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Flashcards in Fluid Therapy Deck (27)
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1
Q

how would you work out how much maintenance fluid a person requires on a daily bases in terms of water and electrolytes?

A

25-30ml/kg/day water
1mmol/kg/day of potassium, sodium and chloride
50-100g/day of glucose to limit starvation ketosis

2
Q

what volume of water does an 80kg patient require over a 24hr period, for example?

A

2 litres

25-30 ml/kg/day

3
Q

what is the risk if large volumes of 0.9% saline are given to a patient?

A

increased risk of hyperchloraemic metabolic acidosis

4
Q

in what patients should Hartmann’s not be used?

A

patients with hyperkalaemia

5
Q

what is Hartmann’s solution also called?

A

compound sodium lactate

6
Q

what does a fluid challenge involve?

A

giving 500ml crystalloid fluid over <15 mins

keep giving bolus of fluid up to 2L and seek expert help if getting no response

7
Q

when giving patients fluids what do you need to regularly measure?

A

U&Es

8
Q

give 3 examples of crystalloid fluids

A

0.9% sodium chloride (with or without KCl) which is also known as saline.
5% glucose (with or without KCl).
Hartmann’s solution

9
Q

what ions does Hartmann’s solution contain?

A

sodium, potassium, calcium, chloride, bicarbonate

10
Q

give 2 examples of what colloids contain which means the fluid remains in the intravascular space

A

gelatin or

albumin

11
Q

which fluid is typically used for fluid resuscitation?

A

normal saline (NaCl 0.9%)

12
Q

what is typically the maximum rate of a potassium infusion?

A

10mmol/hr

but make sure to refer to trust guidelines

13
Q

what is the infusion rate in ml/hr of a typical adult pt needing maintenance fluids?

A

100ml/hr

14
Q

when administering fluids, what is it important to measure?

A

U&Es to be able to adjust fluid type appropriately.
renal function.
fluid status - to know whether fluids are still needed

15
Q

whenever you are prescribing fluids you need to be clear bout what you are treating. what are the 5 R’s of fluid therapy?

A
resuscitation
replacement
routine maintenance
redistribution
reassessment
16
Q

what fluids should you use for resucitation fluids and why?

A

Hartmanns or NaCl because they are isotonic so will remian in intravascular compartment for longer

17
Q

what are the 4 steps in calculating maintenance fluids?

A
  1. weight pt or find out pt weight
  2. calculate 24hr fluid volume in ml (25-30ml x weight (kg))
  3. work out rate in ml/hr - 24hr fluid volume/24h
  4. work out sodium and potassium requirements to choose type of fluid
18
Q

what size bags do fluids come in and do you have to prescribe each bag separately?

A

500ml and 1,000ml

yes, prescribe each bag separately

19
Q

what are the 3 different amounts of potassium a bag can contain?

A

0,
20mmol
40mmol

20
Q

what is the max rate for potassium infusion?

A

10mmol/h

21
Q

can you add extra potassium to hartmanns?

A

no

22
Q

how often should you assess fluid requirements?

A

every 24hrs

23
Q

what is a good routine maintenance regimen? what should you remember to add?

A

0.9%Nacl then 5% dextrose in 1:2 ratio.

remember to add K+

24
Q

what fluids should be sued for 24-48hrs perioperatively?

A

hartmanns

25
Q

if a pt is hypobolaemic due to bleeding, what are the ideal fluids to use for replacment?

A

blood

26
Q

what is a good fluid to give someone who has been vomiting severely?

A

0.9% NaCl - it’s ok to give continually as pt is usually depleted in both Na and Cl.
give potassium replacement too

27
Q

what would too much 0.9% NaCl fluids show on ABG

A

hyperchloraemic metabolic acidosis