Fluids and Electrolytes Imbalances

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Questions and Answers

What is the typical percentage of total body water for men and women?

50% for men, 60% for women

55% for men, 45% for women

50% for both men and women

60% for men, 50% for women (correct)

Hypertonic saline is used primarily to treat dehydration.

False

What is the primary characteristic that differentiates hypertonic solutions from hypotonic solutions?

Hypertonic solutions have a higher osmolarity than plasma, while hypotonic solutions have a lower osmolarity.

A patient with an electrolyte imbalance often requires a treatment plan that includes __________.

pharmacologic interventions Signup and view all the answers

Match the following intravenous fluids with their classification:

Normal Saline = Isotonic solution 5% Dextrose in Water = Isotonic solution 0.45% Saline = Hypotonic solution 3% Saline = Hypertonic solution Signup and view all the answers

Which of the following conditions may benefit from the redistribution of fluid?

Ascites Signup and view all the answers

Hydroxyethyl starch is safe for use in all critically ill patients without any risks.

False Signup and view all the answers

What is one sign or symptom of intravascular volume depletion?

Tachycardia Signup and view all the answers

Intravascular fluid depletion can occur due to _______.

shock Signup and view all the answers

What is the recommended fluid therapy approach for patients requiring fluid resuscitation?

Isotonic solutions Signup and view all the answers

Match the following fluid therapy terms with their definitions:

Fluid resuscitation = Replacement of blood volume due to loss Maintenance fluid = Fluid needed to maintain normal physiological function Osmolarity = Concentration of solute particles in a solution Osmolality = Concentration of solute particles per kilogram of solvent Signup and view all the answers

An increased BUN/SCr ratio greater than 20:1 indicates healthy kidney function.

False Signup and view all the answers

What is the potential effect of using hyper oncotic solutions in fluid resuscitation?

Dehydration due to fluid shifts Signup and view all the answers

What is the primary risk associated with the rapid lowering of sodium levels?

Cerebral edema and herniation Signup and view all the answers

Sterile water can be safely administered intravenously.

False Signup and view all the answers

What osmolarity should intravenous fluids avoid being lower than?

150 mOsm/L Signup and view all the answers

Hypotonic fluids can cause cell __________ and potentially lead to patient death.

hemolysis Signup and view all the answers

Which of the following is considered a hypotonic intravenous fluid?

0.45% sodium chloride Signup and view all the answers

Match the following saline concentrations with their osmolarity:

3% saline = 954 mOsm/L 7.5% saline = 2393 mOsm/L 23.4% saline = 7462 mOsm/L 0.45% saline = 200 mOsm/L Signup and view all the answers

Hypotonic saline can be used for a patient with hypernatremia.

True Signup and view all the answers

What clinical condition can result from administering hypotonic intravenous fluids?

cerebral edema Signup and view all the answers

Study Notes

Fluid Management

Total body water (TBW) is approximately 50% of body weight in women and 60% in men; influenced by muscle and fat composition.
A 70 kg healthy adult has about 42 liters of total fluid.
Management of fluid involves either resuscitation for intravascular depletion or maintenance to support ongoing needs.

Intravascular Volume Depletion

Signs and symptoms appear when at least 15% (750 mL) of blood volume is lost.
Symptoms include tachycardia (HR > 100 beats/min), hypotension (SBP < 80 mm Hg), dry mucous membranes, decreased skin turgor, reduced urine output (0.5 mL/kg/hr), increased BUN/SCr ratio (>20:1), and dizziness.

Hypertonic Saline

Common concentrations include 3% (954 mOsm/L), 7.5% (2393 mOsm/L), and 23.4% (7462 mOsm/L).
Hypertonic saline can rapidly reduce cerebral edema but carries risks of cellular dehydration and fluid overload.

Hypotonic Intravenous Fluids

Hypotonic fluids include 0.225% (quarter normal saline) and 0.45% (half normal saline) sodium chloride.
Administration of hypotonic fluids can lead to cell hemolysis and potentially death; osmolarity should not be less than 150 mOsm/L.
Sterile water must never be given intravenously.

Risks and Monitoring for Fluids

Close monitoring is crucial when using hypertonic or hypotonic saline to mitigate risk of complications.
Hypertonic solutions should be avoided in patients needing fluid resuscitation due to risks of dehydration as fluid shifts from intravascular to interstitial space.
Hydroxyethyl starch and dextran are associated with coagulopathy and acute kidney injury, potentially increasing mortality in critically ill patients.

Electrolyte Imbalances

Assessing electrolyte abnormalities is necessary to formulate appropriate treatment plans tailored to individual patient symptoms and signs.
Proper management of imbalances helps maintain physiological homeostasis and prevent serious complications.

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Description

This quiz explores the appropriate intravenous fluid regimens and the monitoring parameters necessary for patients with electrolyte imbalances. Analyze different types of saline solutions and their roles, risks, and therapeutic guidelines for effective usage. Additionally, assess electrolyte abnormalities and recommend suitable pharmacological interventions.