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Flashcards

Fluids and Electrolytes - Absite

Jennifer Huber Surgery - Absite Review English 81 cards

Cards in this deck (81)

  1. 1Fraction of total body weight that is water2/3 - in men
    more in infants
    less in women
  2. 22/3 of water weight is located where?intracellular - mostly muscle
  3. 31/3 of water weight is located where?extracellular
    2/3 in interstitial
    1/3 in plasma
  4. 4MCC of volume overloadiatrogenic
  5. 50.9% Normal Saline is composed of:Na 154
    Cl 154
  6. 63% Normal Saline componentsNa 513
    Cl 513
  7. 7Lactated Ringers CompositionNa 130, K 4, Ca 2.7, Cl 109, Lactate 28
    Lactate is converted to HCO3 in body
  8. 8Equation for plasma osmolarity & normal range(2 x Na) + (Glucose/18) + (BUN/2.8)
    Normal: 280-295
  9. 9Maintenance Fluids4cc/kg/hr for 1st 10kg
    2cc/kg/hr for 2nd 10kg
    1cc/kg/hr for each kg after
  10. 10Which fluid to chose during OR time and first 24hours afterLactated Ringers
  11. 11Which Fluid to switch to after 24hours of initial fluid post-op?D5 1/2NS + 20mEq KCl
    (dextrose stim insulin release, prevents protein catabolism)
  12. 12Fluid Losses in open abdominal operations0.5-1L/hr
  13. 13Best indicator for adequate fluid replacementUrine Output
  14. 14Rate for adequate U/O0.5cc/kg/hr
  15. 15insensible fluid losses10cc/kg/ady
    75% through skin
    25% respiratory
  16. 16Fluid of choice to resuscitate Sweat Loss (Marathon Runner)Normal Saline
  17. 17Fluid of Choice for Patients with Gastric Fluid Loss (gastric outlet obstruction)Normal Saline
  18. 18Fluid of Choice for pancreas, biliary, or small bowel fluid lossLactated Ringers
  19. 19Fluid of choice for massive diarrheaLactated Ringers
  20. 20Ratio for GI fluid loss replacement1:1
  21. 21Fluid Secretion of Stomach1-2L/day
  22. 22Fluid Secretion of Biliary System500-1,000mL/day
  23. 23Fluid Secretion of Pancreas500-1,000mL/day
  24. 24Fluid Secretion of Duodenum500-1,000mL/day
  25. 25Electrolyte losses in sweathypotonic
    Na conc 35-65
  26. 26Electrolyte losses in salivapotassium, highest concentration in body
  27. 27electrolyte losses from stomachH+, Cl-
  28. 28Electrolyte losses from pancreasHCO3-
  29. 29Electrolyte losses from BileHCO3-
  30. 30Electrolyte losses from small intestineHCO3-, K+
  31. 31Electrolyte losses from Large IntestineK+
  32. 32Normal Body K+ requirement0.5-1mEq/kg/day
  33. 33Normal Body Na Requirement1-2mEq/kg/day
  34. 34HyperK treatmentcalcium gluconate
    Sodium Bicarb, 10U insulin 1amp 50% dextrose, kayexalate, lasix, albuterol
    dialysis if refractory
  35. 35cause of pseudo-hyperKhemolysis of blood
  36. 36First Line treatment for hypoNaWater Restrict
  37. 37What can cause pseudohypoNa?hyperglycemia and hyperlipidemia
  38. 38What is Diabetes Insipidusdecrease ADH, increased urine output, decrease urine specific gravity, increase serum Na and Osm
    occurs with EtOH and head injury
  39. 39Treatment for Diabetes InsipidusChronic: free water
    Acute: DDAVP
  40. 40What is SIADH?Increased ADH
    decreased U/O, conc urine, HypoNa,
    hypo-osm
  41. 41Treatment of Acute SIADHConivaptan, Tolvaptan
  42. 42Treatment of Chronic SIADHFluid Restrict and Diuresis
  43. 43Symptoms of Hypercalcemiausually is calcium >13
    nausea, vomiting, lethargy, HoTN, upset stomach, constipation
  44. 44MC malignant cause of hypercalcemiaBreast Cancer
  45. 45MCC and MC benign cause of hypercalcemiaHyperparathyroidism
  46. 46MCC of hypercalcemic crisisundiagnosed hyperparathyroidism with stressor (ex. surgery)
  47. 47Treatment for hypercalcemiaNS at 200-300cc/hr and Lasix
    if malignant cause: calcitonin, alendronic acid (bisphosphonates), dialysis
  48. 48Fluids NOT to give to a hypercalcemic patientNo Lactated Ringers of Thiazide Diuretics
  49. 49Symptoms of HypocalcemiaCa <8 or ionized Ca <4
    perioral numbness/tingling
    hyperreflexia, Chvostek's sign (facial nerve)
    Trousseau's Sign (carpopedal spasm), prolonged QT
  50. 50Protein Adjustment for Calciumfor every 1g decrease in protein,
    add 0.8 to Calcium
  51. 51MCC for hypocalcemiaprevious thyroidectomy injuring a parathyroid gland
  52. 52Symptoms of hypermagnesemiaLETHARGIC
    lethargy, EKG changes (prolonged PR/QT), Tendon reflexes diminished, HoTN, Arrhythmias (bradycardia), Respiratory arrest, GI issues (N/V), impair breathing (2/2 muscle weakness), Cardiac Arrest
  53. 53Treatment of HypermagnesemiaCalcium gluconate
  54. 54Hypomagnesemia SignsTorsades de pointes
    hyperreflexia
    Nausea
    Irritability, Confusion, Seizures
  55. 55Causes of Hypomagnesemiamassive diuresis, chronic TPN without replacement of Magnesium, ETOH abuse
  56. 56Treatment of HyperphosphatemiaSevelamer (Renagel)
    Low Phosphate Diet (avoid dairy)
    Dialysis
  57. 57What is hypophosphatemia associated with?Refeeding Syndrome
    PO4 shift from extracellular to intracellular
  58. 58Treatment for HypophosphatemiaPotassium phosphate
  59. 59How to measure Anion Gap?Na - (HCO3 +Cl)
  60. 60High Anion Gap Acidosis CausesMUDPILES
    methanol, uremia, DKA, par-aldehydes, isoniazid, lactic acidosis, ethylene glycol, salicylates
  61. 61Causes of Normal AG Metabolic AcidosisLoss of Na/HCO3 (ileostomies, small bowel fistulas, lactulose)
    rapid infusion of fluids w/o HCO3
    primary hypoparathyroid
    mafenide acetate
  62. 62Treatment of Metabolic Acidosistreat underlying cause,
    keep pH >7.2 w/ bicarbonate
  63. 63How Nasogastric Suction affects electrolyteshypochloremic, hypokalemic,
    metabolic alkalosis
  64. 64Respiratory Acidosis pH, CO2, HCO3pH low
    CO2 high
    HCO3 high
  65. 65Respiratory Alkalosis pH, CO2, HCO3pH high
    CO2 low
    HCO3 low
  66. 66Metabolic Acidosis pH, CO2, HCO3pH low
    CO2 low
    HCO3 low
  67. 67Metabolic Alkalosis pH, CO2, HCO3pH high
    CO2 high
    HCO3 high
  68. 68Length of time for respiratory compensation for acidosis/alkalosisCO2 regulation
    takes minutes
  69. 69Length of time for renal compensation for acidosis/alkalosisHCO3 regulation
    hours to days
  70. 70Best test for azotemiaFeNa
  71. 71How to Calculate FeNa(Urine Na/Cr) / (plasmaNa/Cr)
  72. 72PrerenalFeNa <1%
    UNa <20
    BUN/Cr >20
    UrineOsm >500mOsm
  73. 73How much damage does the kidney require before BUN and Cr increase?70% renal mass
  74. 74How Myoglobin affects the Kidneysit converts to ferrihemate in acidic environment which is toxic
    Tx: hydration, alkalizine the urine
  75. 75Effects if Tumor Lysis Syndromerelease of purines and pyrimidines leads to increase PO4, K and uric acid.
    Leads to decrease Ca
    Can increase BUN & Cr from renal damage
  76. 76Risk Factors for developing tumor lysis syndromeleukemias and lymphomas
  77. 77Treatment for Tumor Lysis Syndromehydration (best)
    rasburicase (converts uric acid in allantoin)
    allopurinol (decrease uric acid production)
    diuretics
    alkalinization of urine
  78. 78Vitamin D, areas it becomes active formSkin - UV light converts 7-dehydrocholesterol to cholecalciferol
    goes to LIVER for 25-OH
    then kidney for 1-OH
  79. 79What does active form of Vitamin D do?increases calcium binding protein
    leading to increased intestinal Ca absorption
  80. 80What is Transferrin?transporter of iron
  81. 81What is FerritinStorage form of iron

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Surgery - Absite Review Flashcards on Fluids and Electrolytes - Absite, created by Jennifer Huber on 09/06/2018.
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Jennifer Huber
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