BSNC 3000 Module 9 - Management of Sodium
Imbalances, Fluid and Electrolytes questions with
Ans✔✔s
Categories of postoperative fluid therapy Ans✔✔--
replacement/resuscitative
- maintenance
Replacement/resuscitative therapy Ans✔✔-- correct any existing fluid
and electrolyte deficits resulting from gastrointestinal, urinary, or skin
losses, bleeding, and third spacing
- goal is to maintain organ perfusion
Categories of post-op fluid losses Ans✔✔-- bleeding: S&S usually
present after >15% blood volume loss
- drainage: NG drainage, chest tube drainage (pleural fluid), urinary
drainage
- third spacing: capillary fluid leaks into interstitial spaces or body
cavities (e.g., edema, ascites, pleural effusion, pericardial effusion)
- insensible losses: evaporative loss due to open surgery or wounds
Maintenance therapy Ans✔✔-- provided when the patient is not expected
to eat or drink normally for a prolonged period (e.g., preoperatively or
while on a ventilator)
Goals:
,- preserve fluid and electrolyte balance
- provide some calories (nutrition) to prevent muscle catabolism
Types of fluid therapies Ans✔✔-- crystalloids
- colloids
- blood products
Crystalloids Ans✔✔-- fluid of choice
- distinguished by tonicity (hypotonic, isotonic, hypertonic)
Colloids Ans✔✔-- volume expanders
- contain large molecules like albumin (increase blood colloid osmotic
pressure)
Blood products Ans✔✔-- best volume expanders
- packed red blood cells
- platelets
- fresh frozen plasma and cryoprecipitate
Hypotonic (type of crystalloid) Ans✔✔-- concentration < plasma
- 0.45% NaCl (½ NS), D5W, or D5 ½ NS (once dextrose is metabolized)
- lower osmolality than body fluids
, - uses: to manage conditions that cause cellular dehydration (fluids shift
into cells)
- fluid shifts out of blood into cells
- used to treat cellular dehydration & hypernatremia
Isotonic (type of crystalloid) Ans✔✔-- concentration = plasma
- 0.9% NaCl (normal saline), Lactated Ringer's,
PlasmaLyte
- osmolality is the same as body fluids
- uses: in patients where fluid is mainly needed to restore intravascular
volume (no need for fluid shifting)
- increases intravascular volume
- used to treat ECV deficit and mild sodium imbalances (depending on
cause)
*caution in cardiac/renal disease
Hypertonic (type of crystalloid) Ans✔✔-- concentration > plasma
- 3% NaCl, hypertonic dextrose solutions (D20W)
- higher osmolality than body fluids
- uses: to manage conditions that cause cellular swelling (fluids shift out
of the cells into the intravascular space)
-
Imbalances, Fluid and Electrolytes questions with
Ans✔✔s
Categories of postoperative fluid therapy Ans✔✔--
replacement/resuscitative
- maintenance
Replacement/resuscitative therapy Ans✔✔-- correct any existing fluid
and electrolyte deficits resulting from gastrointestinal, urinary, or skin
losses, bleeding, and third spacing
- goal is to maintain organ perfusion
Categories of post-op fluid losses Ans✔✔-- bleeding: S&S usually
present after >15% blood volume loss
- drainage: NG drainage, chest tube drainage (pleural fluid), urinary
drainage
- third spacing: capillary fluid leaks into interstitial spaces or body
cavities (e.g., edema, ascites, pleural effusion, pericardial effusion)
- insensible losses: evaporative loss due to open surgery or wounds
Maintenance therapy Ans✔✔-- provided when the patient is not expected
to eat or drink normally for a prolonged period (e.g., preoperatively or
while on a ventilator)
Goals:
,- preserve fluid and electrolyte balance
- provide some calories (nutrition) to prevent muscle catabolism
Types of fluid therapies Ans✔✔-- crystalloids
- colloids
- blood products
Crystalloids Ans✔✔-- fluid of choice
- distinguished by tonicity (hypotonic, isotonic, hypertonic)
Colloids Ans✔✔-- volume expanders
- contain large molecules like albumin (increase blood colloid osmotic
pressure)
Blood products Ans✔✔-- best volume expanders
- packed red blood cells
- platelets
- fresh frozen plasma and cryoprecipitate
Hypotonic (type of crystalloid) Ans✔✔-- concentration < plasma
- 0.45% NaCl (½ NS), D5W, or D5 ½ NS (once dextrose is metabolized)
- lower osmolality than body fluids
, - uses: to manage conditions that cause cellular dehydration (fluids shift
into cells)
- fluid shifts out of blood into cells
- used to treat cellular dehydration & hypernatremia
Isotonic (type of crystalloid) Ans✔✔-- concentration = plasma
- 0.9% NaCl (normal saline), Lactated Ringer's,
PlasmaLyte
- osmolality is the same as body fluids
- uses: in patients where fluid is mainly needed to restore intravascular
volume (no need for fluid shifting)
- increases intravascular volume
- used to treat ECV deficit and mild sodium imbalances (depending on
cause)
*caution in cardiac/renal disease
Hypertonic (type of crystalloid) Ans✔✔-- concentration > plasma
- 3% NaCl, hypertonic dextrose solutions (D20W)
- higher osmolality than body fluids
- uses: to manage conditions that cause cellular swelling (fluids shift out
of the cells into the intravascular space)
-
