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Flashcards in Fluid management Deck (14)
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1
Q

Why are IV fluids prescribed?

A
  • Shock: 45o passive leg raise fluid responsiveness
    • Resuscitation
  • No shock + unable to meet fluid/electrolyte needs
    • Maintenance
    • Replacement and redistribution if
      • Complex fluid replacement
      • Complex electrolyte replacement
      • Abnormal distribution issues
2
Q

What considerations should be made when prescribing fluids?

A
  • Aim of the fluid
  • Weight and size of patient
  • Patient co-morbidities: eg. CKD; HF
  • Reason for admission
  • Electrolytes
3
Q

State the contents of 0.9% sodium chloride

A
  • Na+: 150 mmol/L
  • Cl-: 150 mmol/L
4
Q

State the contents of 5% dextrose

A

Glucose: 50 g/L

5
Q

State the contents of Hartmann’s

A
  • Na+: 131 mmol/L
  • K+: 5 mmol/L
  • HCO3-: 29 mmol/L
  • Cl-: 111 mmol/L
  • Ca2+: 2 mmol/L
6
Q

Why is 0.9% saline ideal for fluid resus and maintenence?

A
  • It quickly equilibriates across the ECF
  • Distributes across ICF slower than dextrose
7
Q

Why is 5% dextrose appropriate for fluid maintenence?

A

It quickly distributes across all fluid compartments.

8
Q

What is the benefit of using Hartmann’s solution?

A
  • It provides some potassium in addition to fluid
  • Very similar to normal plasma values of electrolytes
9
Q

State the normal daily fluid and electrolyte requirements for maintenance IV fluids

A
  • Water: 25-30 ml/kg/d
  • Na+, K+ and Cl-: 1 mmol/kg/d
  • Glucose: 50-100 g/d
10
Q

What is important to remember regarding IV K+ replacement?

A
  • Peripheral IV K+ rate should not >40 mmol/L
    • Higher rates require specialist input
  • Available in separate 20 and 40 mmol IV bags
    • Round weight-adjusted K+ to closest 20 mmol
  • Do not add K+ to IV fluid bads
11
Q

List four signs of mild-moderate dehydration

A
  • Dry mucous membranes
  • Dizziness; Fatigue
  • Reduced skin turgor
  • Postural hypotension
  • Slow capillary refill
  • Oligouria
12
Q

List 3 signs of severe dehydration

A
  • Weakness
  • Hypotension; tachycardia
  • Anuria
  • Confusion;Coma
13
Q

List four signs of mild-moderate fluid overload

A
  • Raised JVP
  • Peripheral oedema
  • Pulmonary oedema
    • Pink frothy sputum
    • Cardiac wheeze
    • Basal crepitus
14
Q

List two signs of severe fluid overload

A
  • Tachycardia
  • Tachypnoea; dyspnoea
  • Cyanosis