Water Water Everywhere
What are the three basic fluid compartments of the body?
What is intracellular, interstitial, and plasma (intravascular)?
This is an example of a colloid.
What are plasma expanders such as albumin or blood?
Plasma expanders have LARGE molecules like proteins that can't cross the capillary wall
This is an example of an isotonic fluid.
What is 0.9% NS or Lactated Ringer's?
These are risks of giving multiple liters of 0.9% Normal Saline.
What is AKI, hyperchloremia, plain ol' volume overload?
NS contains high levels of chloride compared to human plasma- can cause excessive acidity in the blood and renal vasoconstriction
What is a better term to use instead of 'dehydration'?
What is total body water loss?
Loss from all three compartments. In contrast, hypovolemia is intravascular (plasma) volume depletion, from something like hemorrhage, diarrhea, vomiting, diuretic use, ect
What is the most physiologic IV fluid?
What is LR?
A solution with a concentration/osmolality similar to our plasma is called what?
What is isotonic?
Which solute is primarily responsible for the osmotic pressure within the intracellular compartment?
What is K+?
K+ is the major cation inside the cell, while Na+ is the major cation in the extracellular fluid
By percentage of mass, you are _____% water?
What is 60%?
Give an example of a plasma expander?
What is albumin, packed red blood cells, or fresh frozen plasma?
What is the tonicity of 1/2NS (0.45% NS)?
What is hypotonic?
Why can't you give sterile water in an IV to a patient?
What is it would cause massive hemolysis due to an osmotic imbalance...RBCs swell and burst, resulting in severe electrolyte imbalance, acute kidney failure, and death.
Plain water is SUPER hypotonic compared with plasma.
Most of your total body water is in this compartment
What is intracellular? (67%)
Interstitial (25%)
Plasma (8%)
The IV fluid that would be used in the setting of intravascular loss, such as days of vomiting/diarrhea or bleeding?
What is isotonic?
But also give blood if from blood loss :)
Name a hypotonic IV fluid you could order.
What is D5W or 0.45% NS?
Define osmotic pressure.
What is the pressure required to prevent the flow of solvent across a semipermeable membrane into a higher-concentration solution?
Hydrostatic pressure... how hard water is pushing (force) on whatever it's touching
The least amount of the total body water lies in this compartment.
What is the plasma?
8% TBW
What is 3% saline, Albumin 25%, D10W, ect
Anything with higher concentration of solutes than plasma
What is the primary physiological effect of administering a 3% hypertonic saline solution?
What is it draws water out of the intracellular space into the extracellular space?
Has a high osmolality creates a gradient which pulls water from cells to balance the concentration.
When should you avoid use of LR?
What is when a patient has metabolic alkalosis? (or has liver disease)
Treat underlying cause. Assuming the patient is hypovolemic and needs resus, could use 0.9%NS!