43 - Fluids - SK / Flashcards
Name the two isotonic crystalloid fluids / these two fluids are the preferred fluids for ________
NS and LR / resuscitation
Normal Saline is ___% NaCl, whereas 1/2 NS is ___% NaCl.
0.9% / 0.45%
Your patient is both hypovolemic and hypernatremic. What fluid do you choose?
1/2 Normal Saline
What is in D5W? / When is it contraindicated?
5% Dextrose & Sterile water / When blood products are being given (D5W causes hemolysis when given w/blood products)
What fluid is preferred for burns and in the first 48-hours post-op?
LR
D5 1/2 NS is often used as a maintenance fluid following fluid resuscitation with NS or LR. What is the purpose of the 5% dextrose in that solution?
Prevents hypoglycemia when pt is NPO, provides calories (~900/3L), prevents catabolism & endogenous protein breakdown
Whole blood, platelets, PRBCs, FFPs & albumin are considered what type of fluids?
Colloids
When is it indicated to give whole blood? / Give 3 examples of conditions that would warrant whole blood transfusion? / In what setting is whole blood most commonly used?
When more than 10 units are required in less than 24 hours / MASSIVE hemorrhage, cardiac surgery, AAA / The military
You are seeing a patient who is hospitalized for a GI bleed. Due to the bleed, the patient’s hemoglobin and hematocrit are both running a bit low. What product will you most likely use to transfuse?
PRBCs
What product would you use to transfuse for a patient who had overdosed on warfarin?
FFP
What’s the difference btw a “type and screen” and a “type and cross”?
Type & Screen = Identifies patient’s ABO and Rh type and serum antibodies.
Type & Cross = Donor RBCs actually mixed w/ patient’s serum to confirm donor blood is compatible
When might you order a Type and Cross for a patient?
Before a procedure where you know the patient will be losing a lot of blood and very likely need a transfusion (i.e. hip replacement)
You see an order written in a patient’s chart that says, “transfuse with 2 units autologous blood.” What does that mean?
The patient previously gave 2 units of blood (knowing s/he was going to have surgery) and is now going to be transfused with that blood - no compatibility issues there!
What is found in PRBCs? / About how much does one unit of PRBCs raise a patient’s hematocrit?
RBCs, WBCs, platelets & 1/4 the plasma of whole blood / ~3%
Your patient is severely immunocompromised. You need to transfuse a blood product, but want to prevent graft-vs-host disease. What blood product do you transfuse?
Irradiated RBCs
