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Flashcards in fluids Deck (83)
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1

ii. The normal osmolarity of serum is about

290

2

iii. At any temperature above absolute zero, electrolytes will

diffuse throughout a solution to achieve uniform osmolarity.

3

iv. In biological systems, fluid compartments

(e.g., the extracellular and intracellular compartments) are separated from each other by semi-permeable membranes

4

If you have two solutions of different concentrations that are separated by a semi-permeable membrane, the tendency of those solutions to equalize their concentration by moving water across the membrane is called the _________

osmotic pressure gradient.

5

vi. The movement of water is called

osmosis

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vii. The effect osmolarity has on this process is called

tonicity

7

_________are fluids that are close to the normal serum osmolarity of 290 mOsm/L.

a. Isotonic fluids are

8

_______fluids are fluids that have a lower osmolarity than serum.

b. Hypotonic fluids

9

_______are fluids that have a higher osmolarity than serum.

Hypertonic fluids are fluids that have a higher osmolarity than serum.

10

small solutes; can move a little freely with this type of fluid

crystalloid

11

big solutes; like blood wit this type of fluid

colloid
protein
plasma

12

nml Na

a. Normal value: between 135-145 mEq/L.

Critical for fluid balance, nerve function, muscle function.

13

c. The #1 extracellular electrolyte.

Na

14

hypotonic crystalloid

D5W

of 1/2 NS (.45%)

15

Because sodium is so closely linked to serum osmolarity, sodium derangement leads to changes of the body’s osmotic pressure gradient.

This causes cells to ______ in hyponatremia

or ______ in hypernatermia


this phenomena is worse here

cells to swell (in hyponatremia), or to shrink (in hypernatremia).


g. While this phenomenon affects all cells, it has an outsized effect on brain cells.

16

hyponatremia is defined as

this is usually due to

Hyponatremia (Na <135)

May not see clinical signs until Na+ is <125.

17

sxs of hyponatermia

Symptoms include lethargy disorientation, muscle cramps, anorexia, hiccups, nausea/vomiting, seizures.

Patient may have weakness, agitation, stupor, hyperreflexia, orthostatic hypotension, delirium, coma, death

18

Extrarenal losses

losing fluids faster than they can replenish it

19

Treatment of hyponatermia is to

correct the water overload (or deficit) and/or raise the sodium. (hypertonic sollution 3%)

vii. Find the underlying cause.
viii. Fluid restriction and monitoring.
ix. May give hypertonic saline for severe symptoms

20

Careful of rapid correction of hyponatremia because

Careful of rapid correction—can cause central pontine myelinolysis (i.e., brain damage).

21

list the colloids

blood
albumin
dextran
FFP
PRBCs

22

dextran

glucose polysaccharide

23

hypernatremia is defined as and caused by

i. Hypernatremia (Na >145)

(1) inadequate fluid intake;
(2) excess water loss;
(3) iatrogenic (in the hospitalized patient).

24

FFP needed for

pts that would be bleeding a lot
(coagulants)

25

PRBC

trauma -usually whole blood but not always

26

how to make decisions about fluids

do you need to make a decision right away

27

unstable pt start with

2 L NS

responder or non responder

28

10% of body weight loss in an adult is what stage of dehydration

severe

29

mild and moderate dehydration looks like

6%
8%

30

replenishing fluids in a pt with CHF or renal failure

really need to be slow with fluids