Fluids Flashcards

1
Q

How much is TBW in terms of percentage? How is the TB split up into intracellular and extracellular water?

A

60% of total body weight= total body water. 2/3 of TBW= intracellular; 1/3 of TBW= extracellular.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does extravascular mean?

A

tissue fluid. It is 3/4 of ECF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does intravascular mean?

A

plasma. It is 1/4 of ECF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How to calculate plasma osmolarity?

A

2 x [Na] + [glucose] + [urea]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how do we diagnose severe hyponatremia, and some symptoms?

A

< 120 meq/L of Na+

and headaches, nausea, vomiting, fatigue, seizures, obtundation, coma, resp.arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can cause hyponatraemia? (think broad categories)

A

can be due to overall loss of fluid volume (diarrhoea/vomiting/waterloss) or due to increased fluid volume- diluting effect (water retention, chronic organ failure) or due to conditions like SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do we treat hyponatraemia due to hypovolemia? How about for hypervolemia?

A

IV N.S for hypovolemia

Fluid restriction and +/- loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can cause hypernatremia?

A

fluid loss (renal/GI), or sodium gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do we treat hypernatremia due to fluid loss?

A

Rehydrate with 5% dextrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What urine out do we want for a fasting patient on maintenance fluids?

A

> 30 ml/h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some types of fluid replacement?

A

5% dextrose- equilibrates between intravascular and extravascular space within hrs
0.9 NaCl - mainly stays in intravascular space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What causes hypokalemia?

A

GI losses like diarrhoea, renal losses , insulin dextrose, beta agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is severe hypokalemia diagnosed? what are some symptoms? What would you see on ECG?

A

Severe= <2.5meq/L
Symptoms include muscle cramps, weakness, fatigue, palpitations.
On ECG= peaked P wave, PR prolongation, ST depression, flat/inverted t wave, U hump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can cause hyperkalemia?

A

K sparing diuretics, Ace inhibitors, Acidosis, cotrimoxazole, renal tubular acidosis type 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do you see on ECG for hyperkalemia? what are some short term treatments for hyperkalemia?

A

ECG: peaked T waves, flat/nonexistent p waves, longPR segment

In short term= treat with insulin/dextrose
+ beta agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what can cause hyperchoremic metabolic acidosis?

A

giving too many bags of normal saline

17
Q

what are the daily sodium requirements in maintenance fluid therapy?

A

1-2 mmol/ kg/ day of sodium

18
Q

what are the daily potassium requirements in maintenance fluid therapy?

A

1-2 mmol/ kg/ day of potassium

19
Q

what are the basal requirements of water?

A

30 ml/kg/day of water

20
Q

what is hartmann’s fluid?

A

sodium lactate, crystalloid fluid replacement (CSL)

21
Q

how much fluid do we replace if there is significant blood loss?

A

If used to replace blood loss, 3 to 4 times the volume lost must be administeredas only 1/3 to 1/4 remains intravascularly.

22
Q

what kind of fluid is dextrose 5%?

A

Maintenance fluid

23
Q

what kind of fluid is normal saline?

A

replacement fluid

24
Q

what kind of fluid is Hartmann’s solution?

A

replacement fluid

25
what is in Hartmann's solution?
``` 131 mEq of sodium ion = 131 mmol/L. 111 mEq of chloride ion = 111 mmol/L. 29 mEq of lactate = 29 mmol/L. 5 mEq of potassium ion = 5 mmol/L. 4 mEq of calcium ion = 2 mmol/L. ```
26
what is a consideration of Hartmann's solution?
contains calcium ions which can cause clotting of blood. so not recommended for use during blood transfusion
27
How might we assess fluids?
Urine output, skin turgor mucus membranes, lactate