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

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

<p>Aldosterone (D)</p> Signup and view all the answers

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

<p>Medications (C)</p> Signup and view all the answers

Which of the following lab values may indicate volume depletion?

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

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

<p>Orthostatic hypotension (D)</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) (D)</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) (A)</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) (B)</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) (C)</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) (C)</p> Signup and view all the answers

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

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

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

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

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

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

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

<p>HetaStarch (D)</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 (C)</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 (A)</p> Signup and view all the answers

Which electrolyte imbalance is commonly associated with hypokalemia and hypocalcemia?

<p>Hypomagnesemia (B)</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 (A)</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 (A)</p> Signup and view all the answers

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

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

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

<p>SIADH (A)</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 (B)</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 (A)</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 (C)</p> Signup and view all the answers

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

<p>20 mEq (D)</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 (D)</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 (A)</p> Signup and view all the answers

Which of the following is a characteristic of hypertonic solutions?

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

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

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

Which of the following is a characteristic of hypotonic solutions?

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

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

<p>Aldosterone (A)</p> Signup and view all the answers

Which of the following is a characteristic of isotonic solutions?

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

Which of the following lab values may indicate volume depletion?

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

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

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

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

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

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

<p>Hypertonic saline (D)</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 (A)</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 (D)</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 (A)</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) (C)</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 (C)</p> Signup and view all the answers

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

<p>Hypophosphatemia (B)</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 (D)</p> Signup and view all the answers

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

<p>Lactated Ringer's (A)</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) (B)</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) (A)</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 (C)</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 (D)</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 (D)</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) (A)</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) (D)</p> Signup and view all the answers

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

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

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

<p>Diarrhea (D)</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) (A)</p> Signup and view all the answers

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

<p>Sodium (C)</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 (D)</p> Signup and view all the answers

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

<p>Dehydration (B)</p> Signup and view all the answers

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

<p>Hypovolemia (A)</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 (D)</p> Signup and view all the answers

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