not exceed 20 mEq/hour  NEVER give as an IV bolus or undiluted. must always be diluted.

oral form of K+

 Must be diluted in water or fruit juice to minimize GI distress or irritation  Monitor for complaints of nausea, vomiting, GI pain, or GI bleeding

Administer colloids

slowly. Monitor for fluid overload and possible heart failure  For blood products, follow administration procedures closely  Monitor closely for signs of transfusion reactions

if not on heart monitor for hypokalemia no faster than

10 mEq/hr

hypercalcemia

flabby muscles