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Fluid Disorders Lecture 2 Volume Depletion Part 2

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alchemist04's version from 2016-06-23 22:00

Section

Question Answer
T or F? When Isotonic Crystalloids is given, it shifts cell tonicity from ICF to ECFFalse, Isotonic Crystalloids does not shift tonicity. Isotonic Crystalloid has tonicity that is similar to that of ICF
T or F? When Hypotonic Crystalloid is given, water shift from ECF into the ICFTrue, water moves into the cell bc
T or F? When Hypertonic Crystalloid is given, water moves ICF to ECFTrue
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Question Answer
Examples of Isotonic Crystalloids (1)(1) NS - Normal Saline (2) Lactated Ringer (3) D5W (5% Dextrose in Water)
Normal Saline composition0.9% of NaCl. Na = 154 mEq and Cl = 154 mEq
Lactated Ringer compositionNa = 130 mEq, Cl = 100 mEq, Lactate = 28 mEq, K = 4 mEq, Ca = 3 mEQ
D5W composition50 g of dextrose (glucose) which when given cells dilevers 1 Litre of water to the cell
T or F? Lactated ringer has similar electrolyte concentration as that of the bloodTrue
T or F? D5W is technically Isotonic in bag, but acts as a hypotonic solution (free water) in the body/cellTrue
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Question Answer
Which fluid therapy is preferred for preoperative fluid administration, fluid resuscitation for shock, hemorrhage, burn, hypotensive or oliguric patients w/ fluid deficiency, patients fluid replacementNS and LR
A patient with hypovolumetric amd hyponatremia is given Lactated Ringer, why is this wrong?LR may cause Lactic acidosis and pH of NS is lower than that of LR
What is the common use of D5W Isotonic Crystalloid?For treatment of Hyperneutremia in pt that are short-term NPO. Use as diluent for piggyback IV medications.
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Question Answer
Hypotonic Crystalloid types(1) Half Normal Saline (0.5% NS or 0.45% NaCl) (2) Quarter NS (1/4 NS or 0.2% NaCl) (3) Sterile water
Half NS Hypotonic Crystalloid composition(1) Na = 77 mEq and Cl = 77 mEq (2) can be considered as 1/2 NS and 1/2 free water
Quarter NS Hypotonic Crystalloid composition(1) Na = 34 mEq and 34 mEq (2) Can be considered as 1/4 Na and 3/4 free water
T or F? Administration of Sterile water by itself could cause cell hemolysis or rapid cell swellingTrue, must add additive b4 admin.
A patient has concomitant hyperneutremia (high salt level that accompanies another health problem), which of the fluid therapy would you give the patient?Hypotonic crystalloid.
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Question Answer
Hypertonic crystalloid types(1) D5NS, D51/2NS, D51/4NS (2) Hypertonic Saline (3% NaCl) (3) Dextrose (10%)
D5NS, D51/2NS, D51/4NS Hypertonic crystalloid composition50 g of dextrose + various amt of Na and Cl
What is the common use of D5NS, D51/2NS, D51/4NS Hypertonic crystalloid?provides some calories with some ECF expansion
3% NaCl hypertonic saline compositionNa = 513 mEq and Cl = 513 mEq
What is the common use of 3% NaCl hypertonic saline?For severe and/or symptomatic hyperneutremia; need to be administered via central line
Dextrose 10% composition100 g of dextrose
What is the common use of 10% dextrose?for prevention of hypoglycemia and as a calorie source
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Question Answer
Colloids are not Crystalloids, what are the composition of Colloids?(1) Protein or (2) Complex sugars which increase Oncotic pressure (3) Albumin, dextran, hetastarch, fresh frozen plasma (FFP)
Albumin composition5% albumin (approximate isotonic), 25% albumin
3 things about Albumin (1)(1) Theoretically more effective than Crystalloids for volume expansion
3 things about Albumin (2)(2) no mortal difference btw albumin and NS when used fluid resuscitation in ICU patients.
3 Things about Albumin (3)(3) Can be used in pt that are refractory to Crystalloid (NS, D5W, Half-normal saline, Quarter NS, Dextrose 10%, 3% NaCl etc)
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Question Answer
Improper use of Albumin includes (1)(1) as nutritional supplementation
Improper use of Albumin includes (2)(2) Hypoalbuminemia
Improper use of Albumin includes (3)(3) fist line of fluid resuscitation
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Question Answer
Limitations of Dextran?(1) Anaphylactic reactions (2) prolonged bleeding times
Limitations of Hetastarch?(1) Hypersensitivity reaction (2) bleeding (3) Renal dysfunction (FDA warning of "Increased Mortality and severe renal injury")
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Question Answer
Fresh Frozen Plasma (FFP) composition(1) protein (2) globulins (3) glucose (4) electrolytes
Fresh Frozen Plasma (FFP) common use (1)(1) Acute blood loss
Fresh Frozen Plasma (FFP) common use (2)(2) Prevent bleeding
Fresh Frozen Plasma (FFP) common use (3)(3) rarely used for the sole purpose of volume expansion
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