Week 3: Fluid & Electrolytes

Question 1

What is the normal osmolality range for plasma and other body fluids?

Answer 1

270 to 300 mOsm/L

Question 2

Increased osmolality means =

Answer 2

Decreased fluid movement into cells

Question 3

Decreased osmolality means =

Answer 3

Increased fluid movement into cells

Question 4

What is Osmosis?

Answer 4

Movement of water across a semipermeable membrane

Question 5

What happens with isotonic fluid?

Answer 5

Net movement – equilibrium

Question 6

What happens with hypotonic fluid?

Answer 6

Fluid moves into the cell

Question 7

What happens with hypertonic fluid?

Answer 7

Fluid moves out of the cell

Question 8

What are the two broad categories of intravenous fluid replacement solutions?

Answer 8

• Crystalloids
• Colloids

Question 9

What are crystalloids?

Answer 9

Solutions that flow easily from inside the bloodstream to cells and tissues

Question 10

What are colloids?

Answer 10

Solutions that are always hypertonic and expand intravascular volume

Question 11

What are isotonic solutions?

Answer 11

Solutions with the same osmolality as plasma

Question 12

What are some examples of isotonic solutions?

Answer 12

• 0.9 NaCl
• D5W
• Ringer’s lactate

Question 13

What are hypotonic solutions used for?

Answer 13

Correct cellular dehydration and maintain daily fluid requirements

Question 14

What are some examples of hypotonic solutions?

Answer 14

• 0.45 NaCl
• 0.25 NaCl
• 0.33 NaCl
• 2.5% dextrose

Question 15

What are hypertonic solutions used for?

Answer 15

Pull water back into circulation, especially in severe hyponatremia

Question 16

What are some examples of hypertonic solutions?

Answer 16

• 3% NaCl
• 5% NaCl
• D5W/0.45% NaCl
• D5W/0.9% NaCl

Question 17

What is the action of 0.9% NaCl?

Answer 17

Expands extracellular fluid space and replaces electrolytes

Question 18

What can happen with 0.9% NaCl administration?

Answer 18

• Fluid overload
• Generalized edema
• Hemodilution
• Electrolyte imbalance

Question 19

What is the action of Lactated Ringer’s?

Answer 19

Expands extracellular fluid space and replaces multiple electrolytes

Question 20

What can happen with Lactated Ringer’s administration?

Answer 20

• Fluid overload
• Generalized edema
• Hemodilution
• Electrolyte imbalance

Question 21

What is the action of hypotonic solutions?

Answer 21

Shifts fluid from extracellular to intracellular spaces

Question 22

What are the contraindications for hypotonic solutions?

Answer 22

• Increased Intracranial Pressure
• Liver disease
• Trauma patients
• Patients with hypervolemia

Question 23

What are the indications for hypertonic solutions?

Answer 23

• Heat-related disorders
• Hypotonic dehydration
• Fresh water drowning

Question 24

What can happen with hypertonic solution administration?

Answer 24

• Fluid overload
• Hypernatremia
• Hyperchloremia

Question 25

What role does sodium play in the body?

Answer 25

* ECF volume and concentration * Generation and transmission of nerve impulses * Acid-base balance

Question 26

What is hypernatremia?

Answer 26

Elevated serum sodium occurring with water loss or sodium gain

Question 27

What are the manifestations of hypernatremia?

Answer 27

* Thirst * Lethargy * Agitation * Seizures * Coma

Question 28

What is hyperkalemia?

Answer 28

High serum potassium caused by massive intake or impaired renal excretion

Question 29

What are the manifestations of hypokalemia?

Answer 29

* Cardiac complications * Skeletal muscle weakness * Weakness of respiratory muscles * Decreased gastrointestinal motility

Question 30

What are the manifestations of hypercalcemia?

Answer 30

* Thirst * CNS deterioration * Increased interstitial fluid

Question 31

What are the manifestations of hypocalcemia?

Answer 31

* Tetany * Muscle twitching * Chvostek’s and Trousseau’s sign

Question 32

What is the importance of understanding fluid and electrolyte therapy?

Answer 32

To know what IV fluid is required, indication, volume, rate & duration

Question 33

What is the significance of monitoring electrolyte levels?

Answer 33

To prevent complications related to imbalances