Vascular Access

Question 1

What percent of intracellular water is found in the cells?

Answer 1

65%

Question 2

Red blood cell volume is = ____%

Answer 2

14 %

Question 3

Plasma volume is approximately ___

Answer 3

2-3 liters

Question 4

Extracellular water found in the interstitial spaces is ____%.

Answer 4

35 %

Question 5

Count of the total number of particles in a solution is equal to the sum of the molalities of all the solutes present in the solution

Answer 5

osmolality

(osmole / kg)

Question 6

The concentration of osmotic solution per liter of fluid.

Answer 6

Osmolarity

Question 7

Ions produce osmotic pressures across cell membranes but not _______ membranes

Answer 7

capillary

Question 8

Normal plasma osmolality is = _____ mOsm/L

Answer 8

285 mOsm/L

Question 9

A form of osmotic pressure exerted by proteins in a blood vessel’s plasma (blood/liquid) that usually tends to pull water into the circulatory system. It is the opposing force to hydrostatic pressure.

Answer 9

Oncotic pressure

Question 10

Normal oncotic pressure is _____ mmHg.

Answer 10

28 mmHg

Question 11

Frequently used in place of osmotic pressure or tension is related to the number of non-penetrating particles found in solution

Answer 11

tonicity

Question 12

Of equal tension. Denoting a solution having the same tonicity as another solution with which it is compared.

Answer 12

Isotonic

Question 13

Having a higher concentration of solute particles per unit volume than a comparison solution, regardless of kinds ofparticles. A solution in which cells shrink due to efflux of water.

Answer 13

Hypertonic

Question 14

Having a lower concentration of solute particules per unit volume than a comparison solution, regardless of kinds of particles. A solution in which cells expand due to influx of water.

Answer 14

Hypotonic

Question 15

Na concentration in plasma:

Answer 15

135-145

Question 16

K concentration in plasma

Answer 16

3.5 - 5.0

Question 17

Ca concentration in plasma

Answer 17

8.8 - 10

Question 18

Mg concentration in plasma

Answer 18

1.5 - 2.5

Question 19

Cl concentration in plasma

Answer 19

100 - 106

Question 20

HCO3 concentration in plasma

Answer 20

22 - 26

Question 21

PO4 concentration in plasma

Answer 21

0.5 - 1.5

Question 22

SO4 concentration in plasma

Answer 22

0.3 - 0.6

Question 23

Replacement of fluids in the body, electrolytes are given in mEq. True or false?

Answer 23

true

Question 24

What fluid can you not use with RBC and why?

Answer 24

LR

Ca found in LR solution causes cells to clot.

Question 25

Extremely hypotonic/hypertonic solutions may be infused in small volumes into _____ vessels, where dilution and distribution are rapid.

Answer 25

large

Question 26

Solutions differing greatly from the normal range may cause:

Answer 26

* tissue irritation * pain on injection * electrolyte shifts * inflammatory * enhanced clotting * phlebitis and thrombophlebitis

Question 27

The generally accepted upper limit for a peripheral IV is ____ mOsm/L. Greater association with phlebitis and should be administered via a central line.

Answer 27

900

Question 28

Very hypotonic IV solutions such as 1/4 NS cause RBCs to swell and burse. If a sufficient number of RBCs are affected, the patient may develop ______ anemia.

Answer 28

hemolytic

Question 29

Fluid replacement in healthy adults: GI is: ____ ml/day Insensible loss is: ____ ml/day Urinary loss is: \_\_\_\_ml/day

Answer 29

100-200 500-1000 1000 Total ≈ 2500 ml/day

Question 30

4-2-1 Rule * 4 ml/kg/hr for 1st \_\_\_\_kg * 2 ml/kg/hr for 2nd ____ kg * 1 ml/kg/hr for all weight \> _____ kg

Answer 30

10 10 20

Question 31

Sensible fluid loss perioperative: For minor surgery (hernia), ____ ml/kg/hr

Answer 31

2-4

Question 32

Sensible fluid loss perioperative: For moderate surgery (chole): \_\_\_- \_\_\_ ml/kg/hr

Answer 32

4-6

Question 33

Sensible fluid loss perioperative: ## Footnote For major surgery (bowel resection): \_\_\_- ___ ml/kg/hr

Answer 33

6-10

Question 34

Replace 1mL blood loss with ____ mL crystalloid or ___ mL colloid.

Answer 34

3mL 1mL

Question 35

Monitor vitals and maintain urine output at a MINIMUM of ____ ml/kg/hr

Answer 35

0.5

Question 36

If patient is more than ___ kg, can use the kg + ___ to get fluid maintenance.

Answer 36

40 40

Question 37

Hysterectomy for 70 kg female: * NOP deficit 10 hrs = ______ ml NS * Maintenance = _____ ml/hr * Blood loss = ____ = ____ ml NS * Sensible loss (\_\_\_ml/kg/hr) = _____ ml/hr * Total case 3 hours: \_\_\_\_\_

Answer 37

* 1100 * 110 * 300 = 900 NS * 4, 280 * 3170

Question 38

Fluid losses from bowel prep ≈ \_\_\_

Answer 38

1 Liter

Question 39

Preoperative fluid losses contributable to:

Answer 39

* bowel prep * vomiting/diarrhea * burns * malnourished * ascites * pulmonary effusion

Question 40

Blood loss can be found in: (3)

Answer 40

suction canisters surgical sponges (4x4) lap pads

Question 41

Surgical sponges can hold approximately ___ ml blood.

Answer 41

10

Question 42

Lap pads can hold approximately ____ - ____ mL blood

Answer 42

100-150ml

Question 43

Aqueous solution of low MW ions with or without glucose are: Examples (3)

Answer 43

crystalloids NS, Lactated Ringers, Plasma-Lyte

Question 43

Aqueous solution of high MW substances are: Examples (2)

Answer 43

Colloids Albumin Hetastarch

Question 44

Crystalloids in sufficient amounts are as effective as colloids in restoring intravascular volume. Severe deficits can be mroe rapidly corrected with crystalloids. True or false?

Answer 44

false, severe deficits more rapidly corrected with colloids

Question 45

Rapid administration of crystalloid \> ___ liters is associated with tissue edema.

Answer 45

4

Question 46

Losses primarily involving water, replace with \_\_\_tonic maintenance solution.

Answer 46

hypo

Question 47

Loss both water and electrolytes, replace with ____ solution. Most intraoperative losses are of this type:

Answer 47

isotonic

Question 48

Intravascular half=life is __ - ___ min

Answer 48

20-30

Question 49

Advantages of colloid (5)

Answer 49

* smaller infused volume * prolonged increase in plasma volume * less peripheral edema * decreased thromoembolism risk * greater oxygen delivery (conflicting data)

Question 50

Disadvantages of colloid:

Answer 50

* expensive * coagulopathy (dextran) * decreased Ca (albumin) * decreased glomerular filtration rate * osmotic diuresis (LMW dextran) * pulmonary edema

Question 51

Crystalloid advantages (3)

Answer 51

* cheaper * greater glomerular filtration rate * replaces IFV losses

Question 52

Crystalloid disadvantages: (3)

Answer 52

* short-lived hemodynamic improvement * peripheral edema * pulmonary edema