Acid-Base Balance and CO2 Relationship

Questions and Answers

What is the primary reason for not using a particular fluid commonly in patients with hepatic dysfunction?

Short duration and no balanced electrolytes (correct)

It leads to hypernatremia in all patients

It causes prolonged vasoconstriction

It is ineffective in resuscitating non-responders

Why can't pure water be injected directly in fluid therapy?

It causes immediate circulatory overload

It leads to lysis of erythrocytes due to osmosis (correct)

It results in significant electrolyte imbalance

It increases blood osmolarity excessively

What is the recommended maintenance fluid requirement during peri-anesthetic care?

5-10 mL/kg/hr

1-2 mL/kg/hr

10-15 mL/kg/hr

2-5 mL/kg/hr (correct)

Which of the following is NOT a contraindication for specific fluid therapy use?

Mild dehydration Signup and view all the answers

What effect does bolus fluid administration have on blood pressure?

Decreases blood pressure through vasodilation Signup and view all the answers

What percentage of 5% Dextrose (D5W) remains in the intravascular fluid (IVF) after metabolism?

5% Signup and view all the answers

Which of the following complications could arise from inappropriate fluid therapy?

Electrolyte imbalances and respiratory distress Signup and view all the answers

What can be inferred about the use of lactate-containing solutions in hepatic patients?

They are contraindicated due to potential metabolic acidosis Signup and view all the answers

What is the primary factor that affects bicarbonate levels in the body?

Partial pressure of CO2 Signup and view all the answers

In the context of electrolyte imbalances, what condition is most likely to occur in diabetic ketoacidosis?

Hyperkalemia Signup and view all the answers

What is the effect of administering medetomidine before surgery in patients with hyperadrenocorticism?

Increases responsiveness to catecholamines Signup and view all the answers

What is the main risk associated with rapid administration of crystalloids during fluid therapy?

Fluid overload Signup and view all the answers

Which ion is crucial for stabilizing the myocardium in cases of hyperkalemia?

Calcium (Ca2+) Signup and view all the answers

Which of the following patients would benefit most from a preoperative assessment of hydration status?

A patient with obesity and muscle weakness Signup and view all the answers

What is the primary role of COP (colloid osmotic pressure) within IV fluids?

Retaining water within vessels Signup and view all the answers

What does increasing the osmolarity of an IV solution primarily affect?

Fluid balance between compartments Signup and view all the answers

In managing fluid therapy complications, what can be a consequence of administering high concentrations of sodium?

Acute kidney injury Signup and view all the answers

What is the primary reason for using short-acting drugs in fluid therapy for patients with high stress responses?

To avoid cumulative effects Signup and view all the answers

Which condition is characterized by a decrease in cardiac output and left atrial enlargement due to reduced filling capacity?

Hypertrophic cardiomyopathy Signup and view all the answers

What physiological factor allows substances to pass through small pores in normal circumstances?

High blood pressure (BP) Signup and view all the answers

What is often a common outcome of hypoventilation in patients with hypothyroidism?

Arrhythmias due to low oxygen levels Signup and view all the answers

What should be avoided in patients requiring stabilization from massive vasoconstriction during surgery?

Acepromazine Signup and view all the answers

What is the primary effect of administering hypotonic fluids on intracellular fluid (ICF)?

Increase the volume of ICF Signup and view all the answers

What happens to osmolarity when isotonic solutions are added to the extracellular fluid (ECF)?

Osmolarity remains unchanged, with no water movement Signup and view all the answers

How does lactate in LRS contribute to maintaining acid-base balance?

Acts as a buffer by consuming H+ and generating bicarbonate Signup and view all the answers

What is a potential complication of administering normal saline?

Hypoproteinemia leading to reduced oncotic pressure Signup and view all the answers

What is the primary indication for using crystalloid solutions during fluid therapy?

To increase blood volume in cases of hemorrhage Signup and view all the answers

What distinguishes hypertonic saline from other intravenous solutions?

It lowers systemic vascular resistance (SVR) Signup and view all the answers

What effect does administering NaCl have in high volumes regarding blood chemistry?

Leads to a drop in plasma pH due to increased chloride Signup and view all the answers

What is a common side effect associated with high volume infusion of normal saline?

Pulmonary edema due to dilutional effects Signup and view all the answers

What characteristic of Plasma-Lyte A makes it advantageous in fluid therapy?

It provides acetate as a source of energy for cells Signup and view all the answers

Why are electrolytes essential in IV therapy?

They facilitate fluid movement between intracellular and extracellular spaces Signup and view all the answers

What occurs when the osmolarities of intravenous fluid (IVF) and interstitial fluid (ISF) are not equal?

Fluid shifts toward the area of lower osmolarity Signup and view all the answers

How does lactate serve a function in fluid resuscitation?

It is metabolized to bicarbonate, counteracting acidosis Signup and view all the answers

What physiological change occurs when water moves from ICF to ECF in response to hypertonicity?

Contraction of cells leading to hypernatremia Signup and view all the answers

Study Notes

Acid-Base Balance and Hormonal Impacts

HCO3- is correlated with CO2 levels: When CO2 increases, HCO3- also increases, indicating alkalosis when above 24 mmol/L.
In acute respiratory disorders, ΔCO2 of 10 correlates with ΔHCO3- of 1 after 12 hours.
Hyperadrenocorticism (Cushing's) leads to elevated blood glucose levels, causing osmotic diuresis, hypovolemia, and dehydration.
Be cautious with nerve blocks to prevent damage or trauma; care for patients with increased responsiveness to catecholamines which may signify hyperthyroidism.
Diabetic ketoacidosis results in ketone production, causing electrolyte imbalances and risk of dehydration and hypovolemia.

Cardiovascular Conditions and Management

Mitral regurgitation involves endocardiosis of the left atrioventricular (LAV) valve; treatment focuses on reducing afterload and improving contractility.
For mitral regurgitation, avoid α-2 agonists as they can cause vasoconstriction.
Hypoadrenocorticism (Addison's) can cause dehydration, azotemia, and hypovolemia; patients require stabilization before surgery.
Dilated cardiomyopathy (DCM) is characterized by weakened heart contractility, with management similar to that of mitral regurgitation.
Hypertrophic cardiomyopathy (HCM) leads to decreased cardiac output and enlarged left atrium; tachycardia should be avoided, and α-2 agonists can be beneficial in lowering heart rate.

Fluid Therapy and Osmolarity Concepts

Osmoles are solutes that dissociate in solution, affecting osmolarity.
Tonicity compares osmolarity between two solutions across cell membranes, critical for understanding fluid shifts.
Hypotonic fluids expand ICF; isotonic fluids maintain osmolarity, while hypertonic fluids raise osmolarity.
Isotonic solutions like LRS contain electrolytes resembling plasma, providing an alkaline effect during metabolism.

Types of Fluid Solutions

Normal saline can induce complications like dilutional effects and pulmonary edema, especially in hypochloremic alkalosis.
Acetated polyionic solutions like Plasma-lyte A are suitable for hepatic-compromised patients due to liver's ability to metabolize lactate.
5% Dextrose (D5W) converts rapidly to water; however, only 5% remains in the intravascular fluid.

Anesthetic Considerations

Ensure pre-anesthetic management to limit stress and monitor blood pressure and heart rate.
Avoid NSAIDs with glucocorticoids during surgery due to their synergistic effects on blood pressure.
Evaluate patients with suspected cardiac illness carefully, utilizing history and diagnostics for better management.
Certain medications, like ketamine, are advised against during instances of tachycardia and renal metabolism concerns.

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Description

This quiz focuses on the intricate relationship between bicarbonate (HCO3) and carbon dioxide (CO2) levels in the body, especially in the context of respiratory disorders. It covers concepts such as alkalosis and the base excess measurement, highlighting crucial changes in HCO3 levels relative to CO2 fluctuations.