22% Sodium Chloride IV Fluids
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Questions and Answers

Which of the following statements about hypotonic solutions is most accurate?

  • Hypotonic solutions have equal osmotic pressure to human plasma.
  • Hypotonic solutions have lower osmotic pressure. (correct)
  • Hypotonic solutions have higher osmotic pressure.
  • Hypotonic solutions have no osmotic pressure.

    • What is the main solute in plasma that largely determines the effective circulating volume (ECF)?

  • Potassium
  • Chloride
  • Sodium (correct)
  • Magnesium

    • Which of the following is responsible for the high extracellular sodium concentration and low extracellular potassium concentration?

  • Aldosterone
  • Angiotensin II
  • Na/K-ATPase pumps (correct)
  • ADH

    • What is the term used to describe a solution that has equal osmotic pressure compared to human plasma?

    <p>Isotonic</p> Signup and view all the answers

    Which of the following hormones is released in response to atrial distension due to fluid overload?

    <p>Natriuretic peptide</p> Signup and view all the answers

    Which of the following is responsible for determining blood volume largely through sodium balance?

    <p>Aldosterone</p> Signup and view all the answers

    Which of the following is a common cause of fluid loss in the body?

    <p>Medications</p> Signup and view all the answers

    Which of the following lab values may indicate volume depletion?

    <p>BUN:SCr ratio &gt; 20:1</p> Signup and view all the answers

    Which of the following is a clinical presentation of volume depletion?

    <p>Orthostatic hypotension</p> Signup and view all the answers

    Which of the following IV fluids is most appropriate for hypovolemia?

    <p>0.9% Sodium Chloride (Normal Saline)</p> Signup and view all the answers

    Which of the following IV fluids provides more intravascular volume expansion than D5W?

    <p>0.9% Sodium Chloride (Normal Saline)</p> Signup and view all the answers

    Which of the following IV fluids is less useful in intravascular volume resuscitation than Normal Saline?

    <p>5% Dextrose (D5W)</p> Signup and view all the answers

    Which of the following IV fluid combinations is NOT recommended for hypovolemic patients?

    <p>22% Sodium Chloride (¼ NS)</p> Signup and view all the answers

    Which of the following IV fluid combinations is NOT recommended for hyperglycemic patients?

    <p>5% Dextrose and 0.9% Sodium Chloride (D5NS)</p> Signup and view all the answers

    Which IV fluid contains other electrolytes in concentrations to mimic plasma?

    <p>Plasma-Lyte</p> Signup and view all the answers

    Which IV fluid is more efficient than normal saline at expanding intravascular volume?

    <p>Albumin 5%</p> Signup and view all the answers

    Which IV fluid should be avoided in patients requiring fluid resuscitation?

    <p>Albumin 25%</p> Signup and view all the answers

    Which IV fluid is associated with an increased risk of mortality and acute kidney injury?

    <p>HetaStarch</p> Signup and view all the answers

    Which medication is a calcium-based phosphate binder used to control hyperphosphatemia in patients with chronic kidney disease (CKD)?

    <p>Calcium Acetate</p> Signup and view all the answers

    Which medication is NOT used to shift potassium into cells as a treatment for severe hyperkalemia?

    <p>Sodium Polystyrene Sulfonate</p> Signup and view all the answers

    Which electrolyte imbalance is commonly associated with hypokalemia and hypocalcemia?

    <p>Hypomagnesemia</p> Signup and view all the answers

    Which medication is used to treat hypophosphatemia in symptomatic patients or patients with a phosphate level below 1.9 mg/dL?

    <p>Potassium Phosphate</p> Signup and view all the answers

    Which electrolyte imbalance is typically controlled with phosphate binders, diet changes, and dialysis in patients with chronic kidney disease (CKD)?

    <p>Hyperphosphatemia</p> Signup and view all the answers

    Which medication is used to treat severe hyperkalemia by preventing arrhythmias associated with hyperkalemia?

    <p>Calcium Gluconate</p> Signup and view all the answers

    Which of the following is NOT a cause of hypovolemic hyponatremia?

    <p>SIADH</p> Signup and view all the answers

    What is the dosing of Tolvaptan (Samsca) for euvolemic/hypervolemic hyponatremia maintenance?

    <p>15 mg PO daily while hospitalized</p> Signup and view all the answers

    What is the dosing of Conivaptan (Vaprisol) for euvolemic/hypervolemic hyponatremia IV treatment?

    <p>20 mg loading dose over 30 minutes, then continuous infusion of 20 mg over 24 hours for 2-4 days</p> Signup and view all the answers

    What is the goal for hypertonic saline treatment of severe or symptomatic hyponatremia?

    <p>Quick but small and controlled rise in Na by 0.75-1.0 mEq/hr to a goal of 120 mEq/L</p> Signup and view all the answers

    What is the recommended initial dosing of potassium replacement for moderate hypokalemia?

    <p>20 mEq</p> Signup and view all the answers

    What is the maximum change in serum sodium that should be targeted during hypertonic saline treatment?

    <p>10-12 mEq/L</p> Signup and view all the answers

    Which of the following is responsible for maintaining high extracellular sodium concentration and low extracellular potassium concentration?

    <p>Na/K-ATPase pumps</p> Signup and view all the answers

    Which of the following is a characteristic of hypertonic solutions?

    <p>They have higher osmotic pressure</p> Signup and view all the answers

    Which hormone is released in response to atrial distension due to fluid overload?

    <p>Natriuretic peptide</p> Signup and view all the answers

    Which of the following is a characteristic of hypotonic solutions?

    <p>They have lower osmotic pressure</p> Signup and view all the answers

    Which of the following hormones is responsible for determining blood volume largely through sodium balance?

    <p>Aldosterone</p> Signup and view all the answers

    Which of the following is a characteristic of isotonic solutions?

    <p>They have equal osmotic pressure</p> Signup and view all the answers

    Which of the following lab values may indicate volume depletion?

    <p>BUN:SCr ratio &gt; 20:1</p> Signup and view all the answers

    Which of the following is a clinical presentation of volume depletion?

    <p>All of the above</p> Signup and view all the answers

    Which medication is used to treat severe hyperkalemia by preventing arrhythmias associated with hyperkalemia?

    <p>Calcium gluconate</p> Signup and view all the answers

    Which IV fluid is more efficient than normal saline at expanding intravascular volume?

    <p>Hypertonic saline</p> Signup and view all the answers

    Which of the following IV fluids is associated with an increased risk of mortality and acute kidney injury?

    <p>Normal saline</p> Signup and view all the answers

    Which of the following is a common cause of fluid loss in the body?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is the most appropriate treatment for severe hyperkalemia to prevent arrhythmias associated with hyperkalemia?

    <p>Insulin Regular 10 units IVP x1</p> Signup and view all the answers

    Which of the following medications should be avoided in patients with gastrointestinal (GI) motility disorders when treating hyperkalemia?

    <p>Sodium Zirconium Cyclosilicate (Lokelma)</p> Signup and view all the answers

    Which of the following is the most appropriate treatment for hypomagnesemia in symptomatic patients?

    <p>Magnesium sulfate IV</p> Signup and view all the answers

    Which of the following electrolyte imbalances is commonly associated with hypokalemia and hypocalcemia?

    <p>Hypophosphatemia</p> Signup and view all the answers

    Which of the following is the most accurate statement about hypotonic solutions?

    <p>Hypotonic solutions have a lower osmotic pressure compared to human plasma</p> Signup and view all the answers

    Which of the following IV fluids is most appropriate for hypovolemia?

    <p>Lactated Ringer's</p> Signup and view all the answers

    Which of the following is a treatment option for euvolemic or hypervolemic hyponatremia refractory to fluid restriction?

    <p>Conivaptan (Vaprisol)</p> Signup and view all the answers

    Which of the following IV fluid combinations is NOT recommended for hypernatremic patients?

    <p>22% Sodium Chloride (¼ NS)</p> Signup and view all the answers

    What is the dosing of Conivaptan (Vaprisol) for euvolemic/hypervolemic hyponatremia IV treatment?

    <p>20mg loading dose over 30 minutes, then continuous infusion of 20mg over 24 hours for 2-4 days</p> Signup and view all the answers

    Which of the following IV fluids is NOT commonly used in patients with diabetes or post-op and L&D patients?

    <p>Lactated Ringers</p> Signup and view all the answers

    What is the goal for hypertonic saline treatment of severe or symptomatic hyponatremia?

    <p>Increase serum sodium by 4-6 mEq/L in any 24-hour period</p> Signup and view all the answers

    Which of the following IV fluids is associated with the risk of dilutional coagulopathy?

    <p>5% Dextrose and 0.9% Sodium Chloride (D5NS)</p> Signup and view all the answers

    Which of the following is NOT a cause of hypovolemic hyponatremia?

    <p>Syndrome of inappropriate antidiuretic hormone secretion (SIADH)</p> Signup and view all the answers

    Which of the following IV fluids is NOT recommended for patients requiring fluid resuscitation?

    <p>Lactated Ringers</p> Signup and view all the answers

    Which of the following is a common cause of fluid loss in the body?

    <p>Diarrhea</p> Signup and view all the answers

    Which of the following IV fluids provides calories for dehydrated patients?

    <p>5% Dextrose and 0.9% Sodium Chloride (D5NS)</p> Signup and view all the answers

    What is the main solute in plasma that largely determines the effective circulating volume (ECF)?

    <p>Sodium</p> Signup and view all the answers

    Which of the following IV fluids contains calcium, potassium, and lactate in concentrations to mimic plasma?

    <p>Lactated Ringers</p> Signup and view all the answers

    Which of the following is NOT a cause of third-spacing fluid loss?

    <p>Dehydration</p> Signup and view all the answers

    Which of the following is a potential consequence of third-spacing fluid loss?

    <p>Hypovolemia</p> Signup and view all the answers

    Which of the following is NOT a characteristic of third-spacing fluid loss?

    <p>Fluids can easily return to where they should be</p> Signup and view all the answers

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