Basic Types of Intravenous Fluids Flashcards
Effect of LR in body pH
LR has minimal effects on normal body fluid composition and pH
Risk of using PNSS
Risk of hyperchloremic acidosis, due to high Cl content. High Cl content in the kidneys cannot be rapidly excreted. Dilutional acidosis may develop by reducing base bicarb relative to carbonic acid.
Provide water that is not bound by macromolecules or organelles, thus are free to pass through membranes
Free water solutions
Type of IV fluid:
Whole blood
Blood products, collloid
True or False: LR provides calories to the intravenous system
False. LR does not provides calories
True or False: pNSS provides calories to the intravenous system
False. PNSS does not provide free water or calories
Lactate is converted readily in what organ
Liver. Lactate is converted readily to bicarbonate in the liver.
Effective plasma expanders
Colloids
Type of IV fluid:
Dextrose/crystalloid mixtures (D5LR, D5 0.9NaCl)
Free water solution
How is 3% NaCl acts as a plasma expander
Hypertonic saline increases plasma osmolality and thereby acts as a plasma expander, increasing circulatory volume via movement of intracellular and interstitial water into the intravascular space. (Do not give to CHF patients!)
Usually given when there is a large water deficit in the ICF compartment (indicated by plasma Na > 140 mm)
Electrolyte free water (D5W)
Risk of using 3% NaCl
High risk for hypernatremia
Type of IV fluid:
D50-50
Free water solution
Initial fluid of choice to defend normal blood pressure
Normal or isotonic saline
Type of IV fluid:
Dextran
Colloid
Endpoints for IVF therapy
- Normalization of vital signs
- Urine output >0.5 ml/kg/hr
- Restoration of normal mental status
- Lack of clinical signs of fluid deficit
True or False: D5W provides calories to the intravenous system
True. D5W or 1/4 normal saline, provides 170 cal/L from 5% dextrose
Excellent maintenance fluid in the immediate post-operative period
D5W. Due to added the K.
Usual indications for IV fluid administration
- Defend normal BP
- Return the ICF volume to normal
- Replacing ongoing renal losses
- Maintenance fluids to match insensible losses
- Provide glucose as fluid substrate for brain a d prevention of proteolysis in peripheral tissues
True or False: D5W provides free water to the intravenous system
True. Provides free water for insensible losses and some Na to promote renal function and excretion
Type of IV fluid:
Plasma
Colloid
Free water solution, no role in resuscitation
D5W (glucose: 50mg/dl)
Type of IV fluid:
D20W, D50W
Free water solution
Type of IV fluid:
Pentastarch
Colloid
Fluid that prevents excess catabolism and limits proteolysis
D5W
Components of hypertonic saline (3% NaCl)
1026 mOsm/L, 513 mEq/L Na
Type of IV fluid:
Fresh frozen plasma/FFP
Blood products, colloid
True or False: Is dopamine dose-dependent?
True
A synthetic sympathomimetic amine with positive inotropic action with effects due to selective stimulation of beta-1 adrenergic receptors
Dobutamine
Dobutamine preparation
1 amp contains 250 mg dobutamine
Dopamine factor
For a formulation of 1 dobutamine amp (250 mg) in 250 cc D5W, factor used is 16.6
True or False: is dobutamine dose-dependent?
True
Sample dopamine order
Dopamine drip: 250 mg Dobutamine (1 amp) + 250 cc D5W to run for ___ cc/hr
The only solution that may be administered with blood products
Normal saline, PNSS
Most closely resembles the electrolyte composition of normal blood serum
LR. Lactated Ringer’s solution
Type of IV fluid:
Cryoprecipitates, platelets
Blood products, colloid
Type of IV fluid:
D10W
Free water solution
Type of IV fluid:
Hypertonic solution
3, 5, 7.5%
Crystalloid
Fluid usually given in patients with acute hyponatremia to raise plasma sodium
Hypertonic saline. The ICF volume in the brain rises and could become dangerously high with more prominent decline in plasma sodium, so give hypertonic solution.
Type of IV fluid:
Packed RBC
Blood products, colloid
Initial post-operative maintenance
D5LR
Comes from components of whole blood. Essentially are also considered colloids
Blood products
Type of IV fluid:
Hetastarch
Colloid
Type of IV fluid:
Lactated Ringer’s
Crystalloid
Type of IV fluid:
Albumin
Colloid
Type of IV fluid:
Normal saline (0.9% NaCl or PNSS)
Crystalloid
Type of IV fluid:
D5W (5% dextrose in water)
Free water solution
High molecular weight solutions which draw fluid into intravascular component via oncotic pressure
Colloids
Type of IV fluid:
Ringer’s solution
Crystalloid
Balanced salt electrolyte/salt solution which may be isotonic, hypotonic or hypertonic
Crystalloids