Fluids Paulson Flashcards
Replaces ongoing losses of water and electrolytes under normal physiologic conditions via urine, sweat, respiration, and stool
Maintence therapy
Corrects any existing water and electrolyte defecits from
Replacement therapy
How to calculate maintenance?
• 1. Calculate body weight in kg
• 2. Calculate fluid needed over 24 hours
– 100 ml/kg for first 10 kg
– 50 ml/kg for second 10 kg
– 20 mg/kg for each kg over 20
• 3. Divide total ml over 24 hours for a ml/hr rate
If a patient starts with a defecit, we need to add more than maintence. What is the estimate defecit to add to a dry patient?
3%
If a patient starts with a defecit, we need to add more than maintence. What is the estimate defecit to add to a tachycardic patient?
6%
If a patient starts with a defecit, we need to add more than maintence. What is the estimate defecit to add to a shock patient?
9%
Ng tube losses have high _____ levels
Cl
Solute is large proteins like albumin or other molecules that remain intravascular –> draw water from the cells to intravascular space –> can significantly ↑ intravascular volume but also dehydrate cells
colloids
*like if someone had ascites and you drain it out, albumin comes with it so have to replace albumin
Used more frequently and contains electrolytes (sodium, potassium, calcium, chloride) as the solutes (water pulled towards whatever higher conc of solute is)
Crystalloids
contains the same amount of electrolytes as normal plasma
isotonic
contains more electrolytes than body plasma
hypertonic
contains less electrolytes than body plasma
hypotonic
Best when you have to give large fluid volumes
lactated ringers
Isotonic crystalloid that contains 0.9% sodium chloride in sterile water but large volumes cause problems
normal saline
0.45% NaCl in water and Helpful in hypernatremic patients who do not need extra glucose (ie: diabetics)
1/2 NS
