Fluid Balance Flashcards Preview

Acute Medical Conditions > Fluid Balance > Flashcards

Flashcards in Fluid Balance Deck (32):
1

What happens if intravascular space becomes depleted?

Fluid moves from intracellular to intravascular to try to compensate

2

What affects fluid in each compartment?

Available water
Hydrostatic pressure
Oncotic pressure
Solute concentration

3

What is hydrostatic pressure?

Pressure which blood exerts on the vessel wall created by systole and intravascular volume

4

How is oncotic pressure created?

Pull of proteins in the plasma, albumin create osmotic pressure holding water in the intravascular space

5

What are the indications of the fluid status of intravascular fluid?

Pulse, BP, CVP, urine output, capillary refill, O2 saturation, peripheral skin colour + temp, core temperature, U+E

6

What are the key requirements for adequate circulation and oxygenation?

Effective cardiac function
Systemic vascular resistance
Sufficient blood volume
Appropriate distribution of fluids
Oncotic pressure
Hydrostatic pressure
Sufficient ventilation
Sufficient haemoglobin

7

What are the indications of the fluid status of intracellular fluid?

Thirst
Dry oral membranes
Poor skin turgur
Headache
Concentrated urine
Lower urine output

8

What are the indications of fluid status of interstitial fluid?

Assessment of skin for signs of oedema
Excess fluid in interstitial space can be referred to as third spacing

9

What is a good indicator of adequate circulation?

MAP

10

What is the minimum MAP for tissue perfusion?

60 mmHg

11

What is the normal MAP value?

70-110 mmHg

12

How do you manually work out MAP?

[(diastolic x 2) + systolic] / 3

13

What is central venous pressure?

Invasive hemodynamic assessment using a central venous catheter and transducer system

14

What is the normal CVP range?

3-8 mmHg

15

What does high CVP pressure mean?

Fluid excess

16

What does low CVP pressure mean?

Fluid deficit

17

What are some of the causes of fluid deficit?

NMB, diarrhoea, vomiting, haemorrhage, fever, burns, wounds, excess diuretics

18

What are some of the potential causes of fluid excess?

Retention of sodium and water, heart failure, liver failure, renal failure, steroids, excess IV fluid administrations or blood transfusion

19

What is pulmonary oedema?

Accumulation of fluid in the lungs from a massive volume overload or left ventricular failure
It is a medical emergency

20

What are the symptoms of pulmonary oedema?

SOB, use of accessory muscles, hypoxia, anxiety, restlessness, coarse crackles on ausculation and percussion, pink frothy fluid

21

What are the treatments for pulmonary oedema?

Urgent medical assessment, assess oxygenation + tissue perfusion + breathlessness, position for max lung expansion + coughing, high flow O2,
diuretics, treat the cause

22

What are the types of hypovolaemia?

Covert compensated (reduced intravascular volume without clinical signs)
Overt compensated (BP maintained but tachy, wide pulse pressure, cool peripheries)
Decompensated hypovolaemia (shock£

23

How do you manage fluid deficits?

Risk of fluid loss, ascertain cause, fluid replacement, fluid challenge, electrolyte replacement, monitor fluid balance, monitor U+E

24

What are the short term venous access devices!

Peripheral catheter
Non-tunnelled CVAD

25

What are the intermediate use venous access devices?

Midline catheter
PICC

26

What are the long term venous access devices?

PICC
Tunnelled CVAD
Implantable port

27

What are isotonic solutions?

Concentration of dissolved particles equal to that of intracellular fluid (0.9% sodium chloride, 5% dextrose, Hartmanns)

28

What are hypotonic solutions?

Tonicity less than intracellular fluid
Osmotic pressure draws water into the cells from extra cellular fluid (0.45% sodium chloride)

29

What are hypertonic solutions?

Tonicity greater than intracellular fluid
Osmotic pressure is unequal inside and outside cell (high concentration dextrose)

30

What are crystalloids?

Small molecule solutes containing electrolytes and glucose (0.9% sodium, 5% dextrose in water)

31

What are colloids?

Large molecules containing gelatines, starches (fresh frozen plasma, blood, albumin)

32

What should be first line treatment for low intravascular blood volume?

Crystalloids