IV Fluids Flashcards
(31 cards)
How does the percentage of water in the body change with age?
% of water decreases with age and so body is adapted to retain salt
This adaptation occurs to maintain fluid and electrolyte balance in older adults.
What happens to albumin during fluid imbalance?
There is a leakage of albumin from the capillaries into the interstitial space
This can contribute to edema and fluid imbalance.
What are the main extracellular and intracellular electrolytes?
Extracellular: Na; Intracellular: K+, Ca, Mg
Sodium is the main ion in extracellular fluid, while potassium is predominant intracellularly.
What are the normal plasma electrolyte levels for sodium?
136-145 mmol/L
This range is crucial for maintaining fluid balance and cellular function.
What are the normal plasma electrolyte levels for potassium?
3.5-5 mmol/L
Adequate potassium levels are essential for cardiac and muscle function.
What are the normal plasma electrolyte levels for chloride?
98-105 mmol/L
Chloride plays a key role in maintaining osmotic pressure and acid-base balance.
What is the normal range for plasma osmolarity?
280-300 mOsm/L
Osmolarity is a measure of solute concentration in plasma.
What happens to salt and water retention immediately after injury?
Salt and water is retained for the first few days; albumin escape rate will increase to 15% from 5%
This retention is part of the body’s response to injury.
What is the purpose of the 5 R’s for prescribing fluids?
- Resuscitation
- Routine Maintenance
- Replacement
- Redistribution
- Reassessment
These guidelines help ensure appropriate fluid management in patients.
What are crystalloids?
Crystalloids are made from simple crystal forming molecules; usually salt or sugar
They act as a carrier for fluid and are often used for IV fluid resuscitation.
What are the advantages of using crystalloids?
Cheaper and more safe; pass freely through semi-permeable membrane; have minimal oncotic pressure; can act as a carrier for fluid
However, they have a short action on plasma expansion.
What are some examples of crystalloids?
- Glucose
- Sodium Chloride
Glucose acts as a carrier for water, while sodium chloride can have various clinical effects.
What are the risks associated with high levels of chloride in IV fluids?
Monitor for hyperchloraemia or acidaemia; reassess IV fluid
High chloride levels can lead to significant clinical issues such as kidney injuries or reduced renal flow
True or False: Fluid boluses can lead to increased mortality.
True
Fluid boluses can exacerbate fluid overload and other complications.
What is fluid creep?
Fluid creep is from drug administration leading to increased fluid, sodium, and chloride burdens
This is particularly concerning in ill patients.
What are colloids?
Colloids are larger molecules, can be blood, albumin, gelatin, or dextran in origin
They are used in specific clinical situations, especially for hypovolemic shock.
What is the recommended fluid for resuscitation?
Sodium containing crystalloid; give 30ml/kg in first 3 hours
This is a standard protocol for fluid resuscitation.
What are the daily maintenance fluid levels needed?
- Water: 25-30ml/kg/day
- Sodium: 1mmol/kg/day
- Potassium: 1mmol/kg/day
- Calories: minimum 400 cal/day
These levels may need adjustment for frail or renal impaired patients.
What are the stages of fluid therapy?
R: Resuscitation
O: Optimisation
S: Stabilisation
E: Evacuation
Each stage focuses on different aspects of fluid management.
What symptoms can low sodium levels cause?
Weakness or seizures; can be because of thiazides, loop diuretics or SSRIs or APs
These symptoms can occur due to fluid overload or loss of body fluids.
What can happen if sodium is given too quickly?
Increased Na in blood leads to water leaving the brain; can cause brain swelling
This is a critical concern in sodium management.
What are the consequences of potassium overdose?
Can kill; can lead to heart attacks; highly irritant
Potassium must be managed carefully to avoid serious complications.
What is the maximum safe rate for potassium administration?
10mmol/hour; 20-30mmol/hour with cardiac monitor; peripherally should be 40mmol/L max
Rapid administration can lead to serious complications.
What happens to potassium levels if magnesium levels are low?
Potassium will continue to be lost until magnesium levels are restored
Magnesium plays a critical role in potassium reabsorption.
