4: IV fluid prescribing Flashcards Preview

Renal Week 1 2017/18 > 4: IV fluid prescribing > Flashcards

Flashcards in 4: IV fluid prescribing Deck (29)
Loading flashcards...
1

Why may patients be given fluids?

Resuscitation in emergencies

Replacement in deficiency (could also be an emergency)

Routine maintenance

2

It is important that people being given IV fluids are ___.

reassessed

3

passive leg raise for indication of fluid level

4

If a patient is hypotensive, how much fluid can you give them in 500ml boluses before you should call for help?

2L

5

If a patient is at risk of heart failure, you should give ___ml boluses of fluid.

250ml

6

look at values for routine maintenance

7

look at table for types of fluid therapy and what to use for each

8

In routine maintenance, your daily fluid requirement depends on your ___.

weight

9

All fluids apart from crystalloids (and colloids) rapidly ___ out of the vascular system.

redistribute

10

Why isn't 0.9% NaCl used for routine maintenance?

Twice the daily Na

11

potassium chloride is almost a controlled drug

12

use hartmann's in dka (contains K) - hypokalaemia, monitor

13

remember for routine maintenance:

need to make up to 2L

and need to be within daily requirements

you can half / double / mix things

14

When are colloid solutions used?

Severe sepsis

revise that lecture

15

large volume ascites paracentesis in liver failure:

evacuated space > loads of fluid drains in after paracentesis

so blood volume goes down, renals not perfused, nothing else perfused

give colloids (hyperoncotic, stays in the vascular system) to avoid this

16

hepatorenal syndrome in liver failure:

kidneys don't work

give colloid fluids

17

blood products which can be given IV:

packed red cells

platelets

fresh frozen plasma (full of antibodies)

cryoprecipitate

18

What can cause hyponatraemia?

Too much water (fluid overload e.g SIADH)

Too little salt

19

How do you treat hyponatraemia due to

a) too much water

b) too little salt?

a) Fluid restrict

b) Give 0.9% NaCl

20

Which endocrine disorder causes hyponatraemia in a euvolaemic patient?

SIADH

21

What happens to plasma and urine osmolality in SIADH?

Plasma osmolality decreases - too much salt

Urine osmolality increases - MORE salty water excreted as RAAS turns off

22

In SIADH, urine sodium levels are (high / low).

high

23

How is SIADH treated?

Fluid restrict until cause (inflammation/infection/tumour) is resolved

24

If sodium imbalance is corrected far too quickly, what occurs?

Brain damage

25

Which patients are at risk of brain damage by rapid sodium correct?

Hyponatraemic

Malnutrition

Extremes of age

26

By how much can you change a patient's [Na] in a 24h period?

4-6

27

Sodium excess / deficiency must be corrected very ___.

slowly

28

In emergency correction of hyponatraemia, how much are you aiming to correct [Na] by?

4-6

just in less time

29