NURS 1141 - Exam 2 WITH ANSWERS
Hypotonic - ANSWER- Will push fluid to extravascular space
Isotonic - ANSWER- No change in fluid shift
Hypertonic - ANSWER- Will draw fluid into the vascular system
Lactated Ringers - ANSWER-
Sodium Chloride - ANSWER- Normal saline contains 154 mEq Na per liter
Contraindicated in hypernatremia or hyperchloremia
Albumin - ANSWER- Colloid
Natural protein produced in the liver - 70% of colloid oncotic pressure
Human donor
Contraindicated in severe heart failure
Concentrations 5-25%
Onset - 1 minute, Half Life - 16 hour, Duration - 24 hour
Dextran - ANSWER- Colloid
Solution of glucose
Concentration 40, 70, 75, mixed in D5w or 0.9ns
Contraindications - heart failure, renal insufficiency, severe dehydration
Onset - 5 min, Half Life - 2-6 hr, Duration 4-6 hr
Crystalloids - ANSWER- Lactated Ringers, Normal Saline
Substances in a solution that diffuse through a semi-permeable membrane
Can leak out of the vessels
Colloids - ANSWER- Albumin, Dextran
Protein substances that increase the colloid oncotic pressure
Hypertonic!
"Plasma expander"
More expensive - more likely to induce bleeding
Potassium Chloride - ANSWER- "most abundant electrolyte inside sells" (95% intracell)
Normal concentration 3.5-5 mEq/L (150 intracell)
Indicated in K+ deficiency
Chloride works on hypochloremia which typically accompanies hypoK+
Contraindications - hyperkalemia, renal disease, dehydration, untreated addisons
disease, hemolytic disease, tissue breakdown
SE - n/v/d, GI ulcers/bleeding
Dose 20-40mEq/L peripheral, 60mEq/L central - 10mEq/hr no tele, 20mEq/hr tele
, Toxicity - weakness, paresthesia, paralysis, dysrhythmia
**hyperK+ fixed by dextrose/insulin, bicarb, Ca gluc/chloride
Interactions - K+ sparing diuretics, ACE inhibitors = + K+, non-paring
diuretic,/amphotrecin B, mineral alocorticiods = - K+
Renal role in fluid/electrolyte balance - ANSWER- Filtering, excreting, or retaining water
and electroylytes in the kidneys
Glomerular Filtration Rate - ANSWER- amount of filtrate formed in all the renal
corpuscles of both kidneys each minute
Creatinine Clearance - ANSWER- measurement of the rate at which creatinine is
cleared from the blood by the kidney
Acetazolamide (Diamox) - ANSWER- Carbonic Anhydrase Inhibitor
Actions: Weak Diuretic, inhibits CA in kidney, brain, eye, pee out bicarb, making them
acidotic, increase rate
Uses: Reduces intraocular pressure (glaucoma) reduces seizure activity, also used in
ICU as respiratory stimulant with metabolic alkalosis for weaning off vent
Furosemide - ANSWER- Sulfonamide-type loop
Dose 20, 40, 80mg
IV 10mg/mL (IV is half oral dose)
*Use peroxide for oral irritation
Dumps K+, can cause dehydration/ortho changes
May inhibit uric acid excretion -> gout
Interactions - alchohol/narcs/sedatives -> ortho change
Dig - may increase K+ excretion
*Watch for doses > 200mg
Hydrochlorothiazide - ANSWER- Thiazide-type
Dose - 12.5/25/50 oral tablets/capsules (12.5-200mg)
Administer with food/milk
Plasma uric acid issues
May induce hyperglycemia in DM (adjust DM meds)
Metolazone (zaroxolyn) - ANSWER- Thiazide-type diuretic
Dose 2.5/5/10mg (2.5-20mg)
Administer with food/milk
Plasma uric acid issues
May induce hyperglycemia in DM (adjust DM meds)
Spironolactone - ANSWER- Potassium-sparing diuretic
Use - Relief of ascites, edema
Dose - 100mg daily, maint 25-200qd (up to 400)
Adverse Effects - Gynecomastia/ED
Hypotonic - ANSWER- Will push fluid to extravascular space
Isotonic - ANSWER- No change in fluid shift
Hypertonic - ANSWER- Will draw fluid into the vascular system
Lactated Ringers - ANSWER-
Sodium Chloride - ANSWER- Normal saline contains 154 mEq Na per liter
Contraindicated in hypernatremia or hyperchloremia
Albumin - ANSWER- Colloid
Natural protein produced in the liver - 70% of colloid oncotic pressure
Human donor
Contraindicated in severe heart failure
Concentrations 5-25%
Onset - 1 minute, Half Life - 16 hour, Duration - 24 hour
Dextran - ANSWER- Colloid
Solution of glucose
Concentration 40, 70, 75, mixed in D5w or 0.9ns
Contraindications - heart failure, renal insufficiency, severe dehydration
Onset - 5 min, Half Life - 2-6 hr, Duration 4-6 hr
Crystalloids - ANSWER- Lactated Ringers, Normal Saline
Substances in a solution that diffuse through a semi-permeable membrane
Can leak out of the vessels
Colloids - ANSWER- Albumin, Dextran
Protein substances that increase the colloid oncotic pressure
Hypertonic!
"Plasma expander"
More expensive - more likely to induce bleeding
Potassium Chloride - ANSWER- "most abundant electrolyte inside sells" (95% intracell)
Normal concentration 3.5-5 mEq/L (150 intracell)
Indicated in K+ deficiency
Chloride works on hypochloremia which typically accompanies hypoK+
Contraindications - hyperkalemia, renal disease, dehydration, untreated addisons
disease, hemolytic disease, tissue breakdown
SE - n/v/d, GI ulcers/bleeding
Dose 20-40mEq/L peripheral, 60mEq/L central - 10mEq/hr no tele, 20mEq/hr tele
, Toxicity - weakness, paresthesia, paralysis, dysrhythmia
**hyperK+ fixed by dextrose/insulin, bicarb, Ca gluc/chloride
Interactions - K+ sparing diuretics, ACE inhibitors = + K+, non-paring
diuretic,/amphotrecin B, mineral alocorticiods = - K+
Renal role in fluid/electrolyte balance - ANSWER- Filtering, excreting, or retaining water
and electroylytes in the kidneys
Glomerular Filtration Rate - ANSWER- amount of filtrate formed in all the renal
corpuscles of both kidneys each minute
Creatinine Clearance - ANSWER- measurement of the rate at which creatinine is
cleared from the blood by the kidney
Acetazolamide (Diamox) - ANSWER- Carbonic Anhydrase Inhibitor
Actions: Weak Diuretic, inhibits CA in kidney, brain, eye, pee out bicarb, making them
acidotic, increase rate
Uses: Reduces intraocular pressure (glaucoma) reduces seizure activity, also used in
ICU as respiratory stimulant with metabolic alkalosis for weaning off vent
Furosemide - ANSWER- Sulfonamide-type loop
Dose 20, 40, 80mg
IV 10mg/mL (IV is half oral dose)
*Use peroxide for oral irritation
Dumps K+, can cause dehydration/ortho changes
May inhibit uric acid excretion -> gout
Interactions - alchohol/narcs/sedatives -> ortho change
Dig - may increase K+ excretion
*Watch for doses > 200mg
Hydrochlorothiazide - ANSWER- Thiazide-type
Dose - 12.5/25/50 oral tablets/capsules (12.5-200mg)
Administer with food/milk
Plasma uric acid issues
May induce hyperglycemia in DM (adjust DM meds)
Metolazone (zaroxolyn) - ANSWER- Thiazide-type diuretic
Dose 2.5/5/10mg (2.5-20mg)
Administer with food/milk
Plasma uric acid issues
May induce hyperglycemia in DM (adjust DM meds)
Spironolactone - ANSWER- Potassium-sparing diuretic
Use - Relief of ascites, edema
Dose - 100mg daily, maint 25-200qd (up to 400)
Adverse Effects - Gynecomastia/ED
