Flashcards in fluids Deck (83)
ii. The normal osmolarity of serum is about
iii. At any temperature above absolute zero, electrolytes will
diffuse throughout a solution to achieve uniform osmolarity.
iv. In biological systems, fluid compartments
(e.g., the extracellular and intracellular compartments) are separated from each other by semi-permeable membranes
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.
vi. The movement of water is called
vii. The effect osmolarity has on this process is called
_________are fluids that are close to the normal serum osmolarity of 290 mOsm/L.
a. Isotonic fluids are
_______fluids are fluids that have a lower osmolarity than serum.
b. Hypotonic fluids
_______are fluids that have a higher osmolarity than serum.
Hypertonic fluids are fluids that have a higher osmolarity than serum.
small solutes; can move a little freely with this type of fluid
big solutes; like blood wit this type of fluid
a. Normal value: between 135-145 mEq/L.
Critical for fluid balance, nerve function, muscle function.
c. The #1 extracellular electrolyte.
of 1/2 NS (.45%)
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.
hyponatremia is defined as
this is usually due to
Hyponatremia (Na <135)
May not see clinical signs until Na+ is <125.
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
losing fluids faster than they can replenish it
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
Careful of rapid correction of hyponatremia because
Careful of rapid correction—can cause central pontine myelinolysis (i.e., brain damage).
list the colloids
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).
FFP needed for
pts that would be bleeding a lot
trauma -usually whole blood but not always
how to make decisions about fluids
do you need to make a decision right away
unstable pt start with
2 L NS
responder or non responder
10% of body weight loss in an adult is what stage of dehydration
mild and moderate dehydration looks like