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Emergency Medicine: Fluid Therapy

Instructions:
  • Answer 50 questions in 15 minutes.
  • If you are not ready to take this test, you can study here.
  • Match each statement with the correct term.
  • Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

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. Access to a vascular space when IV is not possible -rapid placement






2. 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)






3. Short duration of volume expansion -transient hypernatremia -reflex bradycardia






4. 0.45% NaCl -D5W -Norm M






5. Lower eyelid






6. Osmolality of ECF decreases - causing fluid to shift from the ECF to the ICF -ICF volume increases -ECF volume decreases - TBW decreases






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






8. Saliva -evaporation at skin -evaporation at the respiratory tract






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






10. The loss of isotonic fluids from the ECF - primarily from the interstitium






11. TBW - ECF -contains transcellular fluids such as peritonial fluid - CSF - pleural fluid - and synovial fluid.






12. Normalization of vital signs -MAP above 65 -urine output about 0.5 ml/kg/hr






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






14. 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.






15. 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






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






17. 300 mosm/L






18. 132 x BW (kg)^0.75






19. Changes in body weight over time.






20. 10 to 20 ml/kg IV bolus






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






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






23. 20 to 25 mmHG






24. Generates osmotic pressure by causing a shift of water across a boundary that is not permeable to the osmotically active particle.






25. 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






26. Primarily in the vascular space - depending on vascular permeability -increases vascualar volume by 1 to 1.5x volume given






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






28. The most abundant positively charged ion in the ECF.






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






30. Resuscitation - to attain sustained vascular expansion - oncotic support during hypoproteinemia






31. No restricted by the endothelium -equilibrate rapidly between the interstitial and vascular spaces -cell membranes restrict movement from interstitial space - into cells bases on osmolality






32. 70 x BW (kg)^0.75






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






34. Plasma proteins -sodium and associated anions






35. Polydispersed complex starch dissolved in 0.9% NaCl -small molecules confer oncotic pressure -large molecule confer duration of action -a synthetic colloid






36. Resuscitation phase: if the animal is in shock -rehydration phase -maintenance phase






37. The loss of intravascular fluid.






38. 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






39. 1/4 from the intravascular space -3/4 from the interstitium






40. Obese animals have increased elasticity -very thin animals have decreased elasticity






41. Expand the intravascular space by 4 to 6 times for a short duration.






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






43. 20% body weight






44. 40% body weight






45. Used in neonates and avian species with limited vascular access.






46. A natural colloid that is not very efficient at raising albumin or COP.






47. Osmolality of the solution is less that blood - causing a net increase in free water.






48. 60% body weight






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






50. 80 to 90 ml/kg IV bolus