FCCN level 1 Exam With Complete Solutions.
minimum urine output for adult
0.5mL/kg/hr
ADH (antidiuretic hormone)
- water retainer
- vasoconstrictor (also called Vasopressin)
- produced by hypothalamus
- store and released from posterior pituitary
ADH pathway
- hypothalamus senses low blood volumed and increased serum osmolality
- signal pituitary to release ADH
- ADH causes kidney to retain water
- water retention increases blood volume and decreases serum osmolality
ANP (atrial natriuretic peptide)
- cardiac hormone stored in atria
- released when atrial pressure increases
*works opposite of RAAS by decreasing BP and reducing intravascular volume
- important diagnostic marker in CHF
hydrostatic pressure
- forces fluids and solutes through the capillary wall and into the tissue spaces
colloid osmotic pressure
- pulling force of albumin in the intravascular spaces
- pull fluid into vasculature
maintenance fluid therapy
- replaces normal ongoing losses of water and electrolytes (urine, sweat, respiration,
stool)
replacement therapy
- corrects any existing water and or electrolyte deficits
isotonic fluids
- tonicity equal to plasma in the body
- no fluid shifts because the solutions are equally concentrated
- LR
- NS
- D5W
hypotonic fluids
- lower concentration of solutes in the vasculature than in the cell
- fluid shifts into the cell to dilute the electrolytes (CELL SWELLS)
, - 0.45NS
hypertonic fluid
- higher concentration of solutes in the vasculature than in the cell
- pulls fluid out of cells and into the vessels (CELL SHRINKS)
- D5 .45NS
- D5NS
- D5LR
- 3%, 7%, 23.4% NaCl
colloids
- pull fluid into bloodstream
Albumin
- 5% is osmotically equal to plasma
- 25% draws 4 times the normal volume into the circulation
blood
- not a risk free fluid replacement
- this is liquid transplant
third spacing
- fluid is not lost from the body but the fluid is not available for use in the intracellular or
extracellular compartments (fluid is in between tissues/cells)
- this patient is intravascularly dry and still needs more fluid
-
can you give platelets through the ranger
- no it will aggreggate the platelets
hyponatremia
- less than 135 -145
- weakness
- abdominal cramping/leg cramps
- dizzy
- change in LOC
- seizures
different ways to treat hyponatremia
- hypovolemic (give IV fluid)
- euvolemic (fluid restriction)
- hypervolemic (diuretic)
severe hyponatremia
- EMERGENCY
- below 115
- give hypertonic saline if patient is symptomatic
minimum urine output for adult
0.5mL/kg/hr
ADH (antidiuretic hormone)
- water retainer
- vasoconstrictor (also called Vasopressin)
- produced by hypothalamus
- store and released from posterior pituitary
ADH pathway
- hypothalamus senses low blood volumed and increased serum osmolality
- signal pituitary to release ADH
- ADH causes kidney to retain water
- water retention increases blood volume and decreases serum osmolality
ANP (atrial natriuretic peptide)
- cardiac hormone stored in atria
- released when atrial pressure increases
*works opposite of RAAS by decreasing BP and reducing intravascular volume
- important diagnostic marker in CHF
hydrostatic pressure
- forces fluids and solutes through the capillary wall and into the tissue spaces
colloid osmotic pressure
- pulling force of albumin in the intravascular spaces
- pull fluid into vasculature
maintenance fluid therapy
- replaces normal ongoing losses of water and electrolytes (urine, sweat, respiration,
stool)
replacement therapy
- corrects any existing water and or electrolyte deficits
isotonic fluids
- tonicity equal to plasma in the body
- no fluid shifts because the solutions are equally concentrated
- LR
- NS
- D5W
hypotonic fluids
- lower concentration of solutes in the vasculature than in the cell
- fluid shifts into the cell to dilute the electrolytes (CELL SWELLS)
, - 0.45NS
hypertonic fluid
- higher concentration of solutes in the vasculature than in the cell
- pulls fluid out of cells and into the vessels (CELL SHRINKS)
- D5 .45NS
- D5NS
- D5LR
- 3%, 7%, 23.4% NaCl
colloids
- pull fluid into bloodstream
Albumin
- 5% is osmotically equal to plasma
- 25% draws 4 times the normal volume into the circulation
blood
- not a risk free fluid replacement
- this is liquid transplant
third spacing
- fluid is not lost from the body but the fluid is not available for use in the intracellular or
extracellular compartments (fluid is in between tissues/cells)
- this patient is intravascularly dry and still needs more fluid
-
can you give platelets through the ranger
- no it will aggreggate the platelets
hyponatremia
- less than 135 -145
- weakness
- abdominal cramping/leg cramps
- dizzy
- change in LOC
- seizures
different ways to treat hyponatremia
- hypovolemic (give IV fluid)
- euvolemic (fluid restriction)
- hypervolemic (diuretic)
severe hyponatremia
- EMERGENCY
- below 115
- give hypertonic saline if patient is symptomatic
