Until you can answer me the following, I am not allowing you to cannulate and infuse:
Fluid Balance
• Define the boundaries of each of the three fluid compartments and state the proportional volumes typically found in each
• Define the terms: electrolytes, ions, cations, anions. Give examples of each found in the body, and state their physiological functions. (half page)
• Define the term non-electrolyte and give three examples
• Give a brief explanation of the following electrolyte disorders. Include signs and symptoms that may manifest as a result of these.
o Hyponatremia
o Hypernatremia
o Hypokalemia
o Hyperkalemia
• Explain the initial fluid shift that would occur if the if the patients blood volume was suddenly reduced under Starlings Law.
• Define the following terms and explain the role each process plays in human fluid dynamics.
o Diffusion
o Osmosis
o Active Transport
o Facilitated Diffusion
• Define the following terms
o Shock
o Perfusion
o Inotropic
o Chronotropic
o Pulse Pressure
o Mean arterial pressure (MAP)
• Explain these complications of irreversible shock and how we may pre• vent and help treat them.
o Renal Failure
o Acute Respiratory Distress Syndrome (ARDS)
o Disseminated Intravascular Coagulation (IDC)
• Describe the pathophysiology, common presentation and briefly outline the management of distributive, cardiogenic and hypovolaemic shiock
• Discuss the differences between how children and adults (particularly the aged) maintain and respond to blood pressure changes
• Provide a definition of the peripheral resistance and stroke volume
• What factors about a blood vessel determine its peripheral resistance?
• During exercise stroke volume will increase. How is that achieved?
• Explain why fluid tends to shift from the interstitial to intravascular space in the early stages of shock.
• Blood transports a number of substances around the body. What are those substances and how are they transported in the blood
• Pulse Oxymetry measures the oxygenation of the blood flowing through the capillary beds and peripheral tissues. Explain how this concept works and when the use of pulse oxymetry is not indicated and why?
• Define isotonicity, hypertonicity and hypotonicitiy
List the constituent of various IV fluids and there respective tonicity.
o normal saline
o 0.45% NaCl
o 5% Dextrose
o Hartmanns
Homeostasis Regulation
• Explain the Renin-angiotensin pathway and explain how homeostasis of blood pressure and volume is maintained.
• Describe how the kidneys regulate the excretion of water in urine, and the role of the hormones ADH, and Aldosterone
Acid / Base Balance
• What is the normal pH range of body fluids?
• Define the term buffer system and list the 3 major buffer systems involved in acid / base balance
• Briefly describe the renal and respiratory compensatory mechanisms of acid/base balance
• A person presents with hyperventilation syndrome, classic signs of carpopedal spasm, peri-oral parasthesia. Explain the physiology that results in these signs and symptoms.
Trauma
• Explain the difference between blunt trauma and penetrating trauma, the difference in the types of injuries commonly encountered and their MOI (mechanism of injury) and the difference in the management of shock occuring as a result of each.
• Describe causes of shock, other than hypovolaemia, in trauma patients, and how to recognize and manage them.
o Tension pneumothorax
o Myocardial contusion
o Acute Myocardial Infarction
o Spinal injury
• Explain the shock management of this patient (on your 20min ride to hospital) with this head injury?
o B.P - 80/30
o Pulse – 128
o Resps – 28
o GCS - 13
IV Cannulation and Complications
• Indicate the anatomical location of common cannulation sites
• Discuss and explain factors that influence choice of vein for cannulation
• Intravenous cannulas are colour coded. List the colour, gauge and flow ware of various sized IV cannulas.
• Define ‘aseptic technique’ and explain universal safety measures taken while cannulating.
• Describe and discuss the concept of ‘informed and implied consent’.
• When gaining informed consent. List the information that you would inform the patient. (6234 – P.C 3.4)
• Prior to the administration of I.V fluids to a patient what checks should you perform? (6231 – P.C 4.4)
• State the clinical procedure for administering IV fluids to the shocked patient.
• List the signs and symptoms of the three IV complications below.
o Infiltration
o Phlebitis
o Extravasation
• For the following complications of IV cannulation describe the signs and symptoms and management of each.
o Fluid Overload
o Air Embolism
o Catheter Shear
