fluids

Question 1

glucose (dextrose) indications

Answer 1

• glucose 5% - water in patients unable to take enough orally
• 10%, 20% and 50% are used to treat hypoglycaemia when this is severe or cannot be treated orally. glucagon is an alternative
• 10.20.50% - for hyperkalaemia
• 5% - reconstiution and dilution of drugs

Question 2

MOA dextrose

Answer 2

• glucose = monosaccharide. it is isotonic with serum so that is does not indice osmotic lysis of RBC on initial mix with blood. glucose is taken up by cells and metabolised, leaving ‘free’ (hypotonic water that distributes across all body compartments

Question 3

dextrose SE

Answer 3

• 50% = irritant to veins = local pain, phlebitis and thrombosis. so no longer used much unless via central line. 20% also irritant but less
• hyperglycaemia if not balanced administration

Question 4

warnings for giving glucose/dextrose

Answer 4

• thiamine deficiency risk pt –> giving can lead to wernickes - give after pabrinces
• renal failure
• hyponatraemia
• kids
  -pt with brain injury
  = all 3; hyponatraemic encephalopathy

Question 5

how to prescribe glucose in patients who cannot take fluidc orally

Answer 5

• 5%; 2L at 100ml/hr (2 bags)
• add k+ to reciprocate body electrolytes; 20mmol/1L bag
• add sodium containign crystalloid; 0.9% 500m;l at 100ml/hr

Question 6

potassium chloride IV indications

Answer 6

• prevention of potassium depletion in those who cannot take orally
• potasisum depletion and hypokalaemia (<2.5mmol/l, symptomatic or arrhythmias)

Question 7

kcl body requirement

Answer 7

need 1mmol/kg/d

Question 8

SE KCL

Answer 8

• Hyperkalaemia
• arrhythmiias
• irritated veins (do not have rate higher than 20mmol/hr in peripheral veins)

Question 9

who should you not prescribe kcl to

Answer 9

• renal impairment and oliguria patients