Fluid Prescribing

Question 1

What are the four main fluid types?

Answer 1

Sodium Chloride 0.9%

Potassium Chloride 0.3%

Potassium Chloride 0.15%

Glucose 5%

Question 2

Which electrolyte doesn’t come in its own in fluid bag? Which mixed bags is it contained within?

Answer 2

Potassium

Sodium Chloride 0.9%/Potassium Chloride 0.3%

Potassium Chloride 0.15%/Glucose 5%

Question 3

How much sodium is contained within 1000ml of sodium chloride 0.9%?

Answer 3

150mmol

Question 4

How much potassium is contained within 1000ml of potassium chloride 0.3%?

Answer 4

40mmol

Question 5

How much potassium is contained within 1000ml of potassium chloride 0.15%?

Answer 5

20mmol

Question 6

How much glucose is contained within 1000ml of glucose 5%?

Answer 6

50g

Question 7

What is the daily requirement of water?

Answer 7

25-30ml/kg/24hr

Question 8

What is the daily requirement of Na, K and Cl?

Answer 8

1mmol/kg/24hr

Question 9

What is the daily requirement of glucose?

Answer 9

50-100g/24hr

Question 10

What is the maximum potassium replacement rate?

Answer 10

10mmol/hr

Question 11

What is the minimum duration in which potassium chloride 0.3% should be infused at?

Answer 11

4hr

Question 12

What is the minimum duration in which potassium chloride 0.15% should be infused at?

Answer 12

2hr

Question 13

What fluid should be administered in cases of emergency resuscitation? At what rate?

Answer 13

Sodium chloride 0.9% 500ml over 15 minutes

Question 14

What fluid should be administered in cases of emergency hypoglycaemia? At what rate?

Answer 14

Glucose 20% 100ml over 15 minutes

Question 15

What fluid should be administered in cases of emergency hypoglycaemia - and hypotension? At what rate?

Answer 15

IV Sodium Chloride 0.9% 500ml 15 Minutes

THEN

IV Glucose 20% 100ml 15 Minutes

Question 16

What are the three signs that indicate fluid resuscitation requirement?

Answer 16

Hypotension

Tachycardia

Reduced Capillary Refill

Question 17

What fluid should be administered in cases of emergency hypokalaemia? At what rate?

Answer 17

Sodium chloride 0.9%/potassium chloride 0.3% 1000ml over 4 hours

Question 18

What are the four clinical features of hypokalaemia?

Answer 18

Constipation

Muscle Weakness

Arythmias

Hyporeflexia

Question 19

What are the five features of hypokalaemia on ECG scans?

Answer 19

“U have no pot or NO T but a LONG PR and a LONG QT”

U Waves

Small or Absent T Waves

Prolonged PR Interval

Prolonged QT

ST Depression

Question 20

What fluid should be administered in cases of emergency hypercalcaemia? At what rate?

Answer 20

Sodium chloride 0.9% 1000ml over 4 hrs

Question 21

What are the eleven signs of hypercalcaemia?

Answer 21

“Stones, bones, groans, moans, thrones, muscle tone and psychiatric overtones”

Kidney/Biliary Stones

Bone Pain

Abdominal Pain

Non-Specific Symptoms

Constipation & Polyuria

Weakness & Hyporeflexia

Confusion & Depression & Anxiety

Question 22

What is the feature of hypercalcaemia on ECG scans?

Answer 22

Shortened QT interval

Question 23

What maintenance fluid should be administered in cases without deficits or losses? At what rate?

Answer 23

25-30ml/kg/24hr water

1mmol/kg/24hr Na & K

50-100g/24hr glucose

1000ml over 8-12 hours

Question 24

What maintenance fluid should be administered in cases of deficits or losses e.g. electrolyte loss, vomiting, diarrhoea? At what rate?

Answer 24

30ml/kg/24hr water

1mmol/kg/24hr Na & K

50-100g/24hr glucose

1000ml over 4-6 hours

Question 25

What fluid should be avoided in stroke patients?

Answer 25

5% Glucose

Question 26

What fluid should be administered in cases of paediatric emergency resuscitation? At what rate?

Answer 26

Sodium chloride 0.9% 10ml/kg over 15 minutes

Question 27

What maintenance fluid should be administered in paediatric cases of deficits or losses? At what rate?

Answer 27

Sodium Chloride 0.9%/Glucose 5%

100ml/kg/24hr for the first 10kg

50ml/kg/24hr for the next 10kg

20ml/kg/24hr for the remaining weight