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My Own Renal Physiology > Intravenous Fluids > Flashcards

Intravenous Fluids Flashcards

1
Q

Preoperative evaluation of fluid states

A 
Mental status
Skin turgor
Bp
Heart rate
Urinary output
Central venous pressure
Input output chart
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2
Q

Orthostatic hypotension

A

Systolic blood pressure drop of about 20mmHg from supine to standing.
Indicates loss of 6-8% fluid deficit.

One of the immediate signs of dehydration

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3
Q

Composition of iv fluids

A

Crystalloids
Colloids
Or both

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4
Q

Indications for IV fluids

A

Volume rescucutation in severe fluid loss

Vehicle for iv drugs

Needed to keep the veins open. I.e in shock

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5
Q

Crystalloids

A

Clear fluid made of water and electrolute solutions. It crosses semi permeable membrane

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6
Q

Crystalloids grouped into?

A

3
Isotonic
Hypertonic
Hypotonic

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7
Q

Most common iv fluids given?

A

0.9% Nacl. Normal saline

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8
Q

Normal saline and plasma

A

Are isosmolar

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9
Q

Conc of na and cl in normal saline?

A

154mmol/l each

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10
Q

Ph of normal saline?

A

6

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11
Q

Osmolarity of normal saline

A

308mOsm/l

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12
Q

Indications of normal saline

A

Used to replace lost fluids and electrolytes

To dilute drugs

To dilute packed RBCs

Intravascular rescucitation

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13
Q

Advantage of notmal saline

A

A greater portion of it Stays entirely in ecf

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14
Q

Disadvantage of notmal saline

A

When given in excess can produce hyperchloremic metabolic acidosis

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15
Q

Electrolyte content of 3% saline

A

513mmol/l

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16
Q

Osmarity of 3% saline

A

1026mosm/l

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17
Q

Ph of 3% saline

A

5.0

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18
Q

Indications of 3% saline

A

In severe hyponatremia

To rescucutate hypovoleamic shock

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19
Q

Disadvantages of 3% saline

A

Must be administered via cv line, slowly because it can cause phlebitis, necrosis, or hemolysis.

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20
Q

Complications of 3% saline.

A

Edema

Severe renal insufficiency

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21
Q

Precautions in giving 3. % saline

A

Precautions in patients with chronic hear failuire

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22
Q

Composition of 5% dextrose

A

50g/dl glucose

No sodium and chloride, pittasium,calcium

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23
Q

Ph of5% dextrose

A

4.5

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24
Q

Osmolarity of 5% dextrose

A

2520 mosm/l

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25
Q

Indications of 5%dextrose

A

Hypernatremia
To maintain fluid balance in people who cant take anything by mouth
Used postoperatively in conjunction with salt retaining fluids

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26
Q

This iv fluid cannot be used in rescicitation

A

5% dextrose.

Only used for short quick results

27
Q

Side effects of 5% dextrose

A

Iatrogenic hyponatremia
Induces hyperglycemia
Hemolysis cos its not compatible with blood

28
Q

Most physiological soln if crystalloids

A

Ringers lactate. Urs electrolyte composition same as ecf

29
Q

Osmolarity of ringers lactate

A

273mmos/l

30
Q

Ph of ringers lactate

A

6.5

31
Q

Lactate in ringers lactate converted to?

A

Hco3 in liver

32
Q

Indications of ringers lactate

A

Intraoperative fluid loss

Severe hypovoleamia

33
Q

Precautions for ringers lactate

A

Severe metabolic acidosis

Dont give with blood products cos calcium in it chelates antocoagulant calcium in blood

34
Q

Dextrose in normal saline contains

A

0.9% saline, 5% dextrose

Cl and Na-154mmol/l with 5gr glucose

35
Q

Indication of isolyte p

A

Pediatric maintenance fluid

36
Q

Indication of dns

A

Maintenance of fluid
Provides both energy and electrolyes
Compatible with blood

37
Q

Isolyte P contains

A

Multiple electrolytes and dextrose

38
Q

Examples of crystalloid iv solutions

A 
Isolyte p
Dextrose in normal saline
Ringers lactate
Normal saline
3% saline
5% dextrose
39
Q

Colloids

A

Do not cross semi permeable membrane easily hence are always contained in intravascular space- plasma expanders

40
Q

Disadvantages of colloids. Why does it put patient at risk

A

Are gelatinous and cause platelet dysfunction.

Interfere with fibrinolysis and coagulation factor 8 leading to coagulopathy

41
Q

Types of colloids

A

Albumin
Dextran
Gelatins
Hydroxyethyl startches

42
Q

Albumin

A

Already a natural major component of plasma

50-60% of plasma proteins

43
Q

Half life of albumin

A

20 days

44
Q

Types of solutions of albumin

A

2.

5% and 25% form

45
Q

5% albumin solution

A

Isosmotic with plasma

80% volume expansion recorded

46
Q

25% albumin solution

A

200-400% increase in volume

47
Q

Indications of albumim solution

A

Loss of plasma leading to shock in emergency i.e in burns

Fluid rescucitation in icu

Hypoalbumineamia

48
Q

Side effects of albumin

A

Pruritis due to antigen antibody reaction
Anaphylactoid reactions
Coagulation abnormalities compared to synthetic colloids

49
Q

Disadvantages of albumin solution

A

Very expensive

Volume overload which cam cause edema

50
Q

Dextran is

A

Highly branched polysacharide

Produced by bacteria

51
Q

Types of dextran

A

6% dextran or dextran 70

10% dextran or dextran 40

52
Q

Dextran excreted primarily by

A

Kidneys

53
Q

Uses of dextran

A

Used to improve microcirculation

Used in extracorporal circulation

54
Q

Disdvantages of dextran

A

Anaphylactic reactions
Coagulopathies
Interfere with cross matching
Precipitates renal failuire

55
Q

What are gelatins

A

Large molecular weight substances formed from hydrolysis of collagen

70-80% volume expansion

56
Q

Indications for gelatin

A

Rapid volume expansion of intravascular volume

57
Q

Advantages of gelatin

A

Not expensive
No renal failuire
No coagulation inpairment

58
Q

Disadvantages of gelatin

A

Hypersensitivity

Anaphylactoid reactions

59
Q

What are hydroxy ethyl starches

A

Derived from amylopectin

60
Q

Types of hydroxyethyl starches

A

6% isosmolar with plasma

10% hyperosmaolar with plasma

61
Q

Advantages of HES

A

Cost effective

Comparable volume expansion yo albumin

62
Q

Disadvantages

A

Anaphylactoid reactions
Coagulopathy
Renal impairment
Increased amylase level

63
Q

Why colloids are not used as sole fluid replacement in rescucitation?

A

This is because colloids stay exclusively in the intravascular space or vessels and even cause more water to be drawn from the interstitial space into it so you have to add crystalloids which will push some fluid into the interstitial space

My Own Renal Physiology (3 decks)

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