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Fluids > Quick hits fluids + electrolytes > Flashcards

Quick hits fluids + electrolytes Flashcards

1
Q

What major ions are in the intracellular space?

A

K+
Mg+
Phosphate-

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2
Q

What major ions are in the extracellular space?

A

Na+
Ca+
Cl-
HCO3

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3
Q

Total body volume? How is it broken down?

A

Total 42L

Extra - 28L
Intra - 14L (11 interstitial + 3 plasma)

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4
Q

What dictates the passive exchange between capillaries and interstitial fluid?

A

Starling forces

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5
Q

What is the difference between osmolarity and osmolality ?

A
  1. Osmolality is osmoles per kilogram of solvent
  2. Osmolarity is osmoles per liter of solution
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5
Q

How is plasma osmolarity calculated?

A

Na X 2

Also plays a factor

-Glucose
-BUN

-Uremia also can

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6
Q

What does it mean to have high tonicity ? Example?

A

More solutes

Highest
1. NaCl 3%
2. D5+45
3. Albumin
4. D5W

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7
Q

Examples of Hypotonic ?

A

0.45%
D5W

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8
Q

Examples of isotonic?

A

Plasmalyte
LR
0.9%
Hespan

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9
Q

Examples of Hypertonic?

A
  • 3%
  • Anything with dextrose except D5W
    -Dextran 10%
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10
Q

What two solutions will lower Calcium?

A

Albumin binds to it

Citrate in blood binds to it

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11
Q

What may result with a large volume of 0.9%?

A

Hyperchloremic metabolic acidosis

Also

Dilutional effect

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12
Q

What is the black box warning on synthetic colloids? Which is the highest risk?

A

Renal injury

Dextran

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13
Q

What is the most common electrolyte deficiency ?

A

Potassium

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14
Q

How does hypo/hyperkalemia affect the resting membrane potential ?

A

Hyperkalemia - Depolarizes membrane

Hypokalemia - depolarizes membrane

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15
Q

Treatment for hyperkalemia?

A
  1. Calcium to stablize cardiac membrane
  2. Shift K
    - Insulin+D50
    -Hyperventilation
    -Bicarb
    -Beta 2
  3. Elimination
    -Kayexalate
    -Diuretics
    -Dialysis
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16
Q

Presentation of K 5.5-6.5?

A

Peaked T waves

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17
Q

Presentation of K 6.5-7.5?

A

P wave flattening

PR prolongation

18
Q

Presentation of K 7.5-8.5 ?

A

QRS prolongation

19
Q

Presentation of K >8.5?

A

Sine wave – VF

20
Q

S+S of hypokalemia?

A

Long QT
Cramps
Flat T wave
U wave

21
Q

What happens if Sodium is shifted too fast from ICF to ECF (treating hyponatremia)?

What about ECF to ICF (treating hypernatremia)?

A

Central Pontine Myelinolysis

Cerebral edema

22
Q

What sodium level should surgery be delayed?

A

<130

23
Q

Which hormone raises serum calcium? Which lowers?

A

Raises - Parathyroid

Lowers - Calcitonin

24
Q

How does acidosis effect calcium levels?

A

Increases them

25
Q

Signs of hypocalcemia?

A

Laryngospasm
Chvostek
Trousseau
Nerve irritability
Cramps

Long QT

26
Q

Signs of hypercalcemia?

A

Nausea
Abdominal pain
Psychosis
HTN

Short QT

27
Q

How is hypercalcemia treated?

A

0.9% and loop diuretics

28
Q

What is Chvostek sign?

A

Tapping on the angle of the jaw will cause muscle contraction on the ipsilateral side

29
Q

What is Trousseau Sign?

A

Upper BP cuff is inflated for 3 minutes

If muscle spasms occur in the hand and forearm

30
Q

Most abundant electrolyte in the body?

A

Calcium - all stored in bones ( we have a lot of bones)

31
Q

Loss of deep tendon reflexes is a sign of?

A

Hypermagnesemia

32
Q

What are clinical uses of mag?

A

Pre eclampsia (4g load over 10 minutes)

Pain (NMDA antagonism)

Acute bronchospasm

Cardiac rhythm disturbances

33
Q

Treatment for hypermagnesemia?

A

Calcium

34
Q

How does hypermagnesemia affect neuromuscular blockade?

A

Potentiates them

35
Q

Classic sign you should assess in an OB patient for high magnesium?

A

Loss of deep tendon reflexes

36
Q

How is PVR and ICP affected by acidosis?

A

Increased

37
Q

How does acidosis affect the myocardium?

A

Direct depressant

38
Q

Untreated pain in the PACU is most likely to result in what acid-bsae disturbance?

A

Respiratory alkalosis because the patient is hyperventilating

39
Q

How does a change in PaCO2 affect PH?

A

For every 10mmbHg increase in PaCo2, PH will increase by .08

(For chronic disease will only increase by .03)

40
Q

What does the anion gap tell you? Normal?

A

Cause of acidosis

<14

41
Q

How can metabolic alkalosis be created?

A

Increased bicarb (iatrogenic)

Loss of nonvolatile acids (NG suction)

Increased mineralocorticoid (Cushing’s syndrome)

42
Q

What two electrolyte abnormalities are caused by hyperventilation?

A

Hypocalcemia

Hypokalemia

Fluids (5 decks)

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