L7: What fluid to choose?

Question 1

Surgical patients with 3rd spacing

Answer 1

Albumin

Question 2

Alternatives to albumin

Answer 2

Dextran 40
Dextran 70
Hydroxyethyl Starch

Question 3

Severe anemia

Answer 3

PRBCs

Question 4

Hemorrhage

Answer 4

PRBCs

Question 5

Burns/peritonitis

Answer 5

Colloids

Albumin

Question 6

Complete bowel obstruction

Answer 6

TPN

Question 7

Inflammatory bowel disease

→ bowel rest may induce remission

Answer 7

TPN

Question 8

Maintenance fluids for peds

Answer 8

D5/.25NA with 20 meq KCL

Question 9

IV boluses

Answer 9

Isotonic crystalloid

Question 10

Correct warfarin bleeding

Answer 10

Fresh frozen plasma

Question 11

Significant multisystem disease

Answer 11

TPN

Question 12

Correct vitamin K deficiency bleeding

Answer 12

Fresh frozen plasma

Question 13

Edema

Answer 13

Albumin

Question 14

Treatment of dehydration/hypovolemia

Answer 14

Isotonic crystalloid

Question 15

Thrombocytopenia

Answer 15

Platelets

Question 16

Liver disease

Answer 16

Albumin

Question 17

Serum albumin >2.5

Answer 17

albumin is not useful

Question 18

Small bowel resection

Answer 18

TPN

Question 19

Replacement therapy

Answer 19

depends on fluid lost

Question 20

Preferred choice rapid correction of severe hypovolemia

Answer 20

Isotonic crystalloid

Question 21

Impaired platelet function

Answer 21

Platelets

Question 22

Life threatening hyponatremia with significant water excess

Answer 22

Hypertonic crystalloid: 3% NS

Question 23

Maintenance fluids

Answer 23

.5 NS

.25 NS

Question 24

Severe hypovolemia

Answer 24

Don’t use colloids

Question 25

Hypoglycemia

Answer 25

D5W

Question 26

Bolus

Answer 26

NS LR Plasma-lyte PRBCs

Question 27

When crystalloids fail to sustain plasma volume due to low osmotic pressure: considerable protein loss from vascular space (burns, peritonitis)

Answer 27

Colloids

Question 28

Maintenance fluids for an adult

Answer 28

D5/.5NS with 20 meq KCL

Question 29

Pre-existing nutritional deprivation | → unable to tolerate enteral

Answer 29

TPN

Question 30

What's better to use that fresh frozen plasma anyhow

Answer 30

Prothrombin complex concentrates

Question 31

Intra-operative alternative to albumin

Answer 31

Hydroxyethyl Starch

Question 32

Anticipated/actual inadequate energy intake by mouth → adults >7-10 days → peds >3-7 days

Answer 32

TPN