Fluids Flashcards
Fluids containing larger molecular weight particles with plasma oncotic pressures similar to normal plasma proteins
colloids
Examples of colloids
albumin, FFP, hetastarch, dextran
noting or pertaining to a solution containing the same salt concentration as blood
isotonic fluids
Examples of isotonic solutions
0.9% NS or lactated ringers
a solution of lower osmotic pressure than blood
hypotonic fluids
examples of hypotonic fluids
0.45% NaCl and D5 0.45% in NaCl
most osmotically active electrolyte in the body
sodium
easiest way to monitor net gain/loss of fluids
daily weights
tells you the patient has adequate water balance
normal serum sodium
obligate fluid loss of normal adults
1600 ml/day
Ideal fluid to use for maintenance therapy since the kidneys will regulate Na, K, and H20 retention
0.45% NaCl + 20 mEq KCl
Estimate of daily fluid requirements (from ALL sources) in adults without fever/sweats
1500ml + 20ml/kg for each kg >20
How much does water requirement increase for each degree of fever > 37C?
100-150 ml/day for each degree above 37C
Earliest sign of hypovolemia due to the kidneys conserving sodium and water
decreased urine Na (<25 mEq/L)
What is the BUN/Cr ratio with hypovolemia?
> 20:1
Treatment for hypovolemia due to decreased intake or excess excretion while waiting for labs
0.45% NaCl
Treatment for hypovolemia due to decreased intake or excess excretion if serum Na > 145
0.25% NaCl
Treatment for hypovolemia due to decreased intake of excess excretion if serum Na < 138
0.9% NaCl (NS)
Minimum amount of urine that should be made per hr
30cc
Treatment for hypovolemia due to vomiting or diarrhea until labs are back
0.9% NaCl (NS)
Treatment for hypovolemia due to vomiting or diarrhea if serum Na > 145
0.45% NaCl
handled like free water…will diffuse thru body water
1L 5% dextrose
isotonic…distributed in ECF since cell membrane not permeable to sodium
1L 0.9% NS
remains in intravascular space…shock
1L 5% albumin
