Fluid shite

Question 1

how much fluid should pts get in a day

Answer 1

Normal adult -> 3L

Old buggers -> 2L

Question 2

what forumula do you to precribe maintenance fluids in kids

(total fluid in a day)

explain it too eh

Answer 2

Halliday-Segar formula

kid weighs at least 10kg -> x100ml

kid weighs 20kg -> x 50ml

each kg of weight above 20kg -> x20ml

if weighing more than 20kg, then it;s awlays gonna be (10x1000) + (10x50) to start things off

If they only weigh like 12kg, then it’ll be (10x1000) and (2x50)

Question 3

how much maintance fluid would a kid weighing 32kg need

Answer 3

32kg= 10kg + 10kg + 12kg

Use halliday-segar formula

1st 10kg -> 100x 10= 1000ml

2nd 10kg -> 50 x10= 500ml

>10kg -> 20x 12= 240ml

total fluid= 1740ml

Question 4

what fluids do ya give for an old bugger who’s just had a stroke

Answer 4

0.9% saline + 0.15% KCl

1000ml

over 8hrs

Question 5

when shoudl you always probs prescribe maintenance fluids

Answer 5

when pt is NBM

Question 6

What’s the usual prescription of gluocse

Answer 6

10% dextrose

usually like 200ml over 2hrs

Question 7

if someone has a low K, what can you add to the saline

Answer 7

KCl

Question 8

if the pt has already been through 2 bags of saline, which one should you probs give next and why

Answer 8

Dextrose

Don’t wanna give the poor bugger Na overload

Question 9

Replacement fluids types

1. what is usually used
2. what is used if low BG or high Na
3. what is used for ascities

Answer 9

1. plasymlate 148
2. 10% dextrose
3. HAS solution

Question 10

Replacement fluids volumes & rate

1. normal
2. in heart failure pt
3. pt not pissing (no output)

Answer 10

1. 500ml STAT
2. 250ml STAT
3. 1L over 2-4hrs

Question 11

what is pretty much the max voluem of REPLACEMENT/RESUS fluid you give in one go

never go over it

Answer 11

2L

Most are like 500ml anyways so usually sound

Question 12

Maintenance fluid

1. what is usuall used
2. normal volume & rate
3. volume & rate in old buggers

Answer 12

1. saline + whatever you want or dextrose
2. 3L, over 8hrs
3. 2L, over 12hrs

Question 13

Usual volume & rate for fluid resus in kids

Answer 13

20ml/kg

for <10mins (pretty much STAT)

Question 14

what IV fluids do you give for hyperglycemia

Answer 14

1L stat

1L per hour, for the next 8hrs

Question 15

what benzos can be used for seizures

Answer 15

diazepam

lorazepam

midazolam

Question 16

why do you need to always fire in a cathater for a GI bleed

Answer 16

you’re gonna wanna monitor the fluid intake and outake lad

Question 17

what steroids do you use for an exacerabtion of asthma that is…

moderate

severe

Answer 17

moderate -> oral pred

severe -> IV hydrocortisone

Question 18

for the management of hypertension, after you’ve used your ACEi, CCBs & diuretics, what to you add next

Answer 18

K >4.5= B-blcoker

K <4.5 = spirnolactone

Question 19

in kids, it might give you a question on what total amount of fluid.

for this you obvs have to use the halliday sanger formula aloing with working out the % deficit

how do you work out the deficit

Answer 19

% dehydration x weight (kg) x 10