Fluids

Question 1

what % of body weight is fluids?

Answer 1

60 - 2/3 is intracellular and 1/3 is extracellular

Question 2

what does interstitial fluid bathe?

Answer 2

cells

Question 3

what is normal na+ plasma/ interstitial fluid conc?

Answer 3

135-145mmol/L

Question 4

what is the normal intracellular conc of Na+ wihtin intracellular?

Answer 4

10mmMol

Question 5

what is normal K+ plasma/ interstital conc?

Answer 5

3.5-5.3mMol

Question 6

what is normal K+ intracellular conc?

Answer 6

160mMol

Question 7

what is isotonic point?

Answer 7

amount of water transported out is the same as transported in

Question 8

what is hypotonic point?

Answer 8

more water transported into cells - can inflate and burst

Question 9

what is hypertonic point?

Answer 9

water moving out cells causing them to shrink and shrivel

Question 10

how much fluids does average 70kg human need daily?

Answer 10

1.5l

Question 11

how much fluids does human lose daily? how is broken down?

Answer 11

1.5L - mainly urine, smaller amounts by faeces, sweat, evaporation, skin, exhalation

Question 12

how much fluid is required for maintence?

Answer 12

25-30ml/kg/hr

Question 13

how much na/k/cl are required daily?

Answer 13

1mol/kg/24hrs

Question 14

what can increase fluid output?

Answer 14

fistula/ drains, diarrhoea, pyrexia, diuresis, burns, haemorrhage, peritonitis
can be 3rd space loss

Question 15

what is euvolemia?

Answer 15

normal fluid levels

Question 16

what are signs of hypovolemia?

Answer 16

dry mouth thirst, low volume of urine
later weight loss, fever, confusion, blood osmolarity increasing causing fluid to move from interstitial and intra-cellular spaces

Question 17

what are signs of hypervolemia?

Answer 17

causes blood osmolarity to decrease
body oedema
cell swelling
cerebral oedema, coma, seizures

Question 18

what do you look for on someone’s hands in a fluid assessment?

Answer 18

temp, capillary refill time, pulse (rate, vol)

Question 19

what do you assess on patient’s arms within fluid assessment?

Answer 19

skin turgor
blood pressure (lying and standing)

Question 20

what do you assess on patient’s neck within fluid assessment?

Answer 20

JVP

Question 21

what do you assess on a patient’s face within a fluid assessment?

Answer 21

eyes (sunken, tears)
mucus membranes - moist/ dry

Question 22

what suggests a fluid overload?

Answer 22

pulmonary oedema (bi-basal crackles), ascites, sacral oedema, leg oedema, urine output high

Question 23

what is crystalloid fluids and examples?

Answer 23

solutions of small molecules in water – NaCl, hartmanns, dextrose

Question 24

what type of fluid is more superior for initial fluid resuscitation?

Answer 24

crystalloid

Question 25

what are colloid fluids?

Answer 25

solutions of larger organic molecules eg albumin, gelofusine

Question 26

what risk does colloid carry?

Answer 26

anaphylaxis

Question 27

what are the IV fluid indications?

Answer 27

5Rs
1. Resuscitation
2. Routine maintenance
3. Replacement
4. Redistribution
5. Reassessment

Question 28

what are the resus fluids?

Answer 28

500ml bolus of crystalloid eg normal saline/ hartmanns over less than 15 mins

Question 29

if a patient is elderly, malnourished, heart/ kidney impairment how much fluid should be given initially?

Answer 29

250ml over 15 mins and reasses

Question 30

what is the routine volume of fluids daily?

Answer 30

Routine: 25-30ml/kg/day of water

Question 31

what fluids do you give an obese patient?

Answer 31

lower end of range
no one needs 3L of fluid

Question 32

what is the risk with malnourished patients and fluids?

Answer 32

refeeding syndrome