Sodium Handling (Small Group) Flashcards
How do D5W, Normal Saline, and Albumin colloid IV fluids distribute across the body fluid compartments?
D5W - distributes between all compartments
Saline - distributes across ECF (25% plasma, 75% interstitium)
Albumin - distributes only in plasma
If you give loop diuretics or thiazides and the patient gets metabolic alkalosis, what diuretic would you give?
Acetazolamide
True or False: Thiazides get rid of calcium from the urine.
True
What happens to total body water, total extracellular fluid volume, central venous pressure, pulmonary pressure, effective arterial blood volume in nephrotic syndrome?
Nephrotic syndrome causes albumin to be lost from blood into the urine.
This causes a decrease in effective arterial blood volume.
That causes an increase in total body water from compensatory mechanisms.
This increases total ECF volume.
There is a decrease in central venous pressure and pulmonary pressure because water is pooling in the interstitium because there is lower albumin in the blood so lower oncotic pressure in the vessels to pull water back.
What happens to total body water, total extracellular fluid volume, central venous pressure, pulmonary pressure, effective arterial blood volume with biventricular congestive heart failure?
Total body water - increase
Total ECF - increase
Central venous pressure - increase
Pulmonary pressure - increase
Effective arterial blood volume - decrease
What happens to total body water, total extracellular fluid volume, central venous pressure, pulmonary pressure, effective arterial blood volume in a patient with hepatic cirrhosis?
Total body water - increased
Total extracellular fluid volume - increased
Central venous pressure - decreased or increased depending on heart
Pulmonary pressure - decreased or increased depending on heart
Effective arterial blood volume - decreased
Explain Aldosterone Escape
True or False: In acute settings of low body fluid (circulatory shock), you always give saline.
True.
Saline is awesome. Plasma is more expensive and can cause side-effects/allergies/reactions. So, in real practice, saline is used.
If someone has severe diarrhea, they have low volume intravascularly but also interstitially. Saline will help replenish both where as plasma stays in the intravascular space.
