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29 Cards in this Set
- Front
- Back
Calculate the Ideal Body Weight
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Male IBW=50 kg + (2.3 x inches over 60”)
Female IBW= 45 kg + (2.3 x inches over 60”) |
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Calculate the Dosing Body Weight
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DBW = IBW + 0.4(wt –IBW)
–Use if dry weight is 130% or more of IBW |
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Calculate the Nutritional Body Weight
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NBW = IBW + 0.25(wt –IBW)
–Use if dry weight is 130% or more of IBW |
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How do body fluids relate to weight?
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~ 60% of body weight in adults
Intracellular -2/3 (40% of wt) •Extracellular -1/3 (20% of wt) 1/4 extracellular fluid is interstitial 3/4 Intravascular (plasma) |
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What is the percentage of body water for males, females and neonates?
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•Adults
–Men: 50-60% of body wt –Women: 45-55% of body wt •Neonates/Infants –75-90% of body wt |
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What are some sensible water losses?
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•Sensible
–Urination (400-1500 mL) –Defecation (100-200 mL) –Wounds (varies) _____________________ 1 –1.5 L / day |
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What are some insensible water losses
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•Insensible
–Skin (350-400 mL) –Lungs (350-400 mL) ____________________ 1 L / day |
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What are some additional reasons for water loss?
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•NG output
•Vomiting •Diarrhea •Burns •Fistulas •Drains •Bleeding •Large wounds |
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What organs regulate body fluid losses?
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skin, lungs, kidneys
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What types of movement affect solutes, fluids, and both solutes and fluids
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solutes: diffusion, active transport
fluids: osmosis(electrolytes), oncotic pressure (proteins) Both: capillary filtration (BV) |
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What hormones regulate volume?
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Anti-diuretic hormone (ADH), Renin-angiotensin-aldosterone system (RAAS), Atrial Naturetic Peptide (ANP)
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What are MIVF fluid requirements?
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30-40ml/kg/day
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Acidic fluid loss comes from...
Basic fluid loss comes from... |
NG output
pancreas and diarrhea |
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What is the most common MIVF?
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D5W + 1/2 NS + 20mEq/L KCl
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What is the osmolar value of hypotonic, isotonic, and hypertonic solutions?
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Hypotonic < 275 mOsm/L
Isotonic 275-295 mOsm/L Hypertonic >295 mOsm/L |
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Name the 4 types of crystalloid fluids and what they are used for.
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NS replacement/resuscitation [154 mEq/L] Na+ and Cl-
½ NS maintenance LR replacement/resuscitation D5W replacement only |
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What are colloid fluids used for?
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Albumin (5%, 25%), hetastarch,plasmanate, blood
used as plasma expanders, volume expansion, inc plasma oncotic pressure |
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What parameters should be monitored for fluid loss?
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I/O, UOP, BUN/SCr ratio, weight, vitals, CVP
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What lab values signify dehydration?
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BUN/Scr > 20 = dehydration
CVP < 8 = dehydration Increased HR can signal dehydration |
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What is the most common electrolyte disturbance in hospitalized pts?
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hyponatremia (Na<135 mEq/L)
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What causes hypertonic hyponatremia?
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increased glucose
use a corrected Na value |
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What causes isotonic pseudohyponatremia?
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inc. lipids/ proteins inc. plasma volume and dilutes out Na
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What causes hypervolemic hypotonic hyponatremia?
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edema from kidney failure, cirrhosis, HF
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What causes isovolemic hypotonic hyponatremia?
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SIADH
Water intake exceeds capacity of the kidneys to excrete water –Urine Osm generally > 100 mOsm/kg –Urine Na+ generally > 20-30 mEq/L |
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What causes hypovolemic hypotonic hyponatremia?
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dehydration
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What is the normal Na level?
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135-145mEq/L
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How do you calculate osmolality? What is the normal range?
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osmolality=(2xNa)+(BUN/2.8)+(Glu/18)
Normal range: 280-295mOsm/L |
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Calculate the Osmolar gap.
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Osmolar gap= measured Osm/L - calculated Osm/L
>15= osmolar gap Means the presence of unidentified particles |
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Corrected Serum Na
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Na (serum) + 1.6(BG -100/100)
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