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Renal > Intravenous Fluid > Flashcards

Intravenous Fluid Flashcards

1
Q

Percentage of water in total body weight

A

60%

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2
Q

Factors that affect total body water percentage

A

Âge
Gender
Body habitus

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3
Q

Total water body weight percentage in women

A

50%

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4
Q

Total body water percentage in infants

A

80%

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5
Q

Do obese people have more or less water

A

Less

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6
Q

Intracellular volume is ….. of TBW

A

2/3

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7
Q

Extra cellular volume Is ….. of TBW

A

1/3 ( 1/4 plasma volume and 3/4 interstitial fluid )

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8
Q

How to determine fluid status before operation

A 
Mental status 
Intake and output history 
Blood pressure ( supine and standing ) 
Heart rate 
Skin turgor
Urinary output 
Central venous pressure
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9
Q

What allows movement of water across the plasma membrane

A

osmotic pressure and hydrostatic pressure

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10
Q

Major electrolytes in the blood

A 
Sodium
 magnesium 
potassium 
chloride 
calcium 
bicarbonate
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11
Q

What is required for electrolytes to cross the plasma membrane

A

Active transport

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12
Q

The role of proteins in the plasma

A

To maintain the osmotic gradient and keeping fluid intravascular

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13
Q

2 Types of IV fluids

A

Crystalloids

Colloids

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14
Q

Crystalloids composition

A

Water
electrolytes
Water soluble molecules

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15
Q

Colloids composition

A

Large insoluble molecules

Proteins

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16
Q

One example of a colloid fluid

A

Blood and products

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17
Q

Advantage of using crystalloids fluids

A

Simple
cost effective
different combinations
no immune response

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18
Q

Advantage of colloid fluids

A

Higher osmotic pressure

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19
Q

Disadvantage of colloids fluid

A

More expensive

Immune response possible

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20
Q

3 types of crystalloids based on osmo

A

Isotonic
Hypertonic
Hypotonic

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21
Q

Isotonic fluids

A

Same osmotic concentration than extra cellular plasma (250-375L) so no shift between ECF and ICF

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22
Q

Hypertonic fluids

A

Greater osmotic concentration (more than 375L)

So Fluid goes from ICF to ECF ( dehydration of cells )

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23
Q

Hypotonic fluids

A

Less osmotic concentration ( less than 250L)

So fluids goes from ECF to ICF

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24
Q

Normal plasma composition with concentration

A 
Osmo (280-290) 
Sodium ( 135-145) 
Chloride (96-106)
Potassium ( 35-52) 
Calcium (4.4-5.2) 
Magnesium (1.8-2.4)
HCO3 ( 22-26) 
Lactate (1)
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25
Common isotonic IV fluids
``` Plasma Normal saline (0.90NS) Lactated ringers (LR) ```
26
Normal saline composition
Osmo 308 Sodium 154 Chloride 154 All the rest is O
27
Is normal saline balanced or unbalanced
Unbalanced
28
Most common used fluids
Normal saline
29
Why is the issue with normal saline
High chloride level -> hyperchloremic metabolic acidosis Acute kidney injury due to GFR impacted Slower renal clearance
30
Lactated ringers composition
``` Osmo 273 Sodium 130 Chloride 109 Potassium 4 Calcium 3 Lactate 28 ```
31
Is lactated ringers balanced or unbalanced
Balanced
32
Issues with lactated ringer
Slight hypotonic so can lead to intracellular shift Can cause cerebro edema Hepatic hypoperfusion can’t métabolisé Lactate rapidly enough so should avoid it for patient with liver issues
33
Plasmalyte composition
``` Osmo 295 Sodium 140 Chloride 98 Potassium 5 Magnesium 4 Gluconate 27 ```
34
Is plasmalyte balanced or unbalanced
Balanced
35
Hypertonic fluids type
3% normal saline
36
3% normal saline composition
Osmo 1030
37
Usage of 3% normal saline
Treatment of cerebral edema, severe symptomatic hyponatremia
38
Type of hypotonic IV fluids
1/2 normal saline (0.45NS)
39
Composition of 0.45NS
Osmo 154 Sodium 77 Chloride 77
40
When not to use 0.45 NS
If head injury or edema patient
41
Dextrose containing fluids types
``` 5% dextrose water (D5W) 5% dextrose -1/2 NS 5% dextrose - NS (D5NS) 5% dextrose -Lactated rangers (D5LR) 10% dextrose -water (D10W) ```
42
Types of colloids based on albumin volume
5% albumin - osmo 309 | 25% albumin - osmo 312
43
Advantage oh albumin
Préserve rénal function in critically ill patient | Low levels albumin patients
44
Orthostatic hypotension
Systolic blood pressure decreases by more than 20mmgh when going from supine to standing
45
Osmolality definition and units
Osmotic active solute per volume of solution (mOsm/L)
46
Osmolarity
mOsm/Kg
47
Indication for intravenous fluid
Volume resuscitation Vehicle for IV drugs Keep vein open
48
normal saline 0.9% indication
Intravascular resuscitation Replacement of salt loss ( diarrhea and vomiting) Dilute packed RBC prior to transfusion Dilute drugs
49
Complications of normal saline
Hyperchloremic metabolic acidosis
50
Indication for 3% saline
severe hyponatremia coma/ seizure resuscitate hypovolemic shock
51
How to administer 3% saline
Slow | With CV line to prevent phlebitis, necrosis and hemolysis
52
Complication of 3% saline
Precaution in CHF Severe renal insufficiency Edema with sodium retention
53
5% dextrose Indication
Maintain water balance when they can’t take anything by mouth used post operatively with salt retaining fluid hypernatremia treatment treatment
54
Indication for ringer lactate
Deficit intraoperative fluid loss Severe hypovolemia
55
RL indication
Déficit intra operative fluid loss Severe hypovolemia
56
RL precautions
Severe metabolic acidosis when impaired Lactate conversion Do not give with blood products can decrease anticoagulant activity
57
DNS indication
Maintenance solution correction of fluids deficits compatible with blood
58
Isolyte p indication
Pediatric maintenance fluid
59
Why are colloid more Dangerous
They can cause Platelets dysfunction interfere with fibrinolysis and coagulation factors
60
Albumin indication
Emergency treatment of shock when loss of plasma acute management of burns fluid resuscitation in ICU hypoalbuminemia
61
Albumin side effects
Pruritis Anaphylactoid reactions Coagulation abnormalities
62
Disadvantage of albumin
Cost | Volume overload
63
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Renal (16 decks)

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