16.8.2013(sanjay Pandya) Flashcards
Insensible fluid input
300ml water due to oxidation
TBW
60% of body weight in males
50% of body weight in females
80% in newborn infants
Insensible fluid loss
500ml through skin
400ml through lungs
100ml through feces
Normal daily insensible fluid loss
700 ml
Fluid lost through moderate sweating
500ml
Fluid lost due to severe sweating or high fever
1-1.5L
Fluid loss due to burns or laparotomy
0.5-3 L
Calcium concentration is high in
ECF
Major cations in ICF
K+
Mg+
Equivalents
Moles* valence
Conversion from mmol/L to mg/dl
mmol/L = mg/dl*10/atomic weight
mEq cation or anion/gm of salt
Nacl-17 Kcl-13 NaHco3-12 Calcium gluconate-4 Calcium chloride-14 MgSO4-8
Normal plasma osmolality
275-295 mOsm/kg
Most physiological IV fluid
RL
Composition of Ringer lactate
Na-130 K-4 Cl-109 Lactate-28 Ca-3
Daily requirement of sodium
100mEq or 5.9g
Volume of isotonic saline enough to provide normal requirement of sodium
650ml
Amongst routinely used IV fluids max Cl content is present in
Isotonic saline
DNS
isolyte G(150)
IV fluid that has maximum potassium
Isolyte M(35)
Which IV fluids correct acidosis?
Isolyte E,P,M(acetate)
RL(lactate)
Acetate and lactate are converted to bicarbonate
Which IV fluid directly corrects metabolic alkalosis
Isolyte G
Fluids avoided in renal failure
Isolyte M,P,G,E(risk of Hyperkalemia)
RL(lactate not converted to bicarbonate)
IV fluids avoided in liver failure
RL Isolyte G(ammonium chloride)
Best agent to correct intracellular dehydration
D5
Amount of energy provided by 5%D
170 Kcal/L
1g of hydrous dextrose supplies _______ Kcal
3.4
Rx of ketosis due to starvation,diarrhoea,vomiting and high grade fever
5D
Contraindications to 5D
Cerebral Edema
Neurosurgical procedures
Acute ischemic stroke
Rate of administration of 5D
0.5gm/kg body weight/hr
666ml/hr
Inverted sugar solution
Half dextrose+half fructose
Use of inverted sugar solution
Vomiting of pregnancy
It provides glucose in pts with liver disease
Contraindications to NS
Hypertensive or preeclamptic pt
CCF
renal disease
Cirrhosis
Use of dextrose with half normal saline
Pediatric pts
Early postop
Maintanence fluid
Use of DNS
Correction of vomiting or nasogastric aspiration induced alkalosis and hypochloremia
Fluid of choice for initial treatment of diarrhoea induced dehydration
RL
Drugs that become ineffective when mixed with RL
Ampicillin
AmphotericinB
Thiopental
Ca in RL binds to these drugs
Contraindications to RL
Severe liver disease Severe CCF Addison Severe metabolic acidosis Blood transfusion
Osmolality of 5D
252mosm/kg
Hypotonic solutions
Osmolality less than 240mosm/kg
Hypertonic solutions
Osmolality more than 340 mosm/kg
Use of normal saline
Shock Metabolic alkalosis Hypercalcemia Hyponatremia Blood transfusions Resuscitation Fluid challenges DKA
Fluid of choice in addisonian crisis
DNS