FCCN level 1 Exam Study Guide with

FCCN level 1 Exam Study Guide with Complete Solutions minimum urine output for adult - Correct Answer 0.5mL/kg/hr ADH (antidiuretic hormone) - Correct Answer - water retainer

• vasoconstrictor (also called Vasopressin)
• produced by hypothalamus
• store and released from posterior pituitary

ADH pathway - Correct Answer - 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) - Correct Answer - 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 - Correct Answer - forces fluids and solutes through the capillary wall and into the tissue spaces colloid osmotic pressure - Correct Answer - pulling force of albumin in the intravascular spaces 1 / 3

• pull fluid into vasculature

maintenance fluid therapy - Correct Answer - replaces normal ongoing losses of water and electrolytes (urine, sweat, respiration, stool) replacement therapy - Correct Answer - corrects any existing water and or electrolyte deficits isotonic fluids - Correct Answer - tonicity equal to plasma in the body

• no fluid shifts because the solutions are equally concentrated
• LR
• NS
• D5W

hypotonic fluids - Correct Answer - 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 - Correct Answer - 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 - Correct Answer - pull fluid into bloodstream 2 / 3

Albumin

• 5% is osmotically equal to plasma
• 25% draws 4 times the normal volume into the circulation

blood - Correct Answer - not a risk free fluid replacement

• this is liquid transplant

third spacing - Correct Answer - 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 - Correct Answer - no it will aggreggate the platelets hyponatremia - Correct Answer - less than 135 -145

• weakness
• abdominal cramping/leg cramps
• dizzy
• change in LOC
• seizures

different ways to treat hyponatremia - Correct Answer - hypovolemic (give IV fluid)

• euvolemic (fluid restriction)
• / 3