WEEK 5-Fluids and Electrolytes (Na and K+):

Question 1

Intravascular fluid: IVF

Answer 1

Fluid inside the blood vessel

Question 2

Extravascular fluid: EVF

Answer 2

Fluid outside the blood vessel

Question 3

Colloids—plasma protein

Answer 3

Colloids—plasma protein

Question 4

0.9 is…

Answer 4

NORMAL SALINE

Question 5

Three categories of agents used to replace lost fluid:

Answer 5

Crystalloids
Colloids
Blood products

Question 6

Crystalloids

Answer 6

Fluids that supply water and sodium

Help to maintain osmotic gradient between extravascular and intravascular compartments

Plasma-volume expanders due to sodium concentrations

Do not contain proteins (colloids do)

Contain fluids and electrolytes that are normally found in the body

Crystalloid are also distributed faster than colloids into the interstitial and intracellular compartment

Better to treat dehydration

Monitor for the potential of edema

Question 7

Hypertonic solution

Answer 7

-3%sodium chloride

Question 8

Colloids:

Answer 8

-Effectively move fluid from interstitial compartment to plasma by pulling fluid into the plasma vessels (only when plasma proteins are low)

Fluid will move into the hypertonic area to make it more isotonic—fluid is pulled out from the extravascular space into the intravascular space and increase the blood volume—sometimes called plasma expanders

IE. LACTED RINGERS

Question 9

Colloid: Indications

Answer 9

Expensive
Superior to crystalloids in Plasma Volume (PV) expansion 
Used to treat a variety of conditions
Severe dehydration
Severe edema
Contraindications
May cause allergic reactions
Hypervolemia
Electrolyte disturbance

Question 10

Blood product: indications

Answer 10

Cryopricipitate (cryo) and plasma protein factors (PPF)
To manage acute bleeding

FFP
To increase clotting factor levels in clients with deficiency
(ie. Hemophiliac disease)

PRBCs and Whole blood
To increase 02 carrying capacity for pts with anemia, low hemoglobins, and loss of blood volume

Contraindications of blood products:
Remote risk of transfer of infectious disease

Question 11

Blood Transfusion Terminology

Answer 11

Acute Hemolytic Reaction: causes RBC destruction
Anaphylactic Reaction: severe allergic reaction
Febrile Non-Hemolytic Reaction: sensitization of donor: WBC, platelets, plasma proteins
Sepsis: generalized infection
Phlebitis: inflammation of the vein
Infiltration: fluid enters the subcutaneous space
Hemolysis: breakdown of red blood cells

Question 12

Electrolytes: Potassium

Answer 12

Cationic (positively charged) inside the cell (intracellular space)
95% found in cell
Normal K+ levels outside cell (plasma) 3.5 to 5.0 mmol/L
Critical to body function

Responsible for: 
Muscle contraction
Transmission of nerve impulses
Regulation of heart beat
Maintenance of acid balance

Main indication: treat or prevent potassium depletion

Question 13

Potassium: side effect & adverse reaction

Answer 13

Oral preparation:
Diarrhea, nausea, vomiting, GI Bleeding, ulceration

IV administration:
Pain at injection site
Phlebitis

Excessive administration:
Hyperkalemia (increase levels causing ventricular arrhythmia and cardiac arrest)
Toxic effects

Question 14

Hyperkalmia:

Answer 14

Muscle weakness, paresthesia, paralysis, cardiac rhythm irregularities

Question 15

Electrolytes: Sodium

Answer 15

Counter part to potassium
Positively charged outside the cell
Normal Na+ levels outside the cell 135 to 145 mmol/L
Dietary intake from food in form of sodium chloride (salt)

Question 16

Hyponatermia

Answer 16

: low sodium level

Question 17

Sodium: Is responsible for…

Answer 17

Controls water distribution,
Fluid and electrolyte balance
Osmotic pressure of body fluids
Participates in acid balance

High levels may need IV dextrose to promote excretion

Question 18

D5W mainly used to

Answer 18

prevent dehydration – maintenance solution

Question 19

NS is used to increase

Answer 19

extracellular volume

NS used in blood transfusion—D5W will cause hemolysis of RBCs

Question 20

Before starting K+ assess

Answer 20

ECG, K+ level, intake and output

Question 21

Avoid K+ supplements with pt taking ACE inhibitors

Answer 21

CAUSES HYPOKALEMIA

Question 22

Oral K+

Answer 22

must be diluted to avoid GI irritation and GI bleeD

Question 23

Potassium chloride should never be given

Answer 23

as a bolus or undiluted (cardiac arrest), never IV push

Question 24

Albumin

Answer 24

should always be given slowly—monitor for fluid overload, infuse at room temperature (fluid overload—dyspnea, cyanosis, cough, crackles, wheezes)