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54 terms

Body Fluid Dynamics

STUDY
PLAY
sensible fluids
urine, sweat, feces, vomit, iatrogenic
insensible fluids
respiration, skin
decreased fluid needs
heart/renal failure, fluid overload
Electrolytes in ECF
Na, Cl, Ca
Electrolytes in ICF
K, Mg
Osmolality
/kg
Osmolarity
/L
tonicity
osmotic pressure
normal range for serum osmolality
280-295 (mOsm/kg)
Aldosterone
Na retention (what causes this)
ADH
H2O retention (what causes this)
ANP
H2O, Na excretion (what causes this)
increases ADH
high Na, Osm, hypovolemia, aldosterone, nicotine, morphine (what these do to ADH)
decreases ADH
hypervolemia, dec. osm., ethanol (what these do to ADH)
increases aldosterone
decreased BP, blood volume, Na, increased K (what these do to aldosterone)
decreases aldosterone
ANP (what is does to aldosterone)
increases ANP
volume expansion
isotonic solutions
.9% NS, LR
hypotonic solutions
1/2 NS, D5W
hypertonic solutions
D5W 1/2 NS, D5W 1/4 NS, colloids
free water IV fluids
D5W 1/4 NS, D5W 1/2 NS, 1/2 NS, D5W
NOT free water IV fluids
.9% NS, LR
C/I in liver/renal failure
LR (C/I)
not useful for IV meds
LR (IV meds?)
good for hyperglycemia
LR (diabetes?)
euvolemia
ins match outs
ins
liquids, food, cellular respiration
iso-osmotic
water balance (Na regulated)
from hypothalamus
ADH (where from?)
from adrenal gland
Aldosterone (where from?)
from atria
ANP (where from?)
___causes tachycardia
volume depletion causes ___
___increase stroke volume, catecholamine release, increased PVR
fluid retention causes___
hypovolemia vs dehydration
hypovolemia includes loss of electrolytes
Lisinopril
ACEinh. (vasodilation)
Spironolactone
aldosterone antagonist (excrete Na, retain K)
DDAVP
vasopressin (agonist, increases BP)
Aliskerin
renin inh (vasodilation)
used in px with hypernatremia
hypotonic fluids (.45 NS, D5W)
when to use hypertonic fluids
dehydrated states (what type of fluids to use)
which type distributes freely throughout ECF
crystalloids
which type keeps in intravascular space
(where it goes)colloids
useful in sodium restricted px
D5W (useful in who)
IV medication diluents
D5W, NS (IV meds?)
useful in shock, resuscitation, metabolic, acidosis, head injuries
NS (useful when)
caution in heart failure, edema, hypernatremia
NS (caution when)
expands intravascular fluid volume
LR, NS, Glucose mixes (what it does to intravascular fluid volume)
NS in diabetics?
sure
useful in water replacement, sodium/chlorid depletion, gastric fluid losses
1/2 NS (useful for_)
caution for CV collapse due to hypotonicity
1/2 NS (caution)
colloids
albumin, hetastarch, dextran
plasma expander
also called colloids
colloid with greater potential for anticoagulant effect
dextran
high alert IV's
>0,9% NS