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Questions and Answers
What is the most common electrolyte disturbance due to fluid loss
What is the most common electrolyte disturbance due to fluid loss
- Hyperkalemia
- Hypokalemia
- Hyponatremia (correct)
- Hypernatremia
What is the most common cause of volume loss
What is the most common cause of volume loss
- Diuretics
- Cerebral edema
- Vomiting (correct)
- Diarrhea (correct)
Other causes of volume loss are
Other causes of volume loss are
- Diuretics (correct)
- Renal disease (correct)
- Addison's disease (correct)
- Cerebral edema (correct)
Clinical signs of hyponatremia
Clinical signs of hyponatremia
Changes in potassium are particularly serious because of the clinical signs that can be seen, for example:
Changes in potassium are particularly serious because of the clinical signs that can be seen, for example:
Serum levels begin to _____ when k+ is driven into the cells
Serum levels begin to _____ when k+ is driven into the cells
Serum potassium will decrease only after a considerable loss of total body k+ loss, when serum potassium concentration is _____.
Serum potassium will decrease only after a considerable loss of total body k+ loss, when serum potassium concentration is _____.
Clinical signs of hypokalemia
Clinical signs of hypokalemia
Regarding abnormal serum concentrations of K+, which one is most commonly seen
Regarding abnormal serum concentrations of K+, which one is most commonly seen
Common causes of hypokalemia
Common causes of hypokalemia
Less commonly encountered abnormal serum concentration of K+ is
Less commonly encountered abnormal serum concentration of K+ is
Causes of hyperkalemia
Causes of hyperkalemia
K+ is normally excreted by the kidneys. Acidosis -> K+ being driven out of the cell which can cause which of the following
K+ is normally excreted by the kidneys. Acidosis -> K+ being driven out of the cell which can cause which of the following
Match the electrolyte with its primary function
Match the electrolyte with its primary function
Match the electrolyte to its primary function
Match the electrolyte to its primary function
Match
Match
What is the cell membrane and what is its function
What is the cell membrane and what is its function
The pumping of ____ against its concentration gradient is used for transmitting electrical signals within nerve cells
The pumping of ____ against its concentration gradient is used for transmitting electrical signals within nerve cells
Na+/K+ pump, generate action potentials that are responsible for
Na+/K+ pump, generate action potentials that are responsible for
Osmoreceptors in the hypothalamus detect an increase in plasma concentration which stimulates thirst and the release of _____
Osmoreceptors in the hypothalamus detect an increase in plasma concentration which stimulates thirst and the release of _____
Causes the reabsorption of water
Causes the reabsorption of water
Match Renal hypoperfusion
Match Renal hypoperfusion
Fluid losses happen
Fluid losses happen
What is dehydration
What is dehydration
Indications for use of fluid therapy (7)
Indications for use of fluid therapy (7)
Assessment of fluid and electrolyte imbalance involves what 3 things
Assessment of fluid and electrolyte imbalance involves what 3 things
Match the estimates of dehydration with the clinical signs
Match the estimates of dehydration with the clinical signs
A pound is a
A pound is a
Fluid therapy can play a vital role in the stabilization and recovery of an ill patient. It is used in clinical medicine to: (5)
Fluid therapy can play a vital role in the stabilization and recovery of an ill patient. It is used in clinical medicine to: (5)
Which of the following is accurate of crystalloids
Which of the following is accurate of crystalloids
Colloids contain molecules that can cross cell membranes and enter all fluid compartments
Colloids contain molecules that can cross cell membranes and enter all fluid compartments
Colloids remain in the intravascular space longer because the pressure is greater than in the tissue
Colloids remain in the intravascular space longer because the pressure is greater than in the tissue
Hetastarch can reduce the amount of crystalloids needed for volume resuscitation by 60-100%
Hetastarch can reduce the amount of crystalloids needed for volume resuscitation by 60-100%
Colloid properties remain active for approximately 24-48 hours.
Colloid properties remain active for approximately 24-48 hours.
Adverse effects of colloids
Adverse effects of colloids
First choice for resuscitation
First choice for resuscitation
Commonly used for rehydration and maintenance needs
Commonly used for rehydration and maintenance needs
Lower osmotic pressure relative, which causes fluid shift into the cells, causing swelling of the cells
Lower osmotic pressure relative, which causes fluid shift into the cells, causing swelling of the cells
When dextrose is metabolized it results in a hypotonic solution
When dextrose is metabolized it results in a hypotonic solution
Similar osmotic pressure to the fluids of plasma and cell, the solutions evenly distribute in the extravascular space when given IV
Similar osmotic pressure to the fluids of plasma and cell, the solutions evenly distribute in the extravascular space when given IV
50% of isotonic fluid will remain in the intravascular space of the ECF after one hour
50% of isotonic fluid will remain in the intravascular space of the ECF after one hour
Which of the following is accurate of isotonic crystalloids
Which of the following is accurate of isotonic crystalloids
Most common example of an isotonic crystalloid
Most common example of an isotonic crystalloid
Do not use LRS while giving a blood transfusion because the fluids containing calcium may overcome the anticoagulant properties of citrate, resulting in coagulation of the blood
Do not use LRS while giving a blood transfusion because the fluids containing calcium may overcome the anticoagulant properties of citrate, resulting in coagulation of the blood
Have higher osmotic pressure which causes movement of water out of the cell
Have higher osmotic pressure which causes movement of water out of the cell
Which of the following are accurate of hypertonic crystalloids
Which of the following are accurate of hypertonic crystalloids
If using hypertonic solutions one must use caution and be vigilant of hypernatremia or increased bleeding
If using hypertonic solutions one must use caution and be vigilant of hypernatremia or increased bleeding
Which of the following can occur if hypertonic solutions are given too quickly
Which of the following can occur if hypertonic solutions are given too quickly
Example of hypertonic solutions
Example of hypertonic solutions
For transfusions, solutions such as 5% dextrose are hypotonic and may induce hemolysis
For transfusions, solutions such as 5% dextrose are hypotonic and may induce hemolysis
Which of the following is an example of colloid solutions
Which of the following is an example of colloid solutions
Which of the following are examples of blood products
Which of the following are examples of blood products
Maintenance solutions are used to replace fluid and/or electrolyte deficits
Maintenance solutions are used to replace fluid and/or electrolyte deficits
Which of the following is an example of replacement solutions
Which of the following is an example of replacement solutions
Maintenance solutions are used to maintain hydration and electrolyte levels within the body
Maintenance solutions are used to maintain hydration and electrolyte levels within the body
It is rare that maintenance solutions contain dextrose
It is rare that maintenance solutions contain dextrose
Which of the following is an example of a maintenance solution
Which of the following is an example of a maintenance solution
Potassium (K+) is necessary for the maintenance of several body functions most notably electrical potential in muscles and nerves
Potassium (K+) is necessary for the maintenance of several body functions most notably electrical potential in muscles and nerves
Maximum rate of K+
Maximum rate of K+
Volume of fluid and amount of electrolytes needed normally in a 24hr period is
Volume of fluid and amount of electrolytes needed normally in a 24hr period is
Dehydration correction comes with 3 requirements, #1 is the volume of fluid needed to ______ the patient
Dehydration correction comes with 3 requirements, #1 is the volume of fluid needed to ______ the patient
Dehydration correction comes with 3 requirements, #2 is the volume of fluid needed for ______ requirements
Dehydration correction comes with 3 requirements, #2 is the volume of fluid needed for ______ requirements
Dehydration correction comes with 3 requirements, #3 is the volume of fluid needed to correct __________
Dehydration correction comes with 3 requirements, #3 is the volume of fluid needed to correct __________
Routes for fluid administration
Routes for fluid administration
What are SubQ fluids used for
What are SubQ fluids used for
When administering SubQ fluids the areas where the limbs join the trunk should be used
When administering SubQ fluids the areas where the limbs join the trunk should be used
Do not give 5% dextrose SQ because it will cause necrosis
Do not give 5% dextrose SQ because it will cause necrosis
How long does it usually take for SubQ fluids to be absorbed
How long does it usually take for SubQ fluids to be absorbed
Subcutaneous fluid administration cannot be used in animals that
Subcutaneous fluid administration cannot be used in animals that
Most common sites of IV catheter placement
Most common sites of IV catheter placement
Rate of fluid flow through the catheter is controlled by which of the following
Rate of fluid flow through the catheter is controlled by which of the following
How often should a catheter be flushed if its not being used
How often should a catheter be flushed if its not being used
Complications of IV catheterization include
Complications of IV catheterization include
What to monitor during fluid therapy
What to monitor during fluid therapy
Signs of fluid overload
Signs of fluid overload
Neonatal fluid replacement includes
Neonatal fluid replacement includes
Fluid therapy in clinical situations - acute
Fluid therapy in clinical situations - acute
Fluid therapy in clinical situations - chronic
Fluid therapy in clinical situations - chronic
A number of diseases can affect the bodies ability to stay in equilibrium. Fluid is used:
A number of diseases can affect the bodies ability to stay in equilibrium. Fluid is used:
Clinical syndrome in which the peripheral blood flow is inadequate to return sufficient blood to the heart for normal function
Clinical syndrome in which the peripheral blood flow is inadequate to return sufficient blood to the heart for normal function
What is the main treatment for all types of shock
What is the main treatment for all types of shock
Hypoproteinemia is when
Hypoproteinemia is when
When is it best to use colloids
When is it best to use colloids
Assists the body in eliminating substances that can be excreted by the kidneys (one word)
Assists the body in eliminating substances that can be excreted by the kidneys (one word)
Which of the following is an indication for the use of diuresis
Which of the following is an indication for the use of diuresis
Which of the following is accurate of IV fluids during anesthesia
Which of the following is accurate of IV fluids during anesthesia
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Study Notes
Electrolyte Disturbances
- Hyponatremia is the most common electrolyte disturbance due to fluid loss.
- Volume depletion is the most common cause of fluid loss.
- Other causes of volume loss:
- Gastrointestinal: vomiting, diarrhea, malabsorption
- Renal: diuretics, diabetes insipidus
- Skin: sweating, burns
- Third spacing: ascites, pleural effusion
- Clinical signs of hyponatremia:
- Headache
- Nausea and vomiting
- Confusion
- Lethargy
- Seizures
- Coma
Potassium Disturbances
- Changes in potassium are particularly serious because of the clinical signs that can be seen.
- Serum levels begin to decrease when K+ is driven into the cells.
- Serum potassium will decrease only after a considerable loss of total body K+ loss, when serum potassium concentration is below 2.5 mEq/L.
- Clinical signs of hypokalemia:
- Muscle weakness
- Fatigue
- Constipation
- Arrhythmias
- Respiratory distress
- Hypokalemia is the most commonly seen abnormal serum concentration of K+.
- Common causes of hypokalemia:
- Diuretics
- Vomiting
- Diarrhea
- Renal insufficiency
- Hyperkalemia is a less commonly encountered abnormal serum concentration of K+.
- Causes of hyperkalemia:
- Renal failure
- Acidosis
- Medications
- Trauma
- Rhabdomyolysis
- K+ is normally excreted by the kidneys.
- Acidosis -> K+ being driven out of the cell which can cause hyperkalemia.
Electrolyte Functions
- Sodium (Na+) : Primary function is to maintain fluid balance and regulate blood pressure.
- Potassium (K+) : Primary function is to maintain nerve and muscle function.
- Calcium (Ca2+) : Primary function is to strengthen bones and teeth and regulate muscle contraction.
- Magnesium (Mg2+) : Primary function is to support nerve and muscle function and regulate blood sugar.
- Chloride (Cl-) : Primary function is to maintain fluid balance and acid-base balance.
- Phosphorous (P) : Primary function is to build strong bones and teeth and produce energy in the body.
Cell Membrane & Action Potentials
- The cell membrane is a thin, flexible barrier that surrounds all cells and controls what enters and exits the cell.
- The pumping of Na+ against its concentration gradient is used for transmitting electrical signals within nerve cells.
- Na+/K+ pump, generate action potentials that are responsible for nerve impulse transmission.
Osmoregulation
- Osmoreceptors in the hypothalamus detect an increase in plasma concentration which stimulates thirst and the release of antidiuretic hormone (ADH).
- Antidiuretic hormone (ADH) causes the reabsorption of water in the kidneys.
Renal Hypoperfusion & Fluid Losses
- Renal hypoperfusion refers to decreased blood flow to the kidneys.
- Fluid losses can occur through various routes, including:
- Gi tract: vomiting, diarrhea
- Skin: sweating, burns
- Dehydration is a condition in which the body lacks sufficient water.
- Clinical signs of dehydration:
- Dry mouth
- Thirst
- Decreased urine output
- Fatigue
- Dizziness
- Sunken eyes
Fluid Therapy
- Indications for use of fluid therapy:
- Dehydration
- Volume depletion
- Electrolyte imbalance
- Shock
- Trauma
- Surgery
- Assessment of fluid and electrolyte imbalance involves:
- History and physical examination
- Laboratory tests
- Imaging studies
Dehydration Estimates
-
Estimates of dehydration with clinical signs:
- 1-2% dehydration: Mild thirst
- 3-5% dehydration: Moderate thirst, sunken eyes
- 6-8% dehydration: Severe thirst, sunken eyes, lethargy
- 9-12% dehydration: Critical dehydration, shock
-
A pound is a unit of weight, approximately equal to 0.45 kilograms.
Fluis Therapy Clinical Uses
- Fluid therapy can play a vital role in the stabilization and recovery of an ill patient.
- It is used in clinical medicine to:
- Replace lost fluids and electrolytes
- Maintain fluid balance
- Improve blood pressure
- Support organ function
- Deliver medications
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