Fluids Flashcards
How are maintenance fluids prescribed in adults?
Learn:
25-30ml/kg/day of water
1mmol/kg/day of Na+ and K+ (cannot give potassium faster than 10mmol/hr)
50-100g of glucose (5g/100ml)
Suggest maintenance fluids for an 80kg man.
25 x 80 = 2000ml (2 litres)
1mmol x 80 = 80mmol (40mmol per bag)
50grams = 1000ml
2 1000ml 5% glucose bags
1 1000ml NaCl bags
What should you considered when prescribing maintenance fluids?
Salty then sweet
What is the fastest rate you can give potassium?
10mmol/hr
Why can you not give potassium fast?
Administration of 80 mEq/h, for example, has been associated with electrocardiogram changes and complete heart block
T or F, Always check the magnesium as hypokalaemia will not correct unless magnesium is corrected first
True, Always check the magnesium as hypokalaemia will not correct unless magnesium is corrected first
T or F, Patients rarely need more than 3L of fluid per day.
True
T or F, Consider reducing fluids in elderly/frail, renal impairment or cardiac failure
True
What is the algorithm / Holliday Seger formula for maintenance fluids in young children?
First 10kg = 100ml/kg/24 hrs
Second 10kg = 50ml/kg/24hrs
>20kg = 20ml/kg/24hrs
Suggest maintenance fluids for a child of 40kg?
1000
500
400
= 1900ml
Suggest how it differs for neonates <28 days.
Birth-day1: 50-60ml/kg/day
day 2: 70-80
day 3: 80-100
day 4: 100-120
day 5: 120-150
What is the equation for total fluid replacement?
Fluid deficit + maintenance fluids = total replacement
What is the equation for fluid deficit?
%dehydration x weight x 10
What is the equation for percentage dehydration?
(well weight-current weight/ well weight) x 100
T or F, Fluid resuscitation is required where the child is shocked or haemodynamically compromised. Glucose-free crystalloids (e.g. 0.9% sodium chloride) are used for resuscitation; usually as a stat bolus of 10 mL/kg.
True - glucose free for resuscitation
T or F, In infants and children, the oral or nasogastric route for fluids is preferred where possible.
True - oral or NG preferred
T or F, replacement fluids = fluid deficit + maintenance fluids?
True
T or F, In certain conditions, a smaller resuscitation bolus is used. For example, in neonates, children with cardiac failure, septic shock, diabetic ketoacidosis and major trauma.
True
How should 40mmol of potassium be prescribed?
The maximum recommended rate of potassium infusion via a peripheral line is 10 mmol/hour, whereas rates above 20 mmol/hour require cardiac monitoring
