IV fluids Flashcards
(22 cards)
what kind of IV fluid is used for resuscitation?
crystalloid
what kind of IV fluid is given to a patient if they are hypernatraemic?
dextrose
what kind of IV fluid is given to a patient if they have chronic dehydration?
dextrose
what kind of IV fluid is given if a patient is hyponatraemic?
crystalloid
what’s the difference between dextrose and crystalloid fluids?
dextrose is isotonic therefore only used for maintenance or to correct low fluid status with normal electrolyte status
crystalloid is hypertonic as it has a high Na concentration and stays in the ECF therefore used for electrolyte deficits / resuscitation
in what patients would plasma expanders IV fluid be used ?
patients with liver disease
it has a high album content
what are the main questions you have to ask if you think the patient requires fluid?
what is my patients fluid status?
does my patient need fluid?
how much fluid do they need?
what type of fluid do they need?
what is the presentation of a patient who is hypovalaemic?
pale no sweat tachycardia hypotension tachypnoea oligouria flat veins nausea
what is the presentation of a patient who is hypervalaemic?
sweat tachycardia hypertension tachypnoea veins distended warm and oedematous extremities thirsty dilute urine (could also be oliguria/polyuric)
what mechanism of fluids would you give if someone was hypovolaemic ?
resuscitation
rehydration fluid
what treatment would you give if someone was hypervolaemic?
no fluids
diuretics if respect compromise
harm-filtration if septic
what is the difference between osmolarity and osmolality?
osmolarity is the solute concentration per unit volume of solvent
osmolality is the solute concentration per mass of solvent
what is tonicity?
measure of the osmotic pressure gradient between 2 solutes
what are the 5 R’s when prescribing fluids?
resuscitation routine maintenance redistribution replacement reassessment
what are clinical findings suggestive of hypervolaemia?
Breathing (B);
tachypnoea - RR >20
decreased oxygen saturations
bilateral lung crackles on auscultation
circulation (C);
hypertension
elevated JVP
Exposure (E);
increased urine output
weight gain
peripheral oedema
what are clinical findings suggestive of hypovolaemia?
Breathing (B);
tachycardia
decreased oxygen saturations
Circulation (C); hypotension tachycardia non-visible JVP prolonged cap refill time
Exposure (E);
increased losses from wounds and/or drains
decreased urine output <30ml/hr
sources of abnormal fluid loss i.e. diarrhoea, vomiting, rectal bleeding
weight loss
what are the two main types of fluids used?
crystalloids - small particles
colloid - larger particles
what are the risks associated with colloids?
risk of anaphylaxis
when prescribing routine maintenance fluids, what are the daily fluid requirements?
1 mmol/kg sodium
1 mmol/kg potassium
25-30ml/kg water
50-100g glucose
after what length of time does a patient require nasogastric fluids or enteral feeding for routine maintenance ?
when fluid maintenance it is required for more than 3 days
give example of sources of abnormal fluid and electrolyte losses.
vomiting diarrhoea stoma output loss wounds blood loss - malena, haematemesis urinary loss e.g. diabetes billiard drainage loss dehydration, sweating, fever
give example of patients who have problems with fluid distribution and other complex issues.
gross oedema liver, renal or heart failure severe sepsis hyponatraemia/ hypernatraemia post op fluid retention or redistribution malnutrition and re-feeding syndrome
