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Joeli lectures > Fluid Replacement > Flashcards

Fluid Replacement Flashcards

1
Q

What do we replenish with IV fluids?

A

intravascular space (plasma)

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2
Q

TBW % for females

A

50%

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3
Q

TBW % for males

A

60%

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4
Q

TBW % for newborns

A

80%

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5
Q

Why are infants and young children more vulnerable to dehydration?

A

high metabolic H20 turnover daily/hour
larger SA relative to their weight
greater % of TBW located in ECF (fluid in EC is more available for transfer to environment and is more readily available for evaporation –> dehydration)

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6
Q

Sensible losses of fluid

A

urine
sweat
feces
vomitus

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7
Q

Insensible losses of fluid

A

metabolic water (high metabolic = lose more)
evaporation from skin
evaporation from respiratory tract

insensible is relatively larger component in infants and young children

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8
Q

Fluid loss rises during increased:

A

metabolic rate
fever
ambient temperature

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9
Q

What is the first choice for resuscitation

A

isotonic fluid - normal saline = 0.9% saline

bc fluid needs to stay in the intravascular space

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10
Q

what is the fluid choice for burn patient or surgical?

A

lactated ringers

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11
Q

hypotonic solution

A

full of water –> swelling of cells

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12
Q

hypertonic solution

A

full of solutes –> shrinking of cell

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13
Q

Quick calculation for calculating hourly rate in adult (for weight > or equal to 20 kg)

A

Weight in kg + 40

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14
Q

Na+ needs over 24H

A

30 mEq/L

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15
Q

K+ needs over 24H

A

20 mEq/L

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16
Q

Cl- needs over 24H

A

20 mEq/L

17
Q

1 L H2O =

A

1 kg

18
Q

1 kg =

A

2.2 lbs

19
Q

how are deficits given?

A

first 1/2 given over 8 hours

second 1/2 given over 16 hours

20
Q

Where is most sodium lost from?

A

the ECF

21
Q

amount of sodium last during first 3 days of illness

A

80% of H20 volume and Na+ are lost from the ECF
20% of H20 volume and Na+ are lost from ICF

22
Q

amount of sodium and water lost after day 3 of illness

A

60% of H20 volume and Na+ are lost from ECF
40% of H20 volume are Na+ are lost from ICF

23
Q

Total hourly rate is determined by calculating…

A

maintenance fluids + deficits - any initial bolus

24
Q

what tells us the RATE of fluid replacement

A

H2O

25
Q

What tells us the TYPE of fluid replacement

A

Na+

26
Q

Fluids given for volume expansion

A

crystalloid
colloid

27
Q

Crystalloid fluid

A

water soluble electrolytes in solution
exert a significant hydrostatic effect (pushes against walls to increase volume)

28
Q

colloid fluid

A

larger molecules suspended in aqueous solution; exert oncotic effect (pulls fluid in and retains it in intravascular space and doesn’t let it go out to interstitial space)

Natural: albumin, fresh frozen plasma (FFP), blood
Synthetic: hetastarch

29
Q

What fluid should you use for acidosis

A

lactated ringers –> convert HCO3- in the liver

30
Q

What fluid for burns

A

saline solution from maintenance
plus LR for deficit replacement

31
Q

What fluid for pyloric stenosis (babies –> projectile vomit –> hypochloremic, hypokalemic, metabolic alkalosis)

A

D5 0.45% NS or D10 0.45% NS
Dextrose adds some calories (bc vomiting)
Avoid LR due to alkalosis

32
Q

Effects of adding dextrose to maintenance fluids

A

water will be drawn into the intracellular compartment more effectively

some calories – but minimal – may decrease ketone generation (prevents ketone generation so can be used for someone with DKA)

33
Q

For fever

A

add 10-12% to maintenance fluid per degree C above 37.8 degree C (99F)

bc higher metabolic demands

34
Q

For burns: do not give KCl

A

cell lysis –> intracellular K+ release
Rhabdomyolysis secondary to burn –> increased K+
patient will be hyperkalemic

35
Q

Daily need of Na+ if we are well

A

30 mEq/L or 3 mEq/100 mL

36
Q

signs of fluid overload

A

edema
hepatic congestions
crackles on lungs

37
Q

What tells us HOW MUCH solution

A

water

38
Q

Why is 0.22% NS banned from some hospitals

A

too hypotonic and often causes hemolysis

Joeli lectures (18 decks)

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