Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgical Biology > Fluids, electrolytes, and acid-base therapy > Flashcards

Fluids, electrolytes, and acid-base therapy Flashcards

1
Q

Fluids in the body are distributed in two compartments: the  _________ volume and the __________ volume. 

A

intracellular fluid (ICF); extracellular fluid (ECF)

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

What are the four types of extracellular fluids?

A

The  ECF  is  composed  of  interstitial  fluid,  plasma, lymph, and transcellular fluids (such as synovial, pleural, abdominal, and cerebrospinal fluids).

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

T/F:  The normal volume of gastrointestinal secretion in  horses  is  approximately  100 L every 24 hours in a 500-kg  horse.

A

True

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

T/F:  The normal volume of gastrointestinal secretion in  horses  is  approximately  equivalent  to  the  intracellular  fluid  volume.

A

False;  The normal volume of gastrointestinal secretion in  horses  is  approximately  equivalent  to  the  extracellular  fluid  volume, representing about 100 L every 24 hours in a 500-kg  horse.

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

T/F: The volume of total  body water (TBW) represents 55% of body weight in adults and  up to 60% in neonates. 

A

False; The volume of total  body water (TBW) represents 60% of body weight in adults and  up to 80% in neonates. 

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

The ECF volume represents ____ of total  body water (TBW) or ___ of body weight (in adults) to ___ of TBW or ____ of body weight (in neonates) of water.

A

1/3; 20%; 1/2; 40%

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

The ICF volume represents approximately ____ of total  body water (TBW) or ____ of body weight.

A

2/3; 40%

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

T/F:  In neonates, the ECF is approximately 25% of the TBW,  and it decreases to approximately 15% by 24 weeks of age.

A

False; In neonates, the ECF is approximately 40% of the TBW,  and it decreases to approximately 30% by 24 weeks of age.

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

You evaluate a horse that has a heart rate 40-60 bpm, CRT = 2 secs, PCV/TP = 40%/7.0 g/dL, and creatinine of 1.5-2 mg/dL. What do you estimate this horses hydration deficit to be?

A

6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

You evaluate a horse that has a heart rate 61-80 bpm, CRT = 3 secs, PCV/TP = 45%/7.5 g/dL, and creatinine of 2-3 mg/dL. What do you estimate this horses hydration deficit to be?

A

8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

You evaluate a horse that has a heart rate 81-100 bpm, CRT = 4 secs, PCV/TP = 50%/8.0 g/dL, and creatinine of 3-4 mg/dL. What do you estimate this horses hydration deficit to be?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

You evaluate a horse that has a heart rate > 100 bpm, CRT >4 secs, PCV/TP = 50%/ > 8.0 g/dL, and creatinine > 4 mg/dL. What do you estimate this horses hydration deficit to be?

A

12%

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

Which of the following requires hepatic metabolism for conversion to bicarbonate?

  1. acetate
  2. gluconate
  3. lactate
  4. silicate
A

lactate

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

hypocalcemia that is refractory to calcium therapy may indicate ____________.

  1. hypokalemia
  2. hypochloridemia
  3. hypomagnesemia
  4. hyponatremia
A

hypomagnesemia

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

T/F: Hetastarch is less effective than plasma in restoring oncotic pressure.

A

False: Hetastarch is more effective than plasma in restoring oncotic pressure.

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

T/F: The preferred dose of hetastarch is 5 ml/kg.

A

False; 10 ml/kg

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

T/F: Use of a colloid osmometer is indicated to accurately monitor hetastarch therapy.

A

True

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

T/F: Hetastarch is more commonly associated with anaphylactic reactions than dextran.

A

False; Hetastarch is less commonly associated with anaphylactic reactions than dextran.

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

Blood  volume in sedentary horses represents approximately ___ of  body weight. In fit horses, this value can reach ____ of body  weight. In neonates, blood volume represents ____ of body  weight and decreases to adult values by ___________ of age.

A

8%; 14%; 15%; 12 weeks

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

What is the main cation in plasma?

What are the main anions in plasma?

A

 In  plasma, sodium is the main cation, and bicarbonate and chloride are the main anions. 

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

Proteins contribute to the ________  charges, and they also provide oncotic pressure. _________ or  molecules of similar size are the main contributors to oncotic  pressure.

A

negative; Albumin

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

The __________ ______ accounts for about 75% of the ECF,  and it is composed mainly of sodium, bicarbonate, and chloride, but the concentration of protein there is ______ than in  plasma.

A

interstitial fluid; lower

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

What are the main cations of the intracellular fluid compartment?
What are the main anions of the ICF compartment?

A

  the important ICF  cations  are  potassium  and  magnesium,  and  the  important ICF anions are phosphates and proteins

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

Water  and  ionic  solute  exchange  between  the  vascular  and 
interstitial compartments occurs at the capillary level and is  rapid; equilibrium is reached within ___ to ___ minutes. The rate  of exchange or net filtration that occurs between these compartments is controlled by a balance between the forces that favor  filtration (capillary _________ pressure and tissue _______ pressure) and the forces that tend to retain fluid within the vascular  space (plasma ________ pressure and tissue _________ pressure).

A

30 to 60 minutes; hydrostatic; oncotic; oncotic hydrostatic

Exchanges between the extracellular and intracellular compartments are comparatively slow, taking up to 24 hours to  reach equilibrium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

T/F:  Sodium accounts for most of the  osmotically active particles in the ECF.

A

True;  Sodium is the most abundant cation  in the ECF. Other osmotically active  compounds that make a significant contribution to ECF osmolarity are glucose and urea. 

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Exchanges between the extracellular and intracellular compartments are comparatively slow, taking up to ___ ______ to  reach equilibrium.

A

24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the definition of a buffer?

A

 a buffer is a compound  that can accept or donate protons to maintain the pH within a  narrow range. 

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

 In the body, _________ is the primary buffer  system of the extracellular fluid, whereas _____ and inorganic  and  organic  ________  represent  the  principal  intracellular  buffers.

A

bicarbonate; protein; phosphates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

The dissociation of carbonic acid is expressed by the law of mass action: what is the equation?

A

H + HCO <=> H2CO3 <=> CO2 + H2O
In the body, this system is open, and carbonic acid, in the presence of carbonic anhydrase, forms CO2, which is eliminated  entirely from the system by alveolar ventilation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

T/F:  An acute increase in  hydrogen ions from a fixed acid load is immediately buffered by  bicarbonate and intracellular buffers. 

A

True; This is the acute physiochemical response. Alveolar ventilation is subsequently modified, and this is complete within hours to further minimize  changes in pH by normalizing the ratio of HCO3− to PCO2. 

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

T/F:  An acute increase in volatile  CO2,  is immediately buffered by  bicarbonate. 

A

False; An acute increase in volatile  CO2, cannot be buffered by HCO3−; therefore, the  hydrogen ions generated from the dissociation of carbonic acid  must be buffered by intracellular buffers.

32
Q

Renal adaptation or responses to acute acidosis, characterized by increased HCO3− reabsorption or regeneration and net acid secretion, takes __ to __ _____ to achieve maximal effectiveness.

A

2 to 5 days

33
Q

T/F: In terms of the four primary acid-base disorders, the metabolic disorders refer to the net excess or deficit of  nonvolatile or fixed acid, whereas the respiratory disturbances  refer to a net deficit or excess of volatile acid (dissolved CO2).

A

True

34
Q

Metabolic acidosis is present when there is a _________ in HCO3− 

A

decrease

* caused by either loss or buffering of nonvolatile acids

35
Q

T/F: Common  causes of metabolic acidosis in horses include accumulation of  lactic acid as a result of poor perfusion, and HCO3− losses in  the gastrointestinal tract resulting from diarrhea. 

A

True

36
Q

Metabolic alkalosis  is  present  when  there  is  a _________  concentration  of  HCO3−.

A

an  increased

37
Q

T/F: Metabolic alkalosis is commonly associated with a disproportionate loss of chloride ions. 

A

True

38
Q

T/F: Respiratory acidosis is present  when the PCO2 is decreased in response to alveolar hyperventilation.

A

False; Respiratory acidosis is present  when the PCO2 is increased in response to alveolar hypoventilation.

39
Q

 Respiratory alkalosis is present when the ______ is decreased. 

A

PCO2 (hyperventilation)

40
Q

 For __________ disorders, the secondary or  adaptive respiratory response begins immediately and is complete  within  _____.  In  ___________  disorders,  the  adaptive  response begins with an acute, immediate titration by nonbicarbonate buffers that results in an initial change in plasma  HCO3− concentration. This is followed by a chronic response  mediated by the ________ that involves net acid secretion and  bicarbonate resorption. This response begins within _________ and  takes ___ to ___ _______ to be complete. 

A

metabolic; hours; respiratory; kidney; hours; 2 to 5 days

41
Q

T/F: When a primary disorder occurs with the expected secondary  response, it is considered a mixed acid-base disorder. 

A

False; When a primary disorder occurs with the expected secondary  response, it is considered a simple acid-base disorder.  A mixed  disorder means that two separate primary disorders are present  in the same patient. A mixed disorder is suspected when the  adaptive response is lower or higher than the expected response  from the primary disorder.

42
Q

When is a mixed acid-se disorder suspected?

A

 A mixed disorder is suspected when the  adaptive response is lower or higher than the expected response  from the primary disorder.

43
Q

Metabolic acidosis should be suspected when HCO3 is below the normal range of 20-28 mEq/L. What is the expected compensation/secondary response?

A

There is a secondary  decrease in PCO2 to  compensate for the  primary disorder.
** PCO2 decreases by 1.2 mmHg for every 1 mEq/L decrease in bicarbonate

44
Q

Metabolic alkalosis occurs when there is an increase on HCO3 beyond the normal range (20-28 mEq/L). What is the expected secondary response?

A

PCO2 increases by 0.6-1 mmHg for every 1 mEq/L increase in bicarbonate

45
Q

Respiratory acidosis occurs when there is an increase in PCO2 beyond the normal range (38-46 mmHg). What are the expected secondary responses?

A

In acute respiratory acidosis, [HCO3−] increases by 1 mEq/L for every 10 mmHg increase in PCO2.
In chronic respiratory acidosis, [HCO3−] increases by 3-4 mEq/L for every 10 mmHg increase in PCO2.

46
Q

Respiratory alkalosis occurs when there is a decrease in PCO2 below the normal range (38-46 mmHg). What are the expected secondary responses?

A

In acute respiratory alkalosis, [HCO3−] decreases by 1-3 mEq/L for every 10 mmHg decrease in PCO2.
In chronic respiratory alkalosis, [HCO3−] decreases by 5 mEq/L for every 10 mmHg decrease in PCO2.

47
Q

 The normal PO2 of arterial blood (PaO2) is approximately __ times the fraction of inspired oxygen (FiO2), or ___ to ___ ______ in room air at sea level (FiO2, 21%).

A

5; 80 to  100 mmHg

48
Q

T/F:  Hypoxemia  refers to a decreased PaO2; common causes include a decreased  FiO2 (an example is a decreased barometric pressure associated  with high altitude), hypoventilation, ventilation/perfusion mismatch,  shunt,  or  diffusion  impairment. 

A

True

49
Q

How do you calculate the anion gap?

A

AG = ([Na+] + [K+]) - ([Cl-] + [HCO3-])

The anion gap (AG) is the difference between the sum of the  commonly measured cations and the sum of the commonly  measured anions in serum.

50
Q

T/F: The sum of anions always exceeds the sum of cations in a normal horse.

A

False; The sum of cations always exceeds the sum of anions ( a  normal  AG  of  10.4  ±  1.2 mEq/L has been reported in adult horses), and the  difference is an attempt to estimate the concentration of unmeasured  anions—for  example,  lactate.

51
Q

T/F: Neonates have  a slightly lower AG compared to adult horses.

A

False; Neonates have  a slightly higher AG because of their increased levels of phosphates and globulins.

52
Q

T/F: The AG is considered a good prognostic indicator  of  survival  in  horses  with  abdominal  disorders:  a  value  greater than 25 mEq/L is associated with a significantly lower  survival rate.

A

True

53
Q

T/F: Hypoproteinemia (a decrease in weak acid) results in alkalosis  (an increase in HCO3−).

A

True

54
Q

T/F:  An increase in phosphates,  such  as  that  occurring  with  acute  renal  failure,  causes  an  acidosis.

A

True

55
Q

How do intravenous maintenance fluid differ from replacement fluids?

A

 Intravenous maintenance fluids are lower in sodium and higher in  calcium, potassium, and magnesium than replacement fluids. An appropriate maintenance  fluid  is  0.45% saline  to  which  potassium, magnesium, and calcium were added.  

56
Q

 The _______ ______ _______ provides a bicarbonate precursor, which is either lactate, or acetate plus gluconate. Lactate  requires  _________  metabolism  for  conversion  to  bicarbonate,  whereas acetate and gluconate are metabolized by other tissues. 

A

 balanced electrolyte solutions  (BESs); hepatic

57
Q

 Saline (0.9%)  is higher in sodium and much higher in chloride than serum  concentrations and is used when [Na+] is lower than ___ ______.

A

125 mEq/L.

58
Q

What electrolyte derangements would you expect with long-term IV fluid therapy using solely BES?

A

Long-term fluid therapy solely with a BES will result in hypernatremia, hypokalemia, hypomagnesemia, and hypocalcemia.

59
Q

T/F:  Horses with a metabolic  acidosis  can  become  hyperkalemic,  and  potassium    excretion can occur after correction of the acidemia. 

A

True

60
Q

T/F: Administration of dextrose is indicated for the treatment of  hypertonic dehydration, for animals that are susceptible to or  that have hyperlipemia (miniature horses and donkeys, adult  horses with azotemia), and for pregnant mares as a source of  energy for the fetoplacental unit.

A

True; Because glucose is metabolized rapidly, administration of dextrose in water results in the  administration of free water, which is useful for the correction  of intracellular dehydration. As a source of energy, 5% dextrose  can be administered at a rate of 1 to 2 mg/kg/min.

61
Q

Administration of colloids is indicated when the total protein  concentration is less than _______, the albumin concentration is  less than _____, or the colloid oncotic pressure is less than  ________. 

A

4 g/dL; 2.0 g/dL; 12 mmHg

62
Q

T/F: Higher dosages of hetastarch (20 mL/kg)  were associated with increased coagulation times caused by a  decrease in von Willebrand factor antigen (vWf:Ag) activity and  factor VIII coagulant (FVIII:C).

A

True

63
Q

When a large  volume  of  anticoagulated  whole  blood  is  administered,  the  patient  should  be  monitored  for  ________ __________  and  ______________.

A

anaphylactic  reaction; hypocalcemia

64
Q

T/F: Because the ECF compartment is approximately 3 times the volume of blood, three times as much isotonic crystalloid must be administered to gain the desired amount of circulating volume expansion.

A

True

65
Q

If blood loss for a 500kg horse is estimated at 30% of blood  volume, how much crystalloid fluid is required?

A

30% of blood volume represents 12 L for a 500-kg horse (blood volume is 8% of BW, or 40 L in a 500 kg horse), then 36 L of a  crystalloid fluid is required.

66
Q

Hypertonic crystalloid fluids (7.2% NaCl) have approximately  __ times the tonicity of plasma and ECF.

A

8;  (composition: Na+,  1200 mOsm/L; Cl−, 1200 mOsm/L). Plasma => Na+ (132-146 mmol/L), Cl- (99-109 mmol/L)

67
Q

__________ immediate effect is  to expand the vascular volume by redistribution of fluid from  the interstitial and intracellular spaces. 

A

Hypertonic saline

68
Q

Each liter of hypertonic  saline  will  expand  blood  volume  by  approximately _______. 

A

4.5 L

69
Q

T/F: The  duration of effect of hypertonic saline is directly proportional to the distribution constant,  which  is  the  indexed  cardiac  output, and is estimated at approximately 45 minutes. 

A

True

70
Q

What is the recommended dose of hypertonic saline?

A

The  recommended  dosage  is  4 mL/kg  or  2 L  per  500 kg  horse,  administered as rapidly as possible. 

71
Q

Each  liter  of  administered  colloid  will  further expand the circulating blood volume by approximately  ____, resulting in a total fluid expansion of _____. 

A

1 L; 2 L

72
Q

T/F:  Polyurethane  catheters  should be changed every 3 days, whereas Teflon catheters  may remain in the vein for up to 2 weeks.

A

False;  polypropylene and polyethylene tubing is highly thrombogenic, Teflon is considered “less throbogenic”, but not as safe as polyurethane. Silastic is the least thrombogenic. Teflon  catheters  should be changed every 3 days, whereas polyurethane catheters  may remain in the vein for up to 2 weeks.

73
Q

Arrange in order of most to least thrombogenic:

  1. polyethylene
  2. polypropylene
  3. polyurethane
  4. silastic
  5. teflon
A

polypropylene and polyethylene tubing is highly thrombogenic, Teflon is considered “less throbogenic”, but not as safe as polyurethane. Silastic is the least thrombogenic.

74
Q

T/F: Total body water accounts for approximately 60% of body weight in an adult horse. This is divided between intracellular fluid (2/3 or 40% of BW) and extracellular fluid (1/3 or 20% of BW).

A

True

75
Q

What is the estimated extracellular fluid volume in a 500 kg horse?

A

100 L; Total body water accounts for approximately 60% of body weight in an adult horse. This is divided between intracellular fluid (2/3 or 40% of BW) and extracellular fluid (1/3 or 20% of BW).

76
Q

What is the estimated intracellular fluid volume in a 500 kg horse?

A

200 L; Total body water accounts for approximately 60% of body weight in an adult horse. This is divided between intracellular fluid (2/3 or 40% of BW) and extracellular fluid (1/3 or 20% of BW).

77
Q

Interstitial fluid makes up about ____ of the ECF.

A

75% or 3/4

Surgical Biology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions