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Emergency Medicine: Fluid Therapy

Instructions:
  • Answer 50 questions in 15 minutes.
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  • Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. For every positively charged ion in body fluids - there is a balancing negatively charged ion.






2. 4 ml/kg IV bolus






3. Osmolality of ECF does not change - initiating no fluid shift - between the ECF and ICF -ECF decreases - TBW decreases - and ICF is static






4. 10 to 20 ml/kg IV bolus






5. Sustained volume expansion of the vascular space






6. 70% body weight






7. The loss of intravascular fluid.






8. Practical - with limited equipment required -can be administered on an outpatient basis






9. Osteomyelitis -often only short-lived access






10. Occur at the loss of 30% of blood volume -occur when dehydration reached 10% of body weight






11. Unreliable rate of absorption -cannot be used for resuscitation or replacement of fluids in critically ill patients -hypo- or hypertonic solutions cannot be used due to tissue damage and injury






12. Extracellular water + intracellular water






13. The difference between unmeasured anions and unmeasured cations.






14. Correction of acid-base disorders -rehydration -replacement of ongoing losses -resuscitation






15. Pain and irritation -pressure necrosis -infection






16. A function of daily obligatory solute excretion -based on body surface area rather than body weight






17. Typically an isotonic crystalloid with potassium added - -hypotonic crystalloids for animals with compromised renal - function of in heart failure -






18. Changes in body weight over time.






19. Proportional to the number of non-dissociable (active) ions in solution -not a function of the weight of an ion






20. Extracellular space - with rapid redistribution into the interstitium -only 20 to 30% of the fluids administered remain in the intravascular space after 20 to 30 minutes






21. LRS (lactate) -Plasmalyte (acetate) -Norm R (gluconate) -each provides a bicarbonate precursor






22. Sodium and associated anions






23. 1/4 from the intravascular space -3/4 from the interstitium






24. Replacing a free water deficit (hypernatremia) -during heart or renal disease when the patient has an impaired ability to handle sodium -maintenance fluid therapy (lower Na - high K)






25. Potential for transfusion reactions.






26. Albumin






27. Dextrose allows for an initial match in blood osmolality - but does not act as an effective osmol - as it is rapidly metabolized.






28. 40% body weight






29. A decrease in in capillary oncotic pressure due to protein loss resulting in filtration of fluid into the interstitial fluid.






30. Osmolality of solution is approximately equal to that of blood - replacing water as well as electrolytes.






31. The elasticity of skin depends on hydration status -pull up the skin over the thorax and watch the speed at which - it returns to normal position -also able to assess overhydration






32. Urinary -fecal






33. 20% body weight






34. Lower eyelid






35. All body fluids are iso-osmolar is relation to other body flids despite a different ionic composition.






36. A sunken eyes is associated with reduced volume in the ] - retrobulbar fat -qualitative






37. 60% body weight






38. 40 ml/kg/day






39. The concentration of effective osmoles + the concentration of ineffective osmoles.






40. Maintain the animal in zero fluid balance - with input equaling output.






41. Hypovolemic is the most reponsive -distributive shock -obstructive shock - above the obstruction






42. 132 x BW (kg)^0.75






43. 8% body weight






44. Never use for resuscitation -never bolus; cannot administer rapidly






45. Dose dependent coagulopathy due to dilution of clotting factors and impaired platelet aggregation - especially with hetastarch.






46. Osmolality of solution is greater than that of blood - causing a shift from fluid from the intersitium into the vascular space and rapid vascular volume expansion.






47. Interstitial fluid + blood






48. Resuscitation -anesthetic patients -to treat significant dehydration and ongoing losses -critiacally ill patients






49. Direct vascular access and expansion -rapid administration possible -multiple type of fluids can be used






50. 30% body weight







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