Fluid managment Flashcards
What is fluid management in prescribing?
A critical part of prescribing that includes when and how to prescribe IV fluids, types of fluids and their uses, calculation of maintenance and replacement fluids, and management of fluid overload and dehydration.
What are the indications for using 0.9% Sodium Chloride (Normal Saline)?
Resuscitation, hypovolaemia, hyponatraemia.
What should 0.9% Sodium Chloride be avoided in?
Heart failure, fluid overload.
What is the composition of Hartmann’s (Ringer’s Lactate)?
Na+ 131 mmol/L, K+ 5 mmol/L, Ca²⁺ 2 mmol/L, Lactate 29 mmol/L.
What are the indications for using Hartmann’s?
Resuscitation, perioperative fluid, GI losses.
In what conditions should Hartmann’s be avoided?
Liver disease (lactate metabolism), hyperkalaemia.
What is the purpose of 5% Dextrose (D5W)?
Maintenance fluids, hypernatraemia.
What should 5% Dextrose be avoided in?
Hypovolaemia (no electrolytes).
What is the maintenance fluid calculation for children using the 4-2-1 Rule?
4 mL/kg/hr for first 10 kg, 2 mL/kg/hr for next 10 kg, 1 mL/kg/hr for every kg over 20 kg.
What is the typical adult maintenance fluid prescription?
1 L 0.18% NaCl + 4% glucose + 20 mmol KCl over 8 hours.
What is the best fluid to use for gastrointestinal losses?
0.9% NaCl + KCl.
What volume should be replaced for post-operative losses?
1L over 6 hours.
How should fluid resuscitation for shock be performed?
500 mL 0.9% NaCl STAT over 15 minutes, repeat up to 2L if no improvement.
What is the appropriate fluid choice for DKA?
0.9% NaCl initially, then 5% dextrose.
What are signs of dehydration/hypovolaemia?
Dry mucous membranes, tachycardia, low BP, reduced urine output, raised urea/creatinine.
What are signs of fluid overload?
Peripheral oedema, raised JVP, pulmonary crackles.
What is the treatment for dehydration?
Bolus 500 mL 0.9% NaCl over 15 minutes.
What should be done if signs of fluid overload are present?
Stop IV fluids, give diuretics if needed.
What is the PSA tip for fluid resuscitation?
500 mL 0.9% NaCl STAT.
Fill in the blank: Maintenance fluids should be ______ mL/kg/day.
25-30
What should be monitored to assess fluid status?
Urine output: Target ≥0.5 mL/kg/hr.
