Fluids

Question 1

What are isotonic fluids used for?

Answer 1

Replacement regimes such as dehydration

Question 2

What is the default fluid that is given in most situations?

Answer 2

Sodium chloride 0.9%

Question 3

How much sodium does 1litre of sodium chloride 0.9% contain?

Answer 3

150mmol

Question 4

What can overuse of 5% glucose fluids cause in hospital patients?

Answer 4

Hyponatremia

Question 5

What comprises fluid output ?

Answer 5

Urine
NG tube aspirate
Vomit
Drain fluid
Diarrhoea
Blood loss

Question 6

How many ml per hour per kg should the normal kidney produce?

Answer 6

0.5ml/kg/hour

Question 7

What does raised urea and creatinine in a patient suggest?

Answer 7

Dehydration or pre renal failure due to hypovolaemia

Question 8

What is the normal daily requirement of sodium?

Answer 8

1-2mmol/kg (around 80mmol in 24hrs)

Question 9

What is the normal daily requirement of potassium?

Answer 9

1-2mmol/kg (around 60mmol in 24 hours)

Question 10

What is the approximate daily requirement of water for an adult male?

Answer 10

2000-2500ml

Question 11

List two risks of sodium chloride infusions in large quantities

Answer 11

Hypernatreamia

Acidosis

Question 12

What body compartments does Sodium Chloride enter?

Answer 12

ECF (Interstitial fluid and plasma) Because of the electrolytes it does not enter cells and equilibrates with ECF

Question 13

Does a saline infusion contain more or less sodium than plasma?

Answer 13

More

Question 14

Does a saline infusion contain more or less chlorine than plasma?

Answer 14

More (lots more!)

Question 15

What is the main risk of rapid infusion of large amounts of sodium chloride?

Answer 15

Severe metabolic acidosis

Question 16

Does 5% glucose infusion contain any electrolytes?

Answer 16

No

Question 17

What is 5% glucose infusion good for?

Answer 17

Replacement of water ie pure dehydration

Question 18

What compartments does 5% glucose enter?

Answer 18

All (ICF and ECF) §

Question 19

What compartments does hartmans solution enter?

Answer 19

ECF

Question 20

Which is closer to normal plasma; sodium chloride or hartmans?

Answer 20

Hartmans

Question 21

What is a colloid?

Answer 21

Larger molecules that stay in the intravascular space for longer than crystalloids and attract water due to their oncotic pressure

Question 22

What is the average total body water in an adult male? What proportion is ECF and what proportion is ICF?

Answer 22

42 litres (2/3rds ICF, 1/3rd ECF)

Question 23

What two compartments can ECF be further divided into?

Answer 23

Interstitial fluid

Plasma

Question 24

What body compartments are depleted in dehydraton (pure water deficiency)

Answer 24

All compartments

Question 25

What body compartments are depleted in hypovolemia?

Answer 25

Plasma initially (before fluid begins to move in from other compartments)

Question 26

What body compartments are depleted in vomiting/diarrhoea?

Answer 26

Extracellular fluid (due to the depletion of electrolyte rich fluid)