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75 Cards in this Set
- Front
- Back
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What is "Hydrostatic Pressure?"
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Weight and volume of water
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What is "Osmotic Pressure?"
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Diffusion of water across a semi-permeable membrane from a compartment with less particles to a compartment with more particles
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What is "Osmolarity?"
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The number of solutes in a liter of water
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What are "Electrolytes?"
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Charged particles in body fluids that are essential to transmission of electrical impulses for proper nerve, muscle, and heart function
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What electrolyte regulates fluid between the extracellular and intracellular environment
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SODIUM(Na)
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What regulates balance in the extracellular environment between vascular and intrastitial?
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Proteins
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The vascular part of the extracellular environment is made up of what?
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Plasma which has more proteins
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The interstitial part of the extracellular environment consists of _____________?
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Everything in betwee the cells which has less proteins
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Crystalloids vs. Colloids in Fluid Therapy
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Crystalloids can pass easily through the pores of the compartment, while colloids are too big to pass and thus stay in the vascular bed
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Examples of Crystalloids
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Isotonic, Hypotonic and Hypertonic solutions
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Isotonic solutions
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0.9%NS, LR
275-295 mOsm/L |
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Isotonic solutions are given to whom?
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Bleeding or crashing pt to increase BP. Causes vascular expansion and electrolyte replacement
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Hypotonic Solution
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<250mOsm/L
0.25%NS 0.45%NS D5W(isotonic initially) |
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Hypotonic Solution is used to what?
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Hydrate cells
Causes fluid shift into the cell |
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Hypotonic solution can cause what?
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Hypotension, edema, hyponatremia, and cellular swelling
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Hypertonic Solution
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>375mOsm/L
D50.45%NS D50.9%NS 3%-5%HS |
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Hypertonic Solution is used to cause what?
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Vascular expansion
Electrolyte replacement Inflammation suppression |
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Examples of Colloids
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Albumin
Dextran Mannitol |
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Albumin causes what? and helps with what?
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1. Vascular expansion and protein replacement
2. Blood pressure |
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Dextran causes what? careful with because of what?
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1. Vascular expansion
2. There is an increased risk of bleeding |
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Mannitol causes what? careful with because of what?
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1. Oliguric diuresis and toxin elimination
2. Extravasation, cellular dehydration |
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What solution is the FIRST choice for fluid resuscitation?
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Hypertonic Solution
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What solutions are proinflammatory?
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Isotonic solutions
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What improved tissue oxygenation?
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limiting fluids
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What is permissive hypotension?
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Limiting fluids just enough to maintain BP
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What is sodium responsible for?
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Nerve transmission and maintenance of osmolarity
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What is potassium responsible for?
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Neuromuscular function and cardiac function
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What is magnesium responsible for?
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Muscular function and energy production
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NA/K are regulated by what?
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ADH/Aldosterone respectively
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What is Calcium responsible for?
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Nerve transmission, maintenance of cell wall permeability, clotting mechanism, cardiac impulses, mediating cardiac PM, forming bones and teeth
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What is Phosphorous responsible for?
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Energy production, fat metabolism, and maintenance of acid-base balance
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What is the relationship of Calcium and Phosphorous?
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Inverse relationship that PTH regulates
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Anion Gap: Norm value, what does it indicate
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8-12.5, indicates if there is a lot of organic acids or not
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High Anion Gap indicates ....
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Diabetic ketoacidosis
Lactic acidosis(1st indication of septic shock) |
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Normal anion gap with high chloride indicates...
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acidosis due to diarrhea and renal tubular acidosis
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Low anion gap indicates---
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alkalosis, hypochloremia, NG suctioning and diuretic therapy
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Indications of Hypernatremia
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thirst, tachycardia, lethary, disorientation, weakness, irritability, muscle twitching, low UO, seizures, coma
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Manifestations of Hyponatremia
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HA, weakness, nervousness, NV, confusion, seizures, coma
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At what level is sodium considered a medical emergency?
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<110mEq/L
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Treat hyponatremia with what?
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Hypertonic solution gradually
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Manifestations of Hyperkalemia
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abdominal cramping, fatigue, lethargy, muscle weakness, paralysis
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Manifestations of Hypokalemia
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Muscle weakness or tenderness, *LEG CRAMPS*, drowsiness, confusion, loss of appetite, abdominal distention
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Hyperkalemia on EKG
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Tall, peaked T waves and prolonged PR, widened WRS, shortened QT
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Hypokalemia on EKG
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Flattened T waves, depressed ST, PVC's, VT, V.Fib
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What do you give for hyperkalemia?
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CaCl IV
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Manifestations of hypermagnesemia
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Lethargy, AMS, resp. depression, muscle weakness, coma
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Manifestations of hypomagnesemia
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Muscle weakness, anorexia, nausea, dizziness, lethargy, confusion, coma
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Hypermagnesemia on EKG
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Prolonged PR, widened QRS, lengthened QT
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Hypomagnesemia on EKG
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flattened T wave, ST depression, Shortened QT
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Hypercalcemia/Hypophosphatemia manifestations
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Lethargy, fatigue, AMS, anorexia, N, decreased bowel sounds, constipation, bone, flank, thigh pain
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Hypocalcemia/Hyperphosphatemia Manifestations
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bone or joint pain, sudden seizures, tremors, cramps, numbness, N, abd. distention, V, Constipation
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HyperCa/HypoPhos EKG
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AV blocks
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HypoCa/HyperPhos EKG
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Prolonged ST and QT
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What are the manifestations of hyperchloremia?
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weakness, lethargy, coma, deep/rapid breathing
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What are the manifestations of hypochloremia?
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muscle excitability, tetany, shallow/depressed breathing, muscle weakness, twitching
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How do you treat hyperchloremia?
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Treat the underlying cause, correct electrolyte imbalance, IVF
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How do you treat hypochloremia?
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acetazolamide
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What electrolytes and levels of these electrolytes do you see in dehydrated pt's
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High Cl, High Na
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What is the most common cause of hyperkalemia?
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Renal disease
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What is the most common cause of hypokalemia?
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Diuretic therapy with inadequate potassium replacement
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What is the most common cause of hypermagnesemia?
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Renal failure
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Hypercalcemia and hypocalcemia triggers a reciprocal effect on what?
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phosphorous
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What is the most common cause of hyperphosphatemia?
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Renal failure
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What are the manifestations of hyperchloremia?
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weakness, lethargy, coma, deep/rapid breathing
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What are the manifestations of hypochloremia?
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muscle excitability, tetany, shallow/depressed breathing, muscle weakness, twitching
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How do you treat hyperchloremia?
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Treat the underlying cause, correct electrolyte imbalance, IVF
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How do you treat hypochloremia?
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acetazolamide
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What electrolytes and levels of these electrolytes do you see in dehydrated pt's
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High Cl, High Na
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What is the most common cause of hyperkalemia?
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Renal disease
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What is the most common cause of hypokalemia?
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Diuretic therapy with inadequate potassium replacement
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What is the most common cause of hypermagnesemia?
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Renal failure
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Hypercalcemia and hypocalcemia triggers a reciprocal effect on what?
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phosphorous
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What is the most common cause of hyperphosphatemia?
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Renal failure
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What does aldosterone do?
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Promotes sodium and water retention in the distal nephron of the kidney, thus restoring blood volume
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What are the signs and symptoms of fluid overload?
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JVD, HTN, Adventitious breath sounds, resp. distress
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