5.2 Fluid replacement therapy

Question 1

how does dextrose affect the body fluid levels?

Answer 1

-glucose taken up rapidly by cells
-distributes evenly across all compartments, so wont increase circulating volume
-free water left in ECF

Question 2

how does saline affect the body fluid levels?

Answer 2

-stays in ECF
-no change in osmolarity

Question 3

how does Hartmans affect the body fluid levels?

Answer 3

-stays in ECF
-close to physiological composition

Question 4

examples of ways hospitalised patients are metabolically stressed. negative consequence?

Answer 4

-ADH increase
-dont sweat excessively
-RAAS
-catecholamines
-reduced caloric exoenditure

=fluid overloaded

Question 5

fluid bolus in patients with HF/ kidney failure

Answer 5

250mL not 500mL

Question 6

when would you give resuscitation fluids?

Answer 6

-systolic BP < 100
-HR < 90
-cap refil >2 secs
-RR > 20
-NEWS > 5
-passive leg tasing suggests fluid responsiveness

Question 7

when would you give maintenance fluids?

Answer 7

if haemodynamically stable but can’t meet daily fluid requirements via oral or enteral rotes

during daytime hours to prevent sleep disturbance