Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI Exam 1 > Fluid and Electrolytes Water and Na > Flashcards

Fluid and Electrolytes Water and Na Flashcards

(74 cards)

Start Studying
1
Q

Intacellular fluid comprises how much of the total BW

A

67%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Interstital fluid comprises how much of the total BW

A

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Intravascular fluid comprises how much of the total BW

A

8.3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

***Total BW for OLDER CHILDREN AND MEN LESS THAN 70

A

0.6 X body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

***Total BW for WOMEN LESS THAN 80 AND MEN OVER 70

A

0.5 X body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

***Total BW for WOMEN OVER 70

A

0.45 X body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sodium maintenance needs

A

Closer to 2 mEq/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Potassium maintenance needs

A

Closer to 1 mEq/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

5% loss Volume Depletion

A 
Decreased skin turgor
Dry membranes
Pale skin
Diminished urine output
Normal BP
Normal to increased HR
Flat fontanelle
Consolable CNS
Capillary refill >2 seconds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

10% Volume Depleted

A 
Tenting skin turgor
Very dry membranes
Grey skin color
Severly decreased urine output
Normal to decreased BP
Increased HR
Soft fontanelle
Irritable CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

15% Volume Depleted

A 
Tenting skin turgor
Parched mucous membranes
Mottled skin color
Azotemic urine output
Decreased BP
Significantly increased HR
Sunken fontanelle
Lethargic/coma CNS
Tilt test increase by 30 beats/min
Capillary refill >3 seconds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tilt Test Procedures

A

BP and HR are recorded after pt has been supine for 2-3 minutes
BP/HR are recorded after pt has be standing for 1 minu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Positive Tilt Test

A

Increased HR by 30 beats per minute or more (15% volume loss)
Presence of sx of cerebral hypoperfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Capillary refill

A

Time for the nail bed to return to the normal color is counted in seconds
Less than 2 seconds is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Urine output is an indicator of:

A

Organ perfusion if pt has normal renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Normal urine output is:

A

More than 1.0 mL/kg/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Reduce urine output is:

A

0.5-1.0 mL/kg/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Severely reduced urine output is:

A

Less than 0.5 mL/kg/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lab values in volume depleted:

A

Albumin will increase unless hypoalbuminemic
Hemoglobin will increase unless anemic
BUN:SCr will increase >20:1 in pre-renal azotemia
Serum lactate > 3 mmol?L = severe shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Replacement Fluids 1st thing you do:

A

Initiate a 20 mL/kg bolus over 30 of NS and repeat until improved hemodynamics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Example of how to calculate percent of fluid loss

5% loss in a 70 kg 35 yo man

A

MF: 1500+ (20 50) = 2500
TBW: 0.670*0.05 = 2L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Replacement fluid rules

A

3/4 in the first 24 hours
Rest in the next 24-48 hours
Bolus is ALWAYS NS
RF can be 1/2 NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Isotonic Crystalloids

A

Lactated Ringers
NS
100% extracellular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hypotonic Crystalloids

A

Depending on osmolality fluid will move to intracellular space
D5W has no sodium or chloride
1/2 NS has some sodium and chloride
1/4 NS has even less sodium and chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Hypertonic Crystalloids
3% Saline | High sodium and chlroide
26
Isotonic Crystalloids
0.9% saline or NS | Has sodium and chloride
27
AE of Lactated Ringers
Hyponatremia Hyperkalemia Lactate --> bicarbonate (lactate will accumulate in liver disease)
28
D5W Uses
Uncomplicated dehydration or water deprivation | Dextrose is rapidly taken up by cells leaving free water
29
D5W AE
Hyponatremia
30
D10W
Not used in adults for replacement and is the last one able to be used in a peripheral line - D35W has to be in a central line
31
Crystalloid Advantages
Cheap Long shelf-life No infectious risk No antigenic/allergenic
32
Crystalloid Disadvantages
Not long lasting | 2-4 times mor crystalloid is needed than colloid
33
Protein Colloid Solutions:
``` Albumin 5% or 25% Plasmanate Whole blood PRBC FFP Cryoprecipitates ```
34
Non-Protein Colloid Solutions
Hetastarch 6% | Pentastarch
35
5% Albumin
Isotonic Isooncotic with serum 2-4 potency of LF Hypovolemic states
36
25% Albumin
Isotonic Hyperoncotic **Hypovolemia with edema Can pull fluids from intracellular to intravascular
37
Albumin should be used FOR SURE in:
Cirrhosis because that is the only place it is shown to decrease mortality
38
Normal Sodium
135-145 mEq/L
39
***Serum sodium never reflect:
TOTAL BODY STORES OF SODIUM
40
If your tank size increases, then
You are really hypervolemic and hypernatremic but your levels can show hyponatremic
41
If your tank size decreases, then
You are really hypovolemic and hyponatremic but your levels can show hypernatremic (because you have a higher salt to water ratio even though your salt didn't increase)
42
120-130 mEq/L of Na symptoms
N/V malaise
43
115-120 mEq/L of Na symptoms
Headache Tremors Loss of coordiantion**
44
Less than 115 mEq/L of Na
Seizures and coma**
45
Severity of hyponatremia is absed on:
Absolute decrease in sodium | Rapidity of onset
46
Hyponatremia Assessment Steps
Determine volume status | Calculate serum osmolality
47
Normal serum osmolality:
275-290 mOsm/kg
48
Causes of Hypertonic Hyponatremia
Hyperglycemia (need to correct sodium for elevated glc) | Mannitol or toxic alcohols
49
Pseudohyponatremia
If you have really high lipids (TG), then our serum sodium will be falsely lowered
50
Causes of Isotonic Hyponatremia
Hyperproteinemia Hyperlipidemia Bladder irrigation Pseudohyponatremia
51
Causes of Hypotonic Hyponatremia
(↓ Na and ↓ osmolality) | Must consider volume status
52
Hypotonic Hyponatremia + Hypervolemic
HF Cirrhosis Renal insufficiency
53
Hypotonic Hyponatremia + Hypovolemic
Consider urinary sodium concentration - Less than 20 = extra-renal causes such as sweating, diarrhea, vomiting - Greater than 20 = renal causes typically diuretics
54
Hypotonic Hyponatremia + Euvolemic
Syndrome of Inappropriate ADH (SIADH) Cancer --> SIADH Hypothyroidism
55
Hypertonic and Isotonic HYPOnatremia Treatment
Underlying cause and consider fluids
56
Hypotonic Hypovolemic Hyponatremia Treatment
Calculate volume depletion and correct with NS or 3% if severely sympotomatic
57
***Sodium Rate of Corrects
0.33 mEq/L/hr or 8 mEq/L in 24 hours
58
Hypotonic Hypervolemic Hyponatremia Treatment
``` Underlying condition (diuretic for cirrhosis or CHF) Fluid restriction to less than 1500 mL/day ```
59
Hypotonic Euvolemic Hyponatremia Treatment
``` Fluid restriction IV 3% saline if severe symptoms Demeclocycline AVP receptor antagonists Conivaptan (vaprisol) ```
60
Demeclocycline
Inhibits actiono f ADH in kidneys Delay in onset so only good for chronic - Nephrotoxicity, photsensitivity, hepatotocitiy
61
AVP Receptor Antagonists
Conivaptan Lixivaptan Tolvapatan
62
Conivaptan
$$$ Inhibits ADH - Infusion site rxns, thirst, headache, vomiting IV only
63
Asymptomatic Na Correction Rate
Less than 6 mEq/24 hrs | 0.5-1 mEq/h
64
What happens if you correct hypo too fast?
Osmotic Demyelination Syndrome ODS
65
What happens if you correct hyper too fast?
Urical herniation (stop breathing)
66
Hypernatremia Symptoms
Anorexia, muscle weakness, restlessness N/V
67
Hypernatermia SEVERE symptoms
Altered mental status Lethargy Irritability Coma
68
Hypernatremia + Hypovolemia Causes
Dehydration Dermal: swaeting/burns GI: vomiting/diarrhea Diuretics
69
Hypernatremia + Hypervolemia Causes
Hypertonic saline Tube ffeding Sodium containing antibiotics
70
Hypernatremia + Euvolemia Causes
Low urine osmolality = diabetes insipidus
71
Hypernatremia Treatment Steps
Decrease Na by 0.33 mEq/hr | Determine water deficit and use 1/2 or 1/4 NS
72
Saline options for hypovolemic/hyponatremia
NS
73
Saline options for hypovolemic/ severe hyponatremia
3% NS
74
Saline options for hypovolemic/hypernatremic
1/2 NS (still with a bolus of NS)

GI Exam 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions