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Revision > Fluid Replacement & Management > Flashcards

Fluid Replacement & Management Flashcards

1
Q

What is meant by the term ‘intracellular fluid’?

A
  • Water that is inside cells
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2
Q

What is meant by the term ‘insterstitial fluid’?

A
  • Fluid that surrounds cells
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3
Q

What is meant by the term ‘intravascular fluid’?

A
  • Circulating blood volume
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4
Q

Define the term diffusion

A
  • Blood at high pressure forces plasma out (hydrostatic pressure)
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5
Q

Define the term osmosis

A
  • Diffusion of water molecules from a region of higher concentration to a region of lower concentration, through a partially permeable membrane
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6
Q

Define the term ‘oncotic pressure’

A

The pressure that would have to be applied to prevent osmosis

Whenever the hydrostatic pressure is greater than oncotic pressure - fluid will leave the capillaries

Whenever the oncotic pressure is greater than the hydrostatic pressure - fluid will enter the capillaries

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7
Q

What is an isotonic solution used for?

A
  • Fluid replacement
  • Given to increase the amount of fluid in the intravascular space, without significantly changing the balance of electrolytes in the body
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8
Q

Give an example of an isotonic solution

A
  • 0.9% Normal saline
    Or
  • Hartmans solution
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9
Q

What are the properties of a hypotonic solution?

A
  • Has a lower solute concentration than another solution
  • This causes water to leave a hypotonic solution (intravascular space) and enter an area of higher concentration (RBC’s), via osmosis
  • This occurs as the body strives to maintain a state of balance
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10
Q

Give an example of a hypotonic solution

A
  • 0.45% Saline
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11
Q

What are the properties of a hypertonic solution?

A
  • Has a higher amount of solute than blood does
  • This causes water to want to enter the hypertonic solution (intravascular space) and leave an area of lower solute concentration (RBC’s), via osmosis
  • Can be useful for patients who need electrolytes but who are already in fluid overload such as patients with cardiac failure
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12
Q

Give an example of a hypertonic solution

A
  • 5% Dextrose
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13
Q

What is meant by ‘hypovolaemia’?

A
  • A decrease of the volume of circulating blood, due to conditions such as bleeding, shock and sepsis
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14
Q

What is meant by ‘dehydration’?

A
  • Occurs when water intake is not enough to replace free water lost due to normal physiological processes (such as breathing, urinating and sweating)
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15
Q

List some clinical manifestations of volume depletion

A
  • Hypotension
  • Tachycardia
  • Cap refill more than 5 secs
  • Thready/ absent radial pulse
  • Decreased sweats
  • Blue
  • Cold
  • Dizziness
  • Fainting
  • Muscle cramps
  • Decreased skin turf or
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16
Q

What should a nurse do if a patient is in volume depletion?

A
  • Give a fluid bolus of 500ml crystalloid over less than 15mins
  • Reassess patient using ABCDE approach
  • If less than 2l of fluid has been given, give a further fluid bolus of 250-500ml crystalloid
  • Fluid resuscitation, get help
17
Q

List clinical manifestations of volume overload

A
  • Hypertension
  • SOB
  • Increased RR
  • Increased HR
  • Moist skin
  • Weight gain
  • Oedema
  • Third heart sound
  • Abnormal renal function
18
Q

What is meant by a crystalloid and what type of fluid replacement is it best used for?

A
  • Balanced salt solutions that freely cross capillary walls
  • Rapidly absorbed into interstitial spaces
  • Provides short-term fluid replacement (30-60 mins) of blood volume replacement - stay in intravascular compartment for shorter time than colloids
19
Q

What is meant by a colloid and what type of fluid replacement is it best used for?

A
  • Consists of modified gelatin (gelatin behaves in a similar way to natural blood plasma and increases oncotic pressure)
  • Plasma substitute
  • Also contains electrolytes
  • Provide long-term volume replacement and are generally iso-oncotic with blood
  • Don’t usually cross semi-permeable membrane
20
Q

When would replacement and redistribution be required to be used?

A
  • If a patient has a complex fluid or electrolyte replacement or abnormal distribution, replace fluid or redistribute electrolyte balance
21
Q

What are some conditions that may result in redistribution and replacement?

A
  • D&V
  • Dehydration
  • Fluid overload
  • Billary drainage loss
  • Sweating/ fever
  • Urinary loss
  • Ongoing blood loss
22
Q

What should a nurse do if replacement and redistribution is required?

A
  • Prescribe by adding to routine maintenance
  • Monitor and reassess fluid and biochemical status
  • Check for:
  • Oedema
  • Hypernatraemia/ Hyponatraemia
  • Renal or Cardiac impairment
  • Post op fluid retention
  • Malnourishment
23
Q

What is meant by ‘routine maintenance’?

A
  • Normal daily fluid and electrolyte requirements
24
Q

What are the requirements for routine maintenance?

A
  • 25-30ml/kg/day water
  • 50-100g/day glucose
  • Reassess and monitor patient
  • Stop IV fluids when no longer needed
  • NG fluids or feeding preferable when maintenance needs are more than 3 days
  • 1mmol/kg/day Na, K, Cl
  • Weight based K prescriptions should be rounded to nearest common fluids available
  • K should not be added to IV bags

Revision (8 decks)

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