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23 Cards in this Set
- Front
- Back
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what is the 60-40-20 rule?
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TBW is 60% of body weight
ICF is 40% ECF is 20% - interstitial fluid is 15% - plasma is 5% [- venous fluid 85%] [- arterial fluid 15%] |
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what is normal urine output in adults?
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>1.0 mL/kg/hr
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what is the 100/50/20 [or 4/2/1] rule?
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rule for maintenance fluids:
(0-10) kg - 100/4 mL/kg per day/hr (10-20) kg - 50/2 mL/kg per day/hr (20+) kg - 20/1 mL/kg per day/hr |
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how much should you expect the hct to increase for every liter of fluid deficit?
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3% increase
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how should blood loss be replaced?
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crystalloid at a 3:1 ratio
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what is the mc form of maintenance fluid?
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D51/2NS
(w/ 20 mEq KCl/L) |
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when do symptoms of hyponatremia begin?
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<120 mEq/L
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what is pseudohyponatremia?
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incr in plasma solids lowers plasma sodium concentration, but amount of sodium in plasma is normal
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what causes hypertonic hyponatremia?
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when osmotic substances (glucose, etc) cause an osmotic shift of water out of cells
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in the setting of hypovolemic hyponatremia, a urine Na concentration >40 mmol/L is consistant with _____ and 20-40 mmol/L with _____
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SIADH
salt wasting nephropathy or hypoaldosteronism |
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what is the danger of correcting hypotonic hyponatremia too quickly?
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increasing Na more than 8 mmol/L in the first 24 hrs can lead to central pontine demyelination
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what are the characteristics of central pontine demyelination?
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paralysis
dysphagia dysarthria |
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what happens when you correct hypernatremia too quickly?
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correcting >12 mEq/L per day is assd with cerebral edema
(<8 mEq/L in the first 24 hrs is ideal) |
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how do you treat hypovolemic hypernatremia?
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isotonic NaCl
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how do you treat isovolemic hypernatremia?
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fluids (and vasopressin for diabetes insipidus)
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how do you treat hypervolemic hypernatremia?
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diuretics (furosemide) and D5W
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what is the major form of calcium in the plasma?
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bound to albumin, thus concentration fluctuates w/ albumin concentration
(incr in pH -> incr bound calcium) |
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how do you calculate free (ionized) calcium in a pt with hypoalbuminemia?
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= total calcium - (serum albumin x 0.8)
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how does hypomagnesemia effect calcium levels?
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it can cause hypocalcemia by decreasing PTH secretion
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what does hypo/hyper-calcemia look like on ECG?
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hypo = prolonged QT interval
hyper = shortened QT interval |
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how do you treat symptomatic hypocalcemia?
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IV calcium gluconate
(replace magnesium also) |
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how do you prevent urolithiasis in PTH deficiency?
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thiazide diuretics
(lower urinary calcium) |
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what are the clinical features of hypercalcemia?
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stones
bones groans psychiatric overtones |
