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Y4 > Fluids > Flashcards

Fluids Flashcards

1
Q

If a person has iron deficiency anaemia, you should / should not transfuse red blood cells?

A

Should not

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2
Q

Which fluids are routinely used in fluid resuscitation or maintenance

  • crystalloids
  • colloids
A

Crystalloids

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3
Q

In a dehydrated patient, haematocrit will be high/low?

A

High

- less fluid so more blood

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4
Q

In a dehydrated patient, urea will be high/low?

A

High

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5
Q

2/3 of total body water is

  • extracellular fluid
  • intracellular fluid
A

Intracellular fluid

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6
Q

daily electrolyte requirements:
how many mmol/kg/day of sodium
how many mmol/kg/day of potassium

A

1-2mmol/kg/day sodium

1mmol/kg/day potassium

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7
Q

Clinical signs of dehydration

A 
Dry mucous membranes
Decreased skin turgor
decreased cap refill time 
pulse: weak, tachy 
BP: hypotensive 
Urine: dark
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8
Q

What is the first sign of dehydration

A

Postural hypotension

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9
Q

Blood test findings in dehydrated patient

A

Increased Urea
Increased haematocrit
Hypernatraemia
Hypokalaemia

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10
Q

Dehydrated patient will have hyponatraemia / hypernatraemia. Why?

A

Hypernatraemia

- less water so more sodium

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11
Q

Fluid overloaded patient will have hyponatraemia / hypernatraemia. Why?

A

Hyponatraemia

- excessive drinking / IV fluids decreases the Na:H2O ratio

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12
Q

Crystalloid fluids examples (4)

A

0.9% NaCl
Hartman’s solution
5% dextrose (glucose)
Ringers lactate

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13
Q

Name the top 2 crystalloids for resuscitation?

A

0.9% NaCl

Hartman’s solution

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14
Q

Which crystalloid fluid should you not use in resuscitation?

A

5% dextrose

- has no electrolytes

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15
Q

Why are colloid fluids being used less frequently?

A

Not any better than crystalloids

Increased risk of anaphylaxis

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16
Q

Name 2 types of synthetic colloids

A

Gelatine based “dextrans”

Starch based “gelofusin”

17
Q

Name 2 types of human protein solution colloids

A

Blood products
- FFP, platelets, packed red cells, cryoprecipitate

Human albumin solution

18
Q

If resuscitating a patient with a hyperkalaemia, which fluid should you AVOID giving them

A

Hartmans / ringers lactate

19
Q

If you give patient 500ml of fluid but they are still haemodynamically unstable, what do you do?

A

Crystalloid bolus of 500ml over 15 mins

20
Q

Give up to ___ L of fluid to try and make the patient haemodynamically stable

A

2L

21
Q

Name 2 ways in which you can increase the speed of infusion

A

Increase cannula size

Put pressure on the fluid bag

22
Q

What are the 2 components of ECF

A

Plasma

Interstitial fluid

23
Q

In which 3 sets of patients would you consider prescribing less fluids for resuscitation

A

Old/frail
cardiac failure
risk of refeeding syndrome

24
Q

Agitated patient who storms out the ward. What might be going on

A

Hypovolaemic shock

25
Q

a 70kg person needs XL of fluid for maintenance ?

A

2L

26
Q

How can you reverse pre-renal AKI

A

Give fluids

27
Q

Ways of monitoring fluid balance

A

Clinical examination: signs of dehydration?
Blood tests:
Vital signs: BP, HR
Urine output

28
Q

Abdominal distention (ascites) suggests hypovolaemia / hypervolaemia?

A

Hypervolaemia

29
Q

Signs of hypovolaemia

A 
Hypotension
Tachycardia 
Increased CRT 
Cold peripheries 
Reduced urine output 
Increased resp rate 
Dry mucous membranes 
Reduced skin turgor
30
Q

giving an intravenous hypotonic solution (eg 5% dextrose) will result in the water flowing OUT OF/INTO the intravascular space

A

Out of the intravascular space and into the interstitial space

31
Q

What stays in the intravascular space longer

  • colloids
  • crystalloids
A

Colloids

32
Q

The NICE guidelines for urgent fluid resuscitation

A

An initial 500 ml fluid bolus over 15 minutes (“stat”), followed by reassessment with an ABCDE approach

Repeat boluses of 250 – 500 mls of fluid if required, each time followed by a reassessment

Seek expert help if the patient is not responding, particularly after 2 litres of fluid

33
Q

the rate of potassium infusion should not exceed X mmol/hour, as there is a risk of inducing an arrhythmia or cardiac arrest

A

10mmol/hour

34
Q

When are maintenance fluids typically used?

A

When patient is nil by mouth

35
Q

What does stat mean

A

As quickly as possible

Y4 (23 decks)

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