Fluid Balance and Assessment

Question 1

What might you use 5% glucose solution for?

Answer 1

• ICC replenishment
  
  • e.g if ECC osmolarity is high (DKA) dragging water out

Question 2

What might you use normal saline for? What is one of the possible complications of using it?

Answer 2

• Maintenance fluid (ECC especially)
• Can cause increased Cl, rebound HCO3 decrease and subsequent metabolic acidosis

Question 3

What might you use Hartmann’s solution for? What are some contraindications?

Answer 3

• Maintenance fluid
• Contraindications - hyperkalaemia, liver failure (can’t metabolise lactate), rhabdomyolysis (hypercalcaemia)

Question 4

What might make you take special care with use of a blood transfusion/gelofusion for fluid resuscitation?

Answer 4

Care with burns or states where capillary permeability is increased - increased MW molecules in the IVS can cause ICC dehydration