N244 LECTURE 4 EXAM QUESTIONS WITH
100% VERIFIED CORRECT ANSWERS!!
3% sodium chloride (3% NaCl)
hypertonic, only used for increased ICP
Crystalloid solutions
Solutions of dissolved crystals (for example, salts or sugars) in water; contain compounds that
quickly dissociate in solution.
3ml is needed to replace 1ml of blood
Can NOT carry O2
Colloid solutions
Blood products, albumin
Replacement is 1:1 ratio
CAN carry O2
Gold standard treatment for DKA
Isotonic solutions for stabilization
Lactated ringers
Given when large amounts of blood has been lost, preferred for burn victims
Hypotonic solutions
water moves into the cell, third spacing a concern, can swell cells to the point of rupture (lysing)
isotonic contraction
A decrease in total body water
Decrease in total volume, no change is osmolarity
Causes: vomiting, diarrhea, kidney disease, and misuse of diuretics
Treatment is isotonic fluid, replenish slowly to prevent pulmonary edema
Hypertonic contraction
,loss of water exceeds loss of sodium; a decrease in total body water
Causes: excessive sweating, osmotic diuretics, concentrated foods given to infants, secondary to
extensive burns
Treatment: hypotonic fluids to move water into the cells and expand them, drink water
Crenate
when a cell shrinks due to water loss
types of hypertonic solutions
3% NS
5% NS
10% dextrose in water (D10W)
5% dextrose in 0.9%NS (D5W/NS)
5% dextrose in 0.45% NS (D5W 1/2 NS)
5% dextrose in lactated ringer (D5LR)
Hypotonic solutions
Pull fluid from from intracellular to intravascular
Helps stabilize BP
Increase urine output
Reduce edema
MONiTOR to avoid fluid overloading.
Hypotonic contraction
loss of sodium exceeds loss of water, decrease in total body water
Causes by excessive loss of sodium through the kidney (diuretic therapy, chronic renal
insufficiency, lack of aldosterone)
Treatment: mild- infusing isotonic sodium chloride solution; severe- hypertonic solution
Volume expansion
An increase in total body water
May be isotonic, hypertonic, or hypotonic
, Causes: CHF, cirrhosis with ascites, nephrotic syndrome, overdose with therapeutic fluids
Treatment: diuretics
Respiratory alkalosis
Causes: hyperventilation
Treatment: none, if severe rebreathe CO2 laden expired breath
Respiratory acidosis
retention of CO2, secondary to hypoventilation
Treatment: correction of respiratory impairment, infusion of sodium bicarbonate
Cardiac arrest ABGs
Respiratory acidosis then metabolic acidosis
Overdose ABGs
Respiratory acidosis
PaCO2 is
Acid
HCO3 is
Base
metabolic alkalosis
Causes: excessive loss of gastric acid (vomiting), administration of alkalinizing salts
Treatment: solution of sodium chloride plus potassium chloride
Metabolic acidosis
Causes: chronic renal failure, diarrhea, sepsis, poisoning
Treatment: correction of the underlying cause of acidosis, alkalinizing salt if severe
Potassium
100% VERIFIED CORRECT ANSWERS!!
3% sodium chloride (3% NaCl)
hypertonic, only used for increased ICP
Crystalloid solutions
Solutions of dissolved crystals (for example, salts or sugars) in water; contain compounds that
quickly dissociate in solution.
3ml is needed to replace 1ml of blood
Can NOT carry O2
Colloid solutions
Blood products, albumin
Replacement is 1:1 ratio
CAN carry O2
Gold standard treatment for DKA
Isotonic solutions for stabilization
Lactated ringers
Given when large amounts of blood has been lost, preferred for burn victims
Hypotonic solutions
water moves into the cell, third spacing a concern, can swell cells to the point of rupture (lysing)
isotonic contraction
A decrease in total body water
Decrease in total volume, no change is osmolarity
Causes: vomiting, diarrhea, kidney disease, and misuse of diuretics
Treatment is isotonic fluid, replenish slowly to prevent pulmonary edema
Hypertonic contraction
,loss of water exceeds loss of sodium; a decrease in total body water
Causes: excessive sweating, osmotic diuretics, concentrated foods given to infants, secondary to
extensive burns
Treatment: hypotonic fluids to move water into the cells and expand them, drink water
Crenate
when a cell shrinks due to water loss
types of hypertonic solutions
3% NS
5% NS
10% dextrose in water (D10W)
5% dextrose in 0.9%NS (D5W/NS)
5% dextrose in 0.45% NS (D5W 1/2 NS)
5% dextrose in lactated ringer (D5LR)
Hypotonic solutions
Pull fluid from from intracellular to intravascular
Helps stabilize BP
Increase urine output
Reduce edema
MONiTOR to avoid fluid overloading.
Hypotonic contraction
loss of sodium exceeds loss of water, decrease in total body water
Causes by excessive loss of sodium through the kidney (diuretic therapy, chronic renal
insufficiency, lack of aldosterone)
Treatment: mild- infusing isotonic sodium chloride solution; severe- hypertonic solution
Volume expansion
An increase in total body water
May be isotonic, hypertonic, or hypotonic
, Causes: CHF, cirrhosis with ascites, nephrotic syndrome, overdose with therapeutic fluids
Treatment: diuretics
Respiratory alkalosis
Causes: hyperventilation
Treatment: none, if severe rebreathe CO2 laden expired breath
Respiratory acidosis
retention of CO2, secondary to hypoventilation
Treatment: correction of respiratory impairment, infusion of sodium bicarbonate
Cardiac arrest ABGs
Respiratory acidosis then metabolic acidosis
Overdose ABGs
Respiratory acidosis
PaCO2 is
Acid
HCO3 is
Base
metabolic alkalosis
Causes: excessive loss of gastric acid (vomiting), administration of alkalinizing salts
Treatment: solution of sodium chloride plus potassium chloride
Metabolic acidosis
Causes: chronic renal failure, diarrhea, sepsis, poisoning
Treatment: correction of the underlying cause of acidosis, alkalinizing salt if severe
Potassium
