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Anesthetics > Fluids > Flashcards

Fluids Flashcards

1
Q

What is osmolarity?

A

Conc of osmotically active particles in solution

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2
Q

Daily requirements of water

A

30-40 ml/kg

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3
Q

Daily requirements of energy

A

30-40 kcal/kg

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4
Q

Daily requirements of sodium

A

1-2mmol/kg

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5
Q

Daily requirements of potassium

A

1mmol/kg

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6
Q

Is Na+ + K+ intra or extracellular?

A

Na+ major extracellular

K+ major intracellular

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7
Q

Stress response in homeostasis

A 
ADH release 
Water retention 
Dilutional hyponatraemia 
Renin release 
Sodium retention 
Fluid overload
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8
Q

What is the total obligatory loss for water in adults?

A

1500ml

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9
Q

What is the definition of oliguria?

A

Urine output less than 0.5ml/kg/hr

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10
Q

What are crystalloids + give examples?

A

Water soluble crystalline substance that diffuses across a semi-permeable membrane
NaCl
Dextrose
Dex/Sal
Hartmanns/ Ringers/ compound sodium lactate

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11
Q

What are colloids?

A 
Dispersion of finely divided particles in a medium 
Fluid stays in circulation 
Gelofusine 
Voluven 
Volulyte
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12
Q

Describe composition of 0.9% NaCl

A

% means g/100ml
9g NaCl per L
154 mmol Na 154 mmol Cl

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13
Q

How many litres of NaCl will give a 1L increase in plasma volume?

A

4.7L

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14
Q

What are the consequences of NaCl infusion?

A

Hyperchloraemic acidosis
Metabolic acidosis
High Cl + low HCO3

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15
Q

What does Hartmans contain?

A 
Na
Cl
K
Ca++
Lactate
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16
Q

What is the difference between Hartmans and Ringers?

A

Hartmans = has lactate

17
Q

Describe the composition of dextrose + how much is needed for a 1L increase in plasma volume?

A

50g dextrose per L of water

14L to increase PV by 1L

18
Q

How many calories in 5% dextrose?

A

170

19
Q

What is HAS?

A

Human albumin solution

- pooled human plasma

20
Q

What type of fluid is blood?

A

Colloid

21
Q

What is HES?

A

Starch

22
Q

How to assess fluid status?

A 
Check mucous membranes 
Skin turgor 
Urine output 
BP 
HR 
JVP
23
Q

What is the criteria for mild fluid deficit?

A

Loss of 4% body weight
Loss of skin turgor
Dry mucous membranes

24
Q

What is the criteria for mod fluid deficit?

A

Loss of 5-8% body weight
Oliguria
Tachycardia
Hypotension

25
Q

What is the criteria for severe fluid deficit?

A

Loss of >8% body weight
Profound oliguria
CVS collapse

26
Q

What do you use for a fluid challenge + how do you do it?

A

Large bore IV cannula
Colloid 500ml bolus
Observe BP + HR

27
Q

What patients have abnormal fluid losses?

A 
GI - suction/ vomiting, bowel prep 
Hyperventilation
Fever (12% loss per 1 degree rise)
Burns 
Hyperglycaemia 
Diuretics
28
Q

What are patients with DKA deficient in + what metabolic state are they in?

A 
3-5L fluid deficiency 
300-500mmol Na deficiency 
150-250mmol K deficiency 
Hyperglycaemia 
Hyperketonaemia 
Metabolic acidosis
29
Q

What fluids to give in DKA?

A

Initially 2-3L NaCl

Add K+

Anesthetics (6 decks)

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