Clin skills-Fluids

Question 1

Name 2 types of body fluid compartmetns and their proportions

Answer 1

• NTRACELLULAR FLUID 2/3
  OF TBW
• EXTRACELLULAR FLUID 1/3
  OF TBW

Question 2

Name 2 types of extracellular fluids

Answer 2

• INTERSTITIAL FLUID
  2/3 OF ECF
• INTRAVASCULAR FLUID
  1/3 OF ECF

Question 3

What determines or controls flow of water and electrolytes past the permeable capillary membrane to the extracellular fluid compartment?

Answer 3

FLOW DEPENDS ON OSMOLARITY OF FLUID AND THE BALANCE BETWEEN ONCOTIC
AND HYDROSTATIC FORCES BETWEEN THESE SPACES

*osmolarity: concentration of osmotically active particles dissolved in the blood plasma

Question 4

What determines or controls flow of water and electrolytes past the permeable capillary membrane to the intracellular fluid compartment?

Answer 4

ENERGY DEPENDENT ION PUMPS.

Question 5

What is the impact of hypotonic solution in a cell?

Answer 5

IF A CELL IS PLACED IN A HYPOTONIC SOLUTION IT WILL SWELL UP AND
EVENTUALLY BURST (LYSIS).

*Hypotonic solution is the one with more solute or water outside the cell, and this excess water will move into the cell via osmosis n cause cell lysis

Question 6

Crystalloids

Answer 6

Solutions which contain small molecules or electrolytes. These fluids can be used for resucitation, rehydration, and maintanance.

examples: (e.g. sodium chloride-saline/Hartmann’s/dextrose)

Question 7

Colloids

Answer 7

Solutions that contain macromolecules. Macromolecules can either be synthetic or natural.
Synthetic contain- starch
Natural colloids contain- Human proteins

examples: Albumin, frozen plasma, blood, Gelofusine

• They carry a risk of anaphylaxis, and crystalloids are superior in initial fluid resuscitation thn colloids

Question 8

What makes colloids significant or special?

Answer 8

They remain intavascularly. They fill up intravascular compartment only

Question 9

Colloid drawbacks?

Answer 9

Are expensive and raise safety concerns

Question 10

Hypovolaemia

Answer 10

Decreased volume of circulating blood

Question 11

Two forms of deficits

Answer 11

-hypovolaemia: Resuscitation

• dehydration :rehydration

Question 12

Signs presented by patients with defecits

Answer 12

-Signs of shock (shock is a state of tissue hypoperfussion-state of emergency!!)
- Or sever dehydration

*must look for these signs in your general examination

Question 13

In a shock patient

Answer 13

Give 500ml of balanced crystilloids over 15 min

Question 14

Static parameters when examining patient for shock and dehydration

Answer 14

physiological measurements that provide information about the patient’s condition at a specific point in time, without considering changes over time or dynamic responses to interventions.

-Decreased conscious level, tachypnoea, tachycardia, low blood pressure, pallor and dry mucus membranes, decreased skin turgor, increased capillary refill time, decrease urine output

Question 15

Dynamic parameters when examining patient for shock and dehydration

Answer 15

Assess changes over time or in response to interventions (after IV therapy administration)

Question 16

For a patient who has a condition which is causing fluid loss___

Answer 16

• determine the rate of loss as well as
• the solute content of the losses
• Replace what is lost with a similar volume and monitor serum electrolyte levels

Fever, Burns, gastroenteritis cause ongoing loses

Question 17

Important component of humanhomeostasis. For a normal 70-kg adult. approximate daily fluid balance comprises:

Answer 17

• intake:
  -1500 ml liquid.
  -750 ml in food.
  -250 ml frommetabolismwithin the body.
  Total therefore 2500 ml.

◗output:
-1500 mlurine.
-100 ml in faeces.
-900 mlinsensible water loss(lungs and skin).
Total therefore is about 2500 ml.

Question 18

crystalloids which expand ECF (3/4 interstitial, 1/4 plasma) and are ideally suited to replace ECF losses.

Answer 18

Saline and Ringer lactate