Solutions
What is the major Extracellular electrolyte? Correct Ans -
Sodium
What does low osmolality mean in regard to sodium? Correct Ans
- Dilute sodium
What does high osmolality mean in regard to sodium? Correct Ans
- Concentrated sodium
What is the rule of thumb when it comes to sodium? Correct Ans -
Salt follows water
high and dry
low and wet
What lab can indirectly assess osmolality? Correct Ans - Urine
specific gravity
Hypovolemia Correct Ans - Low blood/fluid volume
Hypervolemia Correct Ans - Increased blood volume
Potassium range Correct Ans - 3.5-5.0 mEq/L
Hypokalemia
Hyperkalemia
Sodium range Correct Ans - 135-145 mEq/mL
Hyponatremia
,Hypernatremia
Albumin range Correct Ans - 3.5-5
Hypoalbuminemia
Hyperproteinemia
Hemoglobin range Correct Ans - 12 - 18
Male and Female
What does osmotic pressure do? Correct Ans - The physical
force that prevents fluid from moving out and through a semi-
permiable membrane
Ex.) Hypotonic solution exerts less pressure, which allows to fluid to
move into the cell
What is one reason to use hypertonic IV solutions? Correct Ans -
Decreasing high intercranial pressure
What complication can happen from rapid correction of sodium?
Correct Ans - Osmotic demylenation syndrome
How does osmotic demylenation syndrome present? Correct Ans
- Ataxia
Confusion
Slurred speech
Drooling
Tremor
Weakness
What is oncotic pressure? Correct Ans - Similar to osmotic
pressure but exerted by colloids or proteins
,What is a colloid? Correct Ans - A term that references big
molecules (albumin or protein) that exert pressure that can help
hold onto fluid or draw fluid towards it.
What occurs with a patient with protein malnutrition regarding
fluid? Correct Ans - These patients cannot hold onto fluid in
the intervascular space, the fluid will leak out into the dependent
interstitial space of least resistance
This manifests as swelling in the abdomen or ankles
What is hydrostatic pressure? Correct Ans - The force of fluid
in a compartment pushing against a cell membrane or a vessel wall
(Venous and Arterial pressure)
What does hydrostatic pressure do at the capillary level? Correct
Ans - It is the major force that pushes water, oxygen, nutrients,
etc out of the vascular system and into the interstitial space.
Hydrostatic Pressure vs Oncotic Pressure Correct Ans -
Hydrostatic = Pushing
Oncotic = Sucking
What does "wide open" mean when talking about IV fluids Correct
Ans - As fast as gravity will allow if the fluid is by gravity
or
999 mL/hr on a pump (and large gauge IV)
What do isotonic crystalloids do? Correct Ans - Allow the body
to shift fluids to the compartments that need it (Fluid resuscitation)
, How fast can you give hypertonic IV solutions? Correct Ans -
100 mL/hr
What is a Crystalloid? Correct Ans - Type of IV fluid that
contains sodium - no protein
Types of colloids Correct Ans - "Plasma expanders"
Albumin
Dextran
Hetastarch
*Affects Clotting*
What type of patient would it be not ideal to give a colloid to?
Correct Ans - Patients who are prone to fluid overload
This is because colloids stay in the vascular space, causing
hydrostatic pressures that increase pulmonary capillary pressure
resulting in pulmonary edema
What pressure does blood increase when given? Correct Ans -
Oncotic pressure
Examples of blood products and their function Correct Ans -
Cryoprecipitate - manages acute bleeding
FFP - increases clotting factors
PRBCs - Increase oxygen carrying capacity
Whole blood - Has a lot of plasma proteins