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Flashcards in Fluids and Electrolytes Deck (93)
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1

we are ___% water

60%

2

What portion is intracellular and what portion is extracellular?

2/3 intracellular
1/3 extracellular

3

what portion of ECF is plasma and what portion is interstitial?

80% interstitial
20% plasma

4

what do you need to consider when managing a patients fluid status?

NPO Deficit
Maintenance
Evaporative Losses and “Third Spacing”
Blood loss

5

what are the two main patient types that you would not want to fluid overload?

1. renal patient who is dialysis-dependent, because their kidneys do not filter the excess fluid.
2. patients with CHF with fluids, because the more preload their hearts have, the less they can respond by increasing contractility and they can end up in cardiogenic pulmonary edema.

6

4/2/1 Rule

4 mL/kg/hr for 1st 10kg
2 mL/kg/hr for 2nd 10kg
1 mL/kg/hr for remaining kg

7

what is the additional fluid requirement for minimal, moderate and severe tissue trauma?

minimal: 2-4mL/kg/hr
moderate: 4-6mL/kg/hr
severe: 6-8mL/kg/hr

8

describe "third spacing"

This refers to an internal redistribution of fluids, especially during large thoracic or abdominal procedures. Intravascular fluid volume is depleted as inflamed tissue sequesters much fluid in the interstitial space. Replacement of this fluid is necessary to avoid organ hypoperfusion, especially in renal insufficiency.

9

what are the advantages and disadvantages of crystalloids?

Advantages: safe, nontoxic, reaction free, and cheap.
Disadvantages: limited time in IV space, edema with large volumes.

10

Solutions of inorganic and small organic molecules dissolved in water. The main solute is saline or glucose and the solution may be iso, hypo, or hypertonic.

crystalloid

11

in terms of acid-base balance, what can NS and LR cause?

Saline solution --> Hyperchloremic metabolic acidosis
Lactated Ringer’s--> Metabolic alkalosis (lactate--> HCO3)

12

what ion in which crystalloid limits its use when transfusing blood products?

Calcium in LR

13

Why is NS used in neuro cases?

pulls fluid out of the tissue, making a clearer visual field for the surgeon

14

Homogeneous noncrystalline substance consisting of large molecules dissolved in a solute. Most are dissolved in normal saline, but glucose, hypertonic saline, and LR have been used as well

Colloid

15

advantages of colloids

Greater capacity to remain in the IV space (longer half life), more efficient for replacing a severe fluid deficit quickly, smaller infused volume.

16

disadvantages of colloids

greater expense, coagulopathy, hypersensitivity reactions

17

what is the difference between hextend and hespand?

Hextend = hetastarch in LR
Hespan = hetastarch in NS

18

Albumin is purified from _________

human plasma

19

______ can lead to a reduction in factor VIII and vWf, impairs plt function, and can prolong PTT.

hetastarch

20

how does dextran 40 improve microcirculation blood flow?

by decreasing blood viscosity and is often used by vascular and plastic surgeons to maintain patency of anastamoses.

21

_________ decreases platelet aggregation and adhesiveness.

dextran (mostly 70)

22

what portion of colloids is distributed intracellularly and extracellularly?

100% extracellular
100% intravascular

23

what is a mEq?

A milliequivalent is defined as 1/1000 of an equivalent of a chemical element, radical or compound. Its abbreviation is "mEq." The equation used to calculate a milliequivalent is atomic weight (g) / (valence x 1000). The unit of measure for mEq is grams (g).

24

what are some normal hematology lab values?

White Blood Cell Count (WBC)(cells/ml): 4,500-10,000
Red Blood Cell Count (RBC)(x 10 6): 4.0-5.5
Hemoglobin (Hgb)(g/dl): 12.0-16.5
Hematocrit (Hct)(%): 36-50
Mean Corpuscular Volume (MCV): 80-100
Platelet Count (plt): 100,000-450,000

25

what are some normal plasma values for electrolytes?

Sodium (Na+)( mEq/L): 135-145
Potassium (K+)(mEq/L): 3.5-5.0
Chloride (Cl-)(mEq/L): 100-106
Calcium (Ca++)(mEq/L): 8.5-10
Bicarbonate (HCO3-) (mEq/L) 22-26
Magnesium (Mg++)(mEq/L): 1.5-2.5
Phosphate (PO4---)(mEq/L): 0.5-1.5
Sulfate (SO4--)(mEq/L): 0.3-0.6

26

what are some normal values for coagulation studies?

Protime (PT)(Extrinsic pathway): 10-14 seconds

Partial Prothrombin Time (PTT)(Intrinsic pathway): 25-39 sec

International Normalized Ratio (INR): 0.8-1.2
INR= PT test/PT normal

27

_______ is the key regulator of water balance in the body

Sodium

28

_______ is the most abundant cation of the ECF and is critical in determining EC and IC osmolarity.

Sodium

29

_______ is the most abundant anion of the ECF

chloride

30

______ is the most abundant intracellular cation

potassium