Fluid and electrolytes balance

Question 1

how much fluid lost in urine

Answer 1

1200ml

Question 2

how much fluid lost in faeces

Answer 2

100ml

Question 3

what is insensible loss and how much of it is lost

Answer 3

fluid loss via the skin and respiratory tract

• 400ml skin
• 400ml respiratory tract
• total 800ml

Question 4

what is a normal stool weight

Answer 4

200ml in 24 hourse

Question 5

what is abnormal stool weight

Answer 5

Volume greater than 200 ml constitutes diarrhoea

Question 6

what causes diarrhoea

Answer 6

rapid propulsion –> decreased absorption –> fluid accumulation

Question 7

what are colloids important for

Answer 7

in resuscitation

Question 8

what does abnormal plasma osmolality cause

Answer 8

causes movement of water between compartments (plasma, intracellular fluid and interstitial fluid)
–> May cause cellular overhydration and oedema

Question 9

What is The standard postoperative regimen for IV replacement

Answer 9

Saline and dextrose 2 :1

Question 10

what are the lactate containing IV fluids

Answer 10

• Ringer Lactate

- Hartmann

Question 11

when can RInger lactate be used

Answer 11

A substantial amount of bicarbonate is produced during lactate metabolism:
Thus Ringer-lactate solution may be used in metabolic acidosis caused by bicarbonate loss

Question 12

what is the minimum daily potassium loss

Answer 12

60-80mmol per day

Question 13

what is the effect of hypo and hyperkalaemia on heart function

Answer 13

cause complicated arrthymias and affect cardiac function

Question 14

what can cause hypo and hyper kalaemia

Answer 14

Alkalosis leads to → hypokalaemia
Acidosis leads to → hyperkalaemia

This is due to K+/H+ antiporter on cell surfaces

Question 15

what are the guidelines for K IV supplements

Answer 15

• Prescribe potassium in mmol, indicating final volume of the solution: e.g. “20 mmol/L in saline, over 8h”
• Maximum rate 10mmol/h : faster only if cardiac monitoring/ central line are available (up to 20 mmol/h)
• Concentrated potassium solution MUST BE DILUTED before use.

Question 16

what are the maximum amounts of advised KCl before it becomes unsafe

Answer 16

• Maximum of 40mmol of KCl per litre of fluid
• Maximum of 20mmol of KCl per hour
• Maximum of 140mmol of KCL per day

Question 17

child worldwide deaths due to diarrhoea are attributable to what

Answer 17

unsafe water, poor sanitation and poor hygiene.

Question 18

what does osmolality mean and how does it work?

Answer 18

The concentration of a solution expressed as the total number of solute particles per kilogram.
water moves from low osmolality body compartment to high osmolality body compartment (osmosis)

Question 19

what does high osmolality result in

Answer 19

High osmolality in the blood, results in cellular dehydration, since water is drawn from the cells and into the blood

Question 20

what does low osmolaliy result in

Answer 20

Low osmolality in the blood, due to water being drawn up into cells, results in cellular over hydration and oedema.

Question 21

what is the target osmolality wise

Answer 21

The target is to have iso-osmotic compartments (when both compartments have equal osmotic pressures)