Fluids Flashcards
What makes up the total body fluid?
- Intracellular fluid
* Extracellular fluid
Where can you lose fluid in your body?
- Kidney
- GI tract
- Lung
- Skin
What is the ratio of fluid between intracellular and extracellular fluid?
2/3 intracellular (25L) and 1/3 extracellular (15L)
What makes up extracellular fluid?
- Intravascular (20%)
* Interstitial (80%)
What are the anion and cation concentrations in extracellular fluid?
- Na+ 145
- K+ 4
- Cl- 115
- Ca2+ 2.5
What are the anion and cation concentrations in intracellular fluid?
- Na+ 12
- K+ 155
- Cl- 4
- Ca2+ <0.5
What is albumin and its purpose considering osmotic gradients?
Main protein within plasma which maintains osmotic gradient keeping H20 within vessels
What are the main crystalloid fluids that can be given?
- 5% dextrose
- Dextrose saline 4%
- Hartmann’s solution
- 0.9% Saline
- 0.45% Saline
What is the electrolyte content of 5% dextrose?
0 Na+
0 Cl-
0.4 K+
!50g glucose!
What is the electrolyte content of dextrose saline 4% / 0.18%?
30 Na+
30 Cl-
0.4 K+
!40g glucose!
What is the electrolyte content of Hartmann’s solution?
131 mmol/L Na+ 111 mmol/L Cl- 5 mmol/L K+ 2 mmol/L Ca2+ 29 mmol/L Bicarbonate
In a 1 litre bag
!Closest physiological fluid!
What is the electrolyte content of 0.9% saline?
154mmol/L Na+
154mmol/L Cl-
in a 1 litre bag
What are indicators that a patient may need fluid resuscitation?
- Systolic BP <100mmHg
- HR >90bpm
- Cap refill >2seconds / peripheries cold to touch
- Resp rate >20breath per min
- NEWS >/= 5
What is meany by fluid resus?
*Give a fluid bolus of 500ml 0.9% sodium chloride over less than 15minutes
When should maintenance fluids be given?
When a patient cannot meet their fluid or electrolyte needs orally or enterally and they do not have a complex need or issues
What are normal daily fluid and electrolyte requirements?
- 25-30ml/kg/24hrs of water
- 2mmol/kg/24hrs of sodium,
- 1mmol/jg/24hrs potassium and chloried
- 50-100 g/2hrs of glucose (e.g. glucose 5% contains 5g/100ml)
How should maintenance K+ be given in 24hr period?
- Requirement is 1mmol/kg/day of K+
- Potassium prescriptions should be rounded to the nearest common fluid available i.e. 67kg person should have fluids containing 20mmol and 40mmol of K+ in 24hour period
What mmol of K+ can you prescribe in a bag or fluids?
Bags that contain KCl saline are available and they typically contain 20 or 40mmol of K+ in a 1litre bag
What are crystalloid fluids?
Fluids that contain small molecules that can easily cross cell membranes i.e. electrolytes
What are the 3 main types of fluids?
- Crystalloids
- Colloids
- Blood products
What are examples of crystalloids?
- 0.9% sodium chloride
- Hartmanns solution
- 5% dextrose (glucose)
What are colloids?
- They have large molecule like gelatin in them
- Thought to expand the intravascular space
- Use is decreasing in favour of crystallloids
What are examples of colloids?
- Isoplex
* Volplex
What are the types of blood products?
- Packed red cells
- Platelets
- Fresh frozen plasma
Why can K+ not be given quickly?
Can have adverse affects on the heart
What is typically the maximum rate you can deliver K+?
10mmol/hr
What does typical a adult weighing 60-70kg require a rate of maintenance fluids of?
Approx 100mls/hr
i.e 2.4L over 24hrs
May require more if additional fluid losses
What should be monitored when using IV fluids?
U&Es so you can adjust fluid electrolyte content accordingly
