NURS 5461 Fluid Replacement UPDATED
ACTUAL Exam Questions and CORRECT
Answers
a. Fluid Replacement - CORRECT ANSWER - I/O equal ~1600mL/day
1. Total Body Water - CORRECT ANSWER - a. Adult males
i. < 65 y/o = 60%
ii. > 65 y/o = 50%
b. Adult females
i. < 65 y/o = 50%
> 65 y/o = 45%
Extracellular fluid volume - CORRECT ANSWER - 1. 1/3 TWB
2. Controlled by Na retention and excretion
3. Water passively follows sodium
4. Body ignores ECF as a whole
a. Samples a portion of it EABV
a. Effective Arterial Blood Volume - CORRECT ANSWER - b. Effective Arterial Blood
Volume
i. Volume in the arteries
ii. ~ 700ml
iii. Function of cardiac output and systemic vascular resistance
*Baro-receptors sense changes in the EABV
-Decreased EABV- increase release of catecholamines and increases CO and SVR, activates
RAAS, increased antidiuretic hormone secretion
-Increase EABV- suppresses RAAS, increase release of atrial natriuretic peptide
, MGRADES EXAMS
i. Manifestations of Dehydration/Volume Loss - CORRECT ANSWER - 1. Thirst, Delayed
capillary refill
2. Dry mucous membranes, cool clammy skin
3. Tachypnea
4. Tachycardia with pulse > 100
5. Postural hypotension (SBP decrease > 20mmHg with standing)
6. Oliguria-calc based on wgt.
7. Depressed mental status of loss of consciousness
8. Peripheral cyanosis
9. Supine Hypotension
10. Hemoconcentration: elevated HCT, increased serum albumin
11. Increased BUN to creatinine ratio, normal is < 20
i. Fluid Therapy - CORRECT ANSWER - 1. Goals of IV Fluid Therapy
a. Normalize hemodynamics
b. Normalize electrolyte imbalances
c. Replace previous fluid and electrolyte losses
d. Replace ongoing fluid and electrolyte losses
e. Provide nutrition
f. Maintain daily fluid and electrolyte requirements
1. Maintenance - CORRECT ANSWER - a. Replaces the ongoing losses of water and
electrolytes under normal physiologic conditions
b. This is usually done when the patient is not expected to eat or drink for a prolonged period of
time i.e. perioperatively or on a ventilator
c. The goal of therapy is to preserve water, electrolyte balance and provide some nutrition
d. If the period of time is expected to go beyond 1-2 weeks, then parenteral or enteral nutrition
should be started