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28 Cards in this Set

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Normal Values:

Blood pressure
Stroke Volume
Cardiac Output
50-100 bpm
60-80cc per stroke
Syst x (2xDias)/3 approx 70-110
HR X SV approx 4-6 L/min
Normal Values

O2 Sats
95% +
12 bpm, 4bpm raise per 1 degree fever
Normal Values

Urine Specific Gravity
Blood Urea Nitrate
Urine Output
1.001 to 1.035 (H20 = 1)
7 to 18 mg/dL
.6 to 1.2 mg/dL
1,500cc/24hrs, 750 in hospital, <500 = body being poisoned
Normal Values

pH ballance
Male: 13-18gm/dL Female: 12-16
Male: 45-62% Female: 37-48%
7.35 to 7.45 = normal pH
270-295 mosm/kg +/- 5lbs body wt

Hypertonic = raised osmolarity
Isotonic = same osmolarity
Hypotonic = lowered osmolarity

Hypo = water from cells to bloodstream, BP raised, cells shrink
3 Cations and their normal values
Sodium (NaCl) 135-145
<Hyponatremia >Hypernatremia

Potassium (K) 3.5-5.0
<Hypokalemia >Hyperkalemia

Magnesium (Mg) 1.8 - 2.7
<Hypomagnesemia >Hypermagnesem
3 Anions and their normal values
Chloride (C) 96-108
<Hypochloremia >Hyperchloremia

Phosphate (P) 2.5-4.5
<Hypophosphatemia >Hyper

Bicarbonate (HCO3) 18-23
<Hypobicabomia >Hyper
3 forms of blood proteins and their responsibilites
1. Globulins (immune function)
2. Fibrinogen (blood clotting)
3. Albumin (maintenance of colloid osmotic pressure)
3 processes that govern the movement of fluid and electrolytes
1. Osmosis: movement of H2O from lesser concentration of solutes to an area of higher concentration

2. Diffusion: movement of molecules from higher conc. to lower conc. (small m&ms)

3. Active Transport: movement against the concentration gradient (sodium potassium pump)
4 areas of fluid in the body
1. Intracellular Fluid (ICF)
2. Extracellular Fluid (ECF)
3. Interstitial Fluid (ISF)
4. Intravascular Fluid (IVF)
We can only measure IVF (bloodstream)
Fluid Volume Loss


Fluid Volume Excess
FVL (Hypovolemia): loss of extracellular fluid volume exceeds intake of fluid

FVE (Hypervolemia): isotonic expansion of the ECF caused by abnormal retention of NaCl and H20 (increase in body NaCl content)
Fluid requirements


Normal daily fluid loss
(total loss and cc loss from urine, solid, and metabolism per day)
25-30 ml/kg per day (lower for elderly and obese)

1,500 cc/day lost
2/3 liquid (800-1500 ccs)
1/3 solid (500-700 ccs)
02 metabolism (150-250ccs)
4 types of liquid draining from wounds
1. Serous (clear liquid)
2. Sanguinous (blood)
3. Serosanguinous (combination)
4. Purulent (thick, cloudy, yellow liquid)
ECF regulated by what 3 major hormonal factors?
1. Aldosterone: regulates sodium balance

2. ADH: controls excretion of water in urine (ADH release = tells body to retain water)

3. Atrial Natriuretic Peptide: stress causes diuresis & decreases cardiac workload
lb - kg
cc - ml
cc - oz
cc - lb
cc - kg
2.2 lb = 1 kg
1 cc = 1 ml
30 cc = 1 oz
500 cc = 1 lb
1000 cc = 1 kg
1. Peaked, narrow T-waves, an ST-segment depression, and a shortened QT interval

2. Acidemia can cause hyperkalemia, and vice-versa

3. Metabolic acidosis is associated with this condition

4. #1 cause: acute renal failure. also crushing injuries and meta acid
First issue/question when giving a diuretic
K+ levels! Have to ask about that immediately
Parkland Formula
Lactated Ringer's solution:

4ml x kg body weight x % TBSA burned.

Day 1: 1/2 to be given in first 8 hours, 1/2 given over next 16 hours

Day 2: varies. Colloid added

Give osmolarity and indication
Isotonic solution in the bag, but becomes hypotonic once in body since sugar is metabolized quickly.

Use this to mix medications & give water, be careful not to give when pt is in shock or if cranial pressure is an issue
.45% NaCl

Give osmolarity and indication
Hypotonic solution given to provide H20 and salt.

Use this to treat hypertonic states, monitor for hyponatremia and swelling
.9% solution

Give osmolarity and indication for use
Hypotonic solution.

Used for ECFV replacement, need to monitor for overload in pt with renal failure
Ringer's lactate

Give osmolarity and indication for use
Hypotonic solution

Used as lactate replacement, also with burn victims. May cause ECFV overload in pt with renal failure
3% NaCl

Give osmolarity and indication for use
VERY HYPERTONIC! Needs to be given in central vein

Given in severy hypernatremia. Ask "how much lasik to give back? Need a diuretic
D5 .45% solution

Give osmolarity and indication for use
Hypertonic solution

Replace water, sodium, and a small amount of sugar. Used a LOT in the hospital. If pt cannot handle salt give them a diuretic as well.
1. Only time I will see a U-wave

2. Flat T waves or inverted T waves or both

3. Depressed ST segments occur
Air Emboli:

3 manifestations

4 interventions
1. Hypotension
2. Weak, rapid pulse
3. Loss of consciousness

1. Immediate clamping of cannula (hollow tube) and replacing a leaking or open infusion system

2. Place the patient on their left side in the Trendelenburg position

3. Asses vital signs and breath sounds

4. Administer oxygen

Their role in maintaining fluid ballance
Kidneys are responsible for regulation of water in the ECF. Every minute, 20% of CO is going to kidney

Their role in maintaining fluid ballance
These are good indicators of FVE. Should hear RALES in the lungs if FVE, also a good indicator of Left Ventricular Failure