Clph 872 Exam 1

Front 1

Calculate the Ideal Body Weight

Back 1

Male IBW=50 kg + (2.3 x inches over 60”)
Female IBW= 45 kg + (2.3 x inches over 60”)

Front 2

Calculate the Dosing Body Weight

Back 2

DBW = IBW + 0.4(wt –IBW)
–Use if dry weight is 130% or more of IBW

Front 3

Calculate the Nutritional Body Weight

Back 3

NBW = IBW + 0.25(wt –IBW)
–Use if dry weight is 130% or more of IBW

Front 4

How do body fluids relate to weight?

Back 4

~ 60% of body weight in adults
Intracellular -2/3 (40% of wt)
•Extracellular -1/3 (20% of wt)
1/4 extracellular fluid is interstitial
3/4 Intravascular (plasma)

Front 5

What is the percentage of body water for males, females and neonates?

Back 5

•Adults
–Men: 50-60% of body wt
–Women: 45-55% of body wt
•Neonates/Infants
–75-90% of body wt

Front 6

What are some sensible water losses?

Back 6

•Sensible
–Urination (400-1500 mL)
–Defecation (100-200 mL)
–Wounds (varies)
_____________________
1 –1.5 L / day

Front 7

What are some insensible water losses

Back 7

•Insensible
–Skin (350-400 mL)
–Lungs (350-400 mL)
____________________
1 L / day

Front 8

What are some additional reasons for water loss?

Back 8

•NG output
•Vomiting
•Diarrhea
•Burns
•Fistulas
•Drains
•Bleeding
•Large wounds

Front 9

What organs regulate body fluid losses?

Back 9

skin, lungs, kidneys

Front 10

What types of movement affect solutes, fluids, and both solutes and fluids

Back 10

solutes: diffusion, active transport
fluids: osmosis(electrolytes), oncotic pressure (proteins)
Both: capillary filtration (BV)

Front 11

What hormones regulate volume?

Back 11

Anti-diuretic hormone (ADH), Renin-angiotensin-aldosterone system (RAAS), Atrial Naturetic Peptide (ANP)

Front 12

What are MIVF fluid requirements?

Back 12

30-40ml/kg/day

Front 13

Acidic fluid loss comes from...

Basic fluid loss comes from...

Back 13

NG output

pancreas and diarrhea

Front 14

What is the most common MIVF?

Back 14

D5W + 1/2 NS + 20mEq/L KCl

Front 15

What is the osmolar value of hypotonic, isotonic, and hypertonic solutions?

Back 15

Hypotonic < 275 mOsm/L
Isotonic 275-295 mOsm/L
Hypertonic >295 mOsm/L

Front 16

Name the 4 types of crystalloid fluids and what they are used for.

Back 16

NS replacement/resuscitation [154 mEq/L] Na+ and Cl-
½ NS maintenance
LR replacement/resuscitation
D5W replacement only

Front 17

What are colloid fluids used for?

Back 17

Albumin (5%, 25%), hetastarch,plasmanate, blood

used as plasma expanders, volume expansion, inc plasma oncotic pressure

Front 18

What parameters should be monitored for fluid loss?

Back 18

I/O, UOP, BUN/SCr ratio, weight, vitals, CVP

Front 19

What lab values signify dehydration?

Back 19

BUN/Scr > 20 = dehydration
CVP < 8 = dehydration
Increased HR can signal dehydration

Front 20

What is the most common electrolyte disturbance in hospitalized pts?

Back 20

hyponatremia (Na<135 mEq/L)

Front 21

What causes hypertonic hyponatremia?

Back 21

increased glucose
use a corrected Na value

Front 22

What causes isotonic pseudohyponatremia?

Back 22

inc. lipids/ proteins inc. plasma volume and dilutes out Na

Front 23

What causes hypervolemic hypotonic hyponatremia?

Back 23

edema from kidney failure, cirrhosis, HF

Front 24

What causes isovolemic hypotonic hyponatremia?

Back 24

SIADH
Water intake exceeds capacity of the kidneys to excrete water
–Urine Osm generally > 100 mOsm/kg
–Urine Na+ generally > 20-30 mEq/L

Front 25

What causes hypovolemic hypotonic hyponatremia?

Back 25

dehydration

Front 26

What is the normal Na level?

Back 26

135-145mEq/L

Front 27

How do you calculate osmolality? What is the normal range?

Back 27

osmolality=(2xNa)+(BUN/2.8)+(Glu/18)

Normal range: 280-295mOsm/L

Front 28

Calculate the Osmolar gap.

Back 28

Osmolar gap= measured Osm/L - calculated Osm/L

>15= osmolar gap

Means the presence of unidentified particles

Front 29

Corrected Serum Na

Back 29

Na (serum) + 1.6(BG -100/100)