2) Fluid Balance and IV Fluids

Question 1

Describe the main fluid compartments of the body:

Answer 1

Intracelullar fluid
Interstitial fluid
Plasma
Lymph
Transcellular fluid

Question 2

List the normal volumes of each fluid compartment in adults:

Answer 2

ICF - 28L

ECF - 14L -> interstitial 10.5L, plasma 3L, transcellular 0.5L

Question 3

Describe the general electrolyte composition of interstitial fluid:

Answer 3

Na+: 145
K+: 4.1
Cl-: 113
No protein

Question 4

Name the renal mechanisms for the regulation of extracellular fluid volume and composition:

Answer 4

Thirst
ADH
RAAS

Question 5

What are the signs and symptoms of hypovolemia?

Answer 5

Tachycardia, low BP, pallor

Dizziness, faint, nausea, thirst

Question 6

Describe the general electrolyte composition of intracellular fluid:

Answer 6

Low sodium, high potassium, low chloride

Some protein

Question 7

What are the normal daily requirements of water, sodium, potassium, chloride and glucose? (vol/kg/day)

Answer 7

Water - 30ml/kg/day
Sodium - 1-2mmol/kg/day
Potassium - 0.5-1mmol/kg/day
Chloride - 1mmol/kg/day
Glucose - 50-100g/day

Question 8

What reasons are there for patients needing IV fluids?

Answer 8

NBM
Fluid loss
Malfunctioning GI tract
Dehydration 
Abnormal electrolytes

Question 9

Name some IV solutions commonly used:

Answer 9

Normal saline
Dextrose
Hartmann’s
Colloids

Question 10

What can cause hypernatremia?

Answer 10

Loss of free water e.g. sweating

Question 11

What are signs of hypernatremia?

Answer 11

Confusion, seizures, coma

Question 12

What are signs of hyponatremia?

Answer 12

Cerebral oedema

Question 13

What are signs of hyperkalemia?

Answer 13

Flaccid paralysis and cardiac abnormalities

Question 14

What are signs of hypokalemia?

Answer 14

Cardiac arrhythmia and asystole