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XIO > Pharm week 3 > Flashcards

Pharm week 3 Flashcards

1
Q

blood capabilities

A

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

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2
Q

water in body is made of

A

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

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3
Q

Fluid inside blood vessels

A

Intravascular fluid (IVF)

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4
Q

Extravascular volume

A

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

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5
Q

Extracellular volume

A

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

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6
Q

Plasma proteins exert constant osmotic pressure****

A

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

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7
Q

ISF exerts hydrostatic pressure (HP)

A

Normally 17 mm Hg

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8
Q

water lost through kidneys

A

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

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9
Q

blood

A

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

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10
Q

blood products can increase

A

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

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11
Q

we are looking to manage

A

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

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12
Q

if we need to increase clotting factors, we use

A

Fresh frozen plasma (FFP)

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13
Q

adverse affects of transfusions

A

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

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14
Q

PRBCs (packed RBCs)

A

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

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15
Q

whole blood

A

for blood loss over 25% of total blood volume

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16
Q

colloids

A

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

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17
Q

colloids

A

Superior to crystalloids in PV expansion, but more
expensive

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18
Q

colloids disadvantages

A

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

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19
Q

types of crystalloids

A

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

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20
Q

crystalloids

A

 Better for treating dehydration rather than
expanding plasma volume

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21
Q

crystalloids -  Used as maintenance fluids to

A

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

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22
Q

types of crytalloids

A

 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

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23
Q

indications for colloids

A

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

24
Q

adverse effects of colloids

A

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

25
Q

crystalloids don’t contain

A

proteins

26
Q

if we need faster expansion

A

use colloids

27
Q

if dehydrated and we need to rehydrate quickly

A

use crystalloids

28
Q

sodium polystyrene sulfonate

A

kayexolate - for hyperkalemia

29
Q

sodium levels

A

135 - 145

30
Q

Hyponatremia symptoms ***

A

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

31
Q

Hypernatremia - symptoms

A

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

32
Q

natremia - either way

A

 Mild
 Treated with oral sodium chloride and/or fluid restriction

 Severe
 Treated with intravenous normal saline or lactated Ringer’s
solution

33
Q

side effect of sodium administration

A

 Oral administration
 Nausea, vomiting, cramps

 IV administration
 Venous phlebitis

34
Q

potassium levels

A

3.5 - 5

35
Q

foods high in potassium

A

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

36
Q

K+ is excreted

A

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

37
Q

Metabolic acidosis = you need what?

A

K+

38
Q

hypokalemia causes

A

 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!

39
Q

hypokalemia can lead to

A

digtoxicity if they’re on digoxin

40
Q

K+ adverse effects

A

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

41
Q

 Hyperkalemia

A

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

42
Q

Treatment of severe hyperkalemia

A

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

43
Q

Ca normal range

A

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

44
Q

mag range

A

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

45
Q

treatmetn for hypomagnesium ***

A

 IV magnesium, calcium gluconate

46
Q

chloride range

A

95 to 108 mEq/L

47
Q

phosphorus

A

1.7 to 2.6 mEq/L

48
Q

Before giving potassium

A

assess ECG

49
Q

DO the fluid electroylte

A

match worksheet WILL BE ON EXAM

50
Q

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

A

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

51
Q

oral form of K+

A

 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

52
Q

Administer colloids

A

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

53
Q

if not on heart monitor for hypokalemia no faster than

A

10 mEq/hr

54
Q

hypercalcemia

A

flabby muscles

55
Q

similar questions on tests

A

as slides

XIO (372 decks)

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