IV Fluids

Question 1

Why is Glucose 5% and sodium chloride 0.9% both iso-osmotic with plasma?

Question 2

Whole body fluid balance ?

Answer 2

-Sodium is the major cation in the extracellular space
Extracellular (140mM), Intracellular (5mM)

• The body can be considered to contain 3 compartments plasma, extracellular and intracellular. The plasma compartment contains a semipermeable membrane for albumin and the cell membrane a semipermeable membrane for sodium. Potassium has a high concentration in the intracellular fluid. Water can move across either membrane by osmosis which is the movement of water not the movement of solute which would be diffusion.

Question 3

Where can 0.9% sodium chloride move to ?

Answer 3

Question 4

Where can 5% glucose be distributed to

Answer 4

Whole body

Question 5

What is the route for patients NBL eg for surgery?

Answer 5

Adults
3L IV maintenance fluids per day: 8h bags (2 saline/1 dextrose)

Elderly/very underweight
2L; 12h bags

In addition to sodium and water, adults also require a daily replacement of potassium.

Question 6

In regards to colloid, NACL0.9%, and glucose 5% how much does it increase the circulating volume of blood?

Answer 6

Question 7

Why would you not use Glucose 5% to treat dehydration ?

Answer 7

Only increases circulating volume by 7% because it travels into the intracellular space.

Question 8

Gluocse 5%

Answer 8

Question 9

Hypertonic Glucose - Glucose 10%, 20%, 50% - can be used for what ?

Answer 9

Question 10

Can glucose 5% be used in diabetics?

Answer 10

Can be used - small amount can be metabolised quickly.

This is isotonic, not hypertonic glucose.

This should not be used for treatment of hypoglycemia for this reason.

Question 11

Sodium Chloride 0.9%

Answer 11

• Can be used in maintenance
  -Can be used for dehydration.
• Be careful of hyperchloremia

Question 13

Where can colloids move to ?

Answer 13

Question 14

Which is the major cation (postive ion) i the extracellular space ?

• sodium
• potassium
  -bicarbonate
  -chloride

Answer 14

• Sodium

Question 15

What is the average daily intake of water ?

Answer 15

2.5 L

Question 16

What percentage of the daily intake of sodium is excreted in the urine?

Answer 16

95%

Question 17

What concentration of glucose is iso-osmotic with 0.9% saline

Answer 17

5% glucose

Question 18

What is the normal range for the concentration of chloride in plasma (units in mmol/l)

Answer 18

95-105

Question 19

What percentage of NaCL 0.9% is retained within the vascular space ?

Answer 19

20%

Question 20

What is the major use of intravenous glucose 5%?

Answer 20

To deliver water intravenously

Question 21

What is the concentration of potassium in a 250ml bag of 0.9% saline containing 20mmol of potassium chloride?

Answer 21

80mmol/L

Question 22

The intravenous infusion rate of potassium delivered by a peripheral line should not normally exceed what ?

Answer 22

10mmol/h

Question 23

Which of the following is NOT a symptom used to detect hypovalemia?

• systolic BP greater than 140
• elevated plasma urea above the normal range
• Heart rate greater than 90bpm
• Respiratory rate greater than 20 breaths per min

Answer 23

• Systolic BP greater than 140

Question 24

What percentage of an administered volume of colloid remains in the vascular space ?

Answer 24

80%