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PHRM 825 > PHRM 825: Fluids and Electrolytes - Fluids > Flashcards

PHRM 825: Fluids and Electrolytes - Fluids Flashcards

1
Q

IBW meaning

A

Ideal body weight

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2
Q

LBW meaning

A

Low body weight (same as IBW)

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3
Q

IBW calculation for males

A

50kg + (2.3 X inches over 60”)

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4
Q

IBW calculation for females

A

45.5kg + (2.3 X inches over 60”)

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5
Q

DBW meaning

A

Dosing body weight

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6
Q

DBW calculation

A

IBW + 0.4 (actual weight - IBW)

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7
Q

When should you use DBW?

A

Use if DBW is greater than 130% of IBW and you are dosing drugs

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8
Q

NBW meaning

A

Nutritional body weight

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9
Q

NBW calculation

A

IBW + 0.25 (actual weight - IBW)

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10
Q

When should you use NBW?

A

Use if DBW is greater than 130% of IBW and you are calculating fluid, electrolyte, and nutrition parameters

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11
Q

What fraction of the body’s fluid is intracellular?

A

2/3

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12
Q

What percentage of the body’s weight is intracellular fluid?

A

40%

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13
Q

What fraction of the body’s fluid is extracellular?

A

1/3

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14
Q

What percentage of the body’s weight is extracellular fluid?

A

20%

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15
Q

What is transcellular fluid?

A

Fluid in the cerebrospinal column, pleural cavity, lymphatic system, joints, eyes

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16
Q

What type of fluid is not subject to daily gains/losses?

A

Transcellular

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17
Q

What percentage of an adult male’s body weight is water?

A

50-60%

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18
Q

What percentage of an adult female’s body weight is water?

A

45-55%

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19
Q

What percentage of neonates/infants body weight is water?

A

75-90%

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20
Q

Why does the amount of water in the body decrease with age?

A

Skeletal muscle mass declines and proportion of fat may increase

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21
Q

What are the 2 categories of fluid losses

A

Sensible (measurable) and insensible (immeasurable)

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22
Q

Sensible fluid losses include

A

Urine, defecation, and wounds

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23
Q

Average fluid lost each day in urine

A

400-1500 mL

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24
Q

Average fluid lost each day in feces

A

100-200 mL

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25
Q

Insensible fluid losses include

A

Fluid lost from the skin and lungs (breathing)

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26
Q

What are 2 ways solutes move across the cell membrane

A

Diffusion and active transport

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27
Q

What are 3 ways fluids move across the cell membrane

A

Osmosis, Capillary filtration, and oncotic pressure

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28
Q

What 3 things regulate the volume of water in the body?

A

Kidneys, thirst, hormonal changes

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29
Q

What 3 hormones regulate the volume of water in the body?

A

ADH, RAAS, ANP

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30
Q

ADH meaning

A

Antidiuretic hormone; aka vasopressin

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31
Q

RAAS meaning

A

Renin-angiotension-aldosterone system

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32
Q

ANP meaning

A

Atrial natriuretic peptide

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33
Q

What does ADH do?

A

Reduces diuresis and increases water retention

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34
Q

What does RAAS do?

A

Controls renin secretion, sodium/water regulation, and active transport of sodium

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35
Q

What does ANP do?

A

Decreases ADH release and counteracts effect of RAAS

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36
Q

Concentration of a solution isotonic to fluids the human body in mOsm/L

A

275-290 mOsm/L

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37
Q

Concentration of a solution hypotonic to fluids in the human body in mOsm/L

A

<275 mOsm/L

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38
Q

Concentration of a solution hypertonic to fluids in the human body in mOsm/L

A

> 290 mOsm/L

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39
Q

Osmolarity definition

A

Measure of solute concentration

40
Q

What 2 things is osmolarity dependent on?

A

pH and temperature

41
Q

IV fluids of hypotonic or hypertonic solutions can result in _______, ________, and ______

A

Hemolysis of RBCs, renal failure, and death

42
Q

Total osmolarity equation

A

Total osmolarity = osmolarity of IV solution + osmolarity of added electrolytes

43
Q

Crystalloids tonicity

A

Isotonic, hypotonic, hypertonic

44
Q

Colloids tonicity

A

Hypertonic

45
Q

Crystalloid examples

A

NS, 1/2 NS, D5W, LR, Balanced salt solutions

46
Q

Colloid examples

A

Albumin, Hetastarch (Hepsan), Tetrastarch (Voluven), Blood, Plasmanate

47
Q

What does a crystalloid solution provide to the patient?

A

Water and/or sodium

48
Q

Crystalloid solutions maintain _____ gradient between _____ and ____ compartments

A

osmotic, intravascular and extravascular

49
Q

Normal Saline is used for

A

Intravascular fluid replacement (resuscitation, hypotension, septic shock, etc.); sodium and/or chloride replacement

50
Q

1/2 Normal Saline is used for

A

Maintenance fluids

51
Q

LR is used for

A

Replacement of blood loss; resuscitation (trauma, burn, intravascular repletion IF SYMPTOMATIC)

52
Q

What crystalloid approximates human plasma

A

Lactated Ringers (LR)

53
Q

D5W is used for

A

Free water replacement if dehydrated

54
Q

D5W is NOT a ______ or ______

A

resuscitative fluid; maintenance IV fluid (MIVF)

55
Q

Balanced Salt solution definition

A

Crystalloid solutions containing physiologic levels of chloride and buffer solutions

56
Q

NS contains ___% higher ___ and ____% higher _____ than normal plasma

A

10% higher Na+ and 50% higher Cl-

57
Q

Examples of balanced salt solutions

A
  • Lactated ringers
  • Normosol-R
  • Plasma-lyte
58
Q

How many mEq/L of Na+ are in crystalloid fluid

A

154

59
Q

How many mEq/L of Cl- are in crystalloid fluid

A

154

60
Q

Colloid solutions are used to

A

-Increase plasma oncotic pressure and move fluid from the interstitial compartment to the intravascular (plasma) compartment

61
Q

What is the 2, 3, 4 rule?

A

We want:

  • Mg+2: >2 mEq/L
  • P-3: >3 mEq/L
  • K+: >4 mEq/L
62
Q

NS is _____

A

hypertonic

63
Q

Plasma expanders include

A

Colloid fluids

64
Q

What are characteristics of plasma expanders

A
  • Increased molecular weight

- Corresponds to increased intravascular retention time (half-life) compared to crystalloids

65
Q

Colloids are used selectively for _______, __________

A

Volume expansion, intravascular repletion in symptomatic patients

66
Q

Colloids may be used in _____ shock

A

hemorrhagic (blood is a colloid)

67
Q

Colloids are considered second-line therapy for _______ shock

A

hypovolemic

68
Q

What is albumin

A

A human derived blood product

69
Q

Albumin is used as supportive/symptomatic treatment unless the patient has ______

A

hypoproteinemia

70
Q

Adverse effects of albumin

A

Hypervolemia, azotemia, infusion related reaction/anaphylaxis

71
Q

Substitution ratio (SR) of synthetic colloids definition

A

number of hydroxyethyl groups per glucose molecule

72
Q

High Substitution ratio (SR) of synthetic colloids results in

A

Prolonged intravascular expansion

73
Q

Numeric value of high substitution ratio (SR)

A

> 0.5

74
Q

High molecular weight (MW) of synthetic colloids does what

A

alters coagulation

75
Q

Numeric value for high Molecular weight of synthetic colloids

A

> 200 kDa

76
Q

High molecular weight (MW) and substitution ratio (SR) in synthetic colloids are associated with what

A

Increased mortality and toxicities

77
Q

Synthetic colloids should be used ______

A

with caution

78
Q

1 unit of RBCs = _____ mL

A

230-350

79
Q

When should blood be used in therapy?

A
  • Acute blood loss (30-40% of blood volume)
  • Inadequate resucitation from fluids alone
  • Preoperatively
  • Low hemoglobin
80
Q

What is the numeric value for low hemoglobin

A

<7-8 g/dL

81
Q

1 unit of RBCs increases hemoglobin by _____ g/dL

A

1

82
Q

What is the most common MIVF?

A

D5W + 1/2 NS + 20 mEq KCl/L

83
Q

Why is D5W + 1/2 NS + 20 mEq KCl/L the most common MIVF?

A

It most closely resembles normal fluid losses and has a similar composition to urine

84
Q

What BUN/SCr ratio may mean dehydration?

A

> 20

85
Q

Shock definition

A

Hypotension that is refractory to fluid resuscitation

86
Q

Effect of shock on heart

A

Tachycardia hypotension

87
Q

Effect of shock on brain

A

Altered mental status

88
Q

Effect of shock on kidneys

A

Decreased urine output

89
Q

Effect of shock on Liver

A

Increased INR

90
Q

Effect of shock on skin

A

Cool, cyanotic

91
Q

Goal for resucitation of shock

A

Increase perfusion throughout the patient via fluid resuscitation and/or vasopressor support

92
Q

CVP meaning

A

Central venous pressure

93
Q

MAP meaning

A

Mean arterial pressure

94
Q

UOP

A

Urinary output

95
Q

CVP, MAP, and UOP goals following shock

A

8-12, 65, 0.5

PHRM 825 (36 decks)

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