GS1 IV fluids: Assessing hydration Flashcards
How much fluid is lost via urine?
1500-2000mls/day
Increased by diuresis and diuretics
How much fluid is lost via insensible losses (i.e. skin and respiratory)?
500mls/daily
Increased by fever and sweating
How much fluid does a healthy adult require?
30mls/kg/24 hours of fluids
Electrolyte requirements for routine replacement?
Sodium, Potassium, Chloride 1 mmol/kg/24 hours
Glucose requirements for routine replacement?
50-100g glucose per day to limit starvation ketones.
3 reasons for patient dehydration and fluid overload?
Risks for dehydration:
- Swallowing problems
- Cognitive impairment
- Diarrhoea/vomiting
Risk for fluid overload:
- Heart failure
- Renal failure
- Hepatic failure
What are the 5 questions to ask before prescribing fluids?
- What is the patient’s hydration status?
- Does the patient need IV fluids?
- How much fluid does patient require?
- What types of fluid does the patient need?
- How should the patient’s fluid therapy be monitored?
What is the presentation of a euvolaemic patient?
- Veins are well filled
- Extremities are warm
- Blood pressure and heart rate are normal.
What is the presentation of a hypovolaemic patient?
- Dry mucous membranes, thirsty
- Cool peripheries
- Tachycardia
- Reduced capillary fill time
- Postural hypotension
- Oliguria (reduced urine volume)
- Agitated.drowsy –> Unconscious
Patient prevention of hypervolaemia?
- Oedamatous patient (Check for sacral, ascites and peripheral oedema)
- Inspiratory crackles
- Raised JVP
- Basal crepitations due to pulmonary oedema
- Hypertension
- Reduced SATs
- Hyponatraemic
What are the 4 types of fluids that can be given?
- Resus fluids: Isotonic fluids with blood
- Maintenance fluids: Supplying daily electrolyte or water or glucose to meet requirements
- Replacement fluids: To correct any fluid and electrolyte imbalance
- Parenteral nutrition fluids: Used to provide complete fluid, electrolyte and nutritional needs for patients who cannot eat or drink for an extended time
