Isotonic Fluids Overview
40 Questions
13 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary use of 0.9% NaCl (Normal Saline)?

  • Treatment of severe dehydration
  • Routine maintenance solution
  • Only solution administered with blood products (correct)
  • Management of chronic renal failure

    • Which fluid is contraindicated in patients with hyperglycemia during fluid resuscitation?

  • 0.45% NaCl (half strength saline)
  • D5W - 5% Dextrose in water (correct)
  • Lactated Ringer’s Solution
  • 3% NaCl (hypertonic saline)

    • What is a possible complication of administering 3% NaCl too quickly?

  • Fluid overload (correct)
  • Peripheral circulatory collapse
  • Hypokalemia
  • Acute renal failure

    • Which solution provides both sodium and chloride but is contraindicated in patients with ph > 7.5?

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

    What is the normal range for serum phosphorus (PO4)?

    <p>2.5-4.5 mg/L</p> Signup and view all the answers

    In which fluid compartment is the majority of an average adult's body fluid located?

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

    What condition is best treated with 0.45% NaCl?

    <p>Hypotonic dehydration</p> Signup and view all the answers

    Which of the following is a symptom of hypochloremia?

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

    What is the osmolarity of D10W - 10% Dextrose in water?

    <p>1011 mOsm/L</p> Signup and view all the answers

    What dietary restriction is recommended for management of hyperphosphatemia?

    <p>Limit dairy products</p> Signup and view all the answers

    Which of the following solutions is not suitable for treating fluid loss due to gastric fluids?

    <p>D5W</p> Signup and view all the answers

    Which hormone increases renal excretion of phosphorus?

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

    In the case of hypophosphatemia, which clinical feature is least likely to be present?

    <p>Soft tissue calcification</p> Signup and view all the answers

    Which of the following is a potential cause of hypochloremia?

    <p>Severe vomiting</p> Signup and view all the answers

    What is the main nursing management intervention for hypophosphatemia?

    <p>Administer oral or IV phosphorus correction</p> Signup and view all the answers

    Which of the following best describes the effect when potassium levels are excessively high?

    <p>Cardiac arrest</p> Signup and view all the answers

    What effect does PTH have on calcium in the body?

    <p>It increases calcium resorption from bones.</p> Signup and view all the answers

    Which of the following is a symptom of hypercalcemia?

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

    What is the definition of hypocalcemia?

    <p>Calcium level less than 8.5 mg/dL</p> Signup and view all the answers

    Which treatment is appropriate for managing hypercalcemia?

    <p>IV phosphate therapy</p> Signup and view all the answers

    What does calcitonin do regarding calcium levels?

    <p>Promotes urinary excretion of calcium.</p> Signup and view all the answers

    Which of the following could lead to hypocalcemia?

    <p>Inflammation of the pancreas</p> Signup and view all the answers

    Which of the following is a function of magnesium?

    <p>It aids in intracellular ATP production.</p> Signup and view all the answers

    What is the normal range for magnesium levels in the body?

    <p>1.3-2.1 mEq/L</p> Signup and view all the answers

    What indicates a state of metabolic alkalosis?

    <p>High plasma Bicarbonate</p> Signup and view all the answers

    Which of the following conditions is associated with metabolic acidosis?

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

    What is the normal range for arterial pH?

    <p>7.35 - 7.45</p> Signup and view all the answers

    What does a PaCO2 level greater than 42 mmHg indicate?

    <p>Respiratory acidosis</p> Signup and view all the answers

    Which symptom is most likely associated with respiratory alkalosis?

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

    Which condition is NOT typically associated with metabolic acidosis?

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

    Which intervention is appropriate for treating respiratory acidosis?

    <p>Improving ventilation</p> Signup and view all the answers

    Which measurement would indicate uncompensated metabolic acidosis?

    <p>Decreased pH with normal bicarbonate</p> Signup and view all the answers

    What serum magnesium level indicates hypermagnesemia?

    <p>Greater than 2.1 mEq/L</p> Signup and view all the answers

    Which of the following symptoms is not associated with hypermagnesemia?

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

    What is a common cause of hypomagnesemia?

    <p>Alcohol withdrawal</p> Signup and view all the answers

    Which of the following management strategies is appropriate for treating hypermagnesemia?

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

    What is the normal range for serum chloride?

    <p>95-108 mEq/L</p> Signup and view all the answers

    Which of the following choices correlates with hyperchloremia?

    <p>Loss of bicarbonate ions</p> Signup and view all the answers

    Which clinical finding would indicate the need for seizure precautions in a patient with hypomagnesemia?

    <p>Prolonged PR and QT intervals</p> Signup and view all the answers

    How does chloride function as a chemical buffer?

    <p>By participating in the chloride shift</p> Signup and view all the answers

    Study Notes

    Isotonic Fluids

    • 0.9% NaCl (Normal Saline/NSS): Contains 154 mEq/L Na and Cl, osmolarity of 308 mOsm/L. Used for hypovolemia, shock, DKA, metabolic alkalosis, hypercalcemia, and mild Na deficiency. Caution in renal failure, heart failure, and edema.
    • D5W (5% Dextrose in Water): Provides 170 calories and free water, osmolarity of 252 mOsm/L. Indicated for hypernatremia and dehydration. Contraindicated post-op due to increased ADH, and in conditions leading to fluid overload or hyperglycemia.
    • Lactated Ringer’s Solution: Contains Na 130 mEq/L, K 4 mEq/L, Ca 3 mEq/L, Cl 109 mEq/L, with osmolarity of 273 mOsm/L. Used for hypovolemia, burns, and fluid losses. Caution in pH > 7.5 and lactic acidosis.

    Hypotonic Fluids

    • 0.45% NaCl (Half Strength Saline): Provides Na, Cl, and free water (77 mEq/L Na and Cl), osmolarity of 154 mOsm/L. Used for hypertonic dehydration and gastric fluid loss. Contraindicated with third space shifts and increased ICP.

    Hypertonic Fluids

    • 3% NaCl (Hypertonic Saline): Contains Na 513 mEq/L, Cl 513 mEq/L, osmolarity of 1026 mOsm/L. Used in critical situations to treat hyponatremia and for ICF excess removal. Requires cautious administration.
    • D10W (10% Dextrose in Water): Hypertonic with osmolarity of 505 mOsm/L.
    • D50W (50% Dextrose in Water): High osmolarity of 1700 mOsm/L.
    • D5NS (5% Dextrose & 0.9% NaCl): Hypertonic, osmolarity 559 mOsm/L.

    Body Fluid Compartments

    • Adults are approximately 60% water, predominantly in the intracellular compartment.

    Regulation of Calcium

    • GIT: Absorbs calcium with Vitamin D.
    • Kidneys: Filter calcium, reabsorbing it in the tubules.
    • PTH (Parathyroid Hormone): Increases serum calcium by stimulating bone resorption, intestinal absorption, and renal reabsorption.
    • Calcitonin: Lowers serum calcium by promoting bone deposition and urinary excretion.

    Calcium Disorders

    • Hypercalcemia: Serum calcium > 10.5 mg/dL. Etiology includes excess supplements and malignancy. Symptoms include nausea, weakness, and lethargy. Management involves hydration, diuretics, and dietary restrictions.
    • Hypocalcemia: Serum calcium < 8.5 mg/dL. Causes include vitamin D deficiency and thyroid surgery. Symptoms include tetany and seizures. Management includes calcium and vitamin D supplementation.

    Magnesium

    • Normal range: 1.3-2.1 mEq/L. Functions include ATP production, protein synthesis, and neuromuscular transmission.

    Magnesium Disorders

    • Hypermagnesemia: Serum magnesium > 2.1 mEq/L, often due to renal failure. Symptoms include lethargy and hypotension. Management includes discontinuing magnesium and dialysis.
    • Hypomagnesemia: Serum magnesium < 1.5 mEq/L, causes range from alcoholism to GIT losses. Symptoms include muscle weakness and ECG changes. Treatment includes dietary intake and IV magnesium.

    Anions

    • Major anions include Chloride (Cl), Phosphates (PO4), and Bicarbonates (HCO3).

    Chloride Disorders

    • Hyperchloremia: Serum Cl > 108 mEq/L, often linked to sodium excess. Symptoms include lethargy and hypertension. Management includes lactated ringers and monitoring.
    • Hypochloremia: Serum Cl < 96 mEq/L. Symptoms include muscle cramps and dysrhythmias. Management includes saline solutions and diet high in Cl-rich foods.

    Phosphate Disorders

    • Hyperphosphatemia: Serum PO4 > 4.5 mg/dL; symptoms include muscle weakness and fatigue. Management includes dietary restrictions and dialysis.
    • Hypophosphatemia: Serum PO4 < 2.5 mg/dL; symptoms include irritability and weakness. Treatment involves phosphorus replacement and dietary adjustment.

    Acid-Base Disturbances

    • Acidosis: pH < 7.35, characterized by increased H+ ions.
    • Alkalosis: pH > 7.45, characterized by decreased H+ ions.

    Metabolic Acidosis

    • Features low pH, increased H ions, and reduced bicarbonate. Common causes are diarrhea and renal insufficiency. Symptoms include confusion and hypotension. Treatment can include bicarbonate administration and hemodialysis.

    Metabolic Alkalosis

    • High pH, decreased H ions, increased bicarbonate, often due to vomiting. Symptoms include muscle twitching and dizziness.

    Respiratory Acidosis

    • Low pH and elevated carbon dioxide levels, typically from pulmonary issues. Management focuses on improving ventilation.

    Respiratory Alkalosis

    • High pH and low carbon dioxide, often due to anxiety. Treatment may involve calming techniques.

    Arterial Blood Gas Analysis

    • Normal values: pH 7.35–7.45, PaCO2 35–45 mmHg, HCO3 22-26 mEq/L, O2 saturation 93-98%. Assess pH for acidosis or alkalosis and determine the primary cause of disturbance.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    This quiz covers the key aspects of isotonic fluids, focusing on 0.9% NaCl and D5W solutions. It discusses their composition, indications for use, and contraindications in clinical settings. Ideal for students learning about fluid therapy in medical courses.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser