Intravenous Fluids

Question 1

Why are both iso-osmotic with plasma?

Answer 1

Osmolality is a binding together property that is produced by the number of particles in a solution

Question 2

Glucose 5%

Answer 2

Molecular weight = 180

Question 3

Sodium Chloride 0.9%

Answer 3

Molecular weight 58.5 (Na+/Cl-)

Question 4

Osmolality

Answer 4

Intracellular -k (H2O)
Extracellular -Na(H2O)
Plasma - Na (H2O) Protein

Question 5

Osmolality

Answer 5

Sodium Na is the major cation in the Extracellular space

Extracellular(140mM)
Intracellular (5mM)

Question 6

Maintenance of IV fluids

Answer 6

In adults, 3 Litres of IV maintenance fluids per day is required - 8hr bags
( 2 saline /1dextrose)

In the elderly/Underweight,
2L: 12hr bags

Adults require 40- 60mmol KCL (Potassium chloride) per day when it is NIL by mouth.

Question 7

What is the percentage of volume of IV fluids remain within the vascular space?

Answer 7

Colloid
Sodium Chloride
Glucose

Question 8

2 types of fluids
Glucose 5%

Answer 8

(d- glucose = dextrose) is used in the body

Isotonic, the acidic pH is 4.5

5% = 5g/100mL, 50g/L MW 180; 280mOsm/L

It is also used to hydrate and deliver water through IV

But, disturbed through extra and intracellular

daily required - 2L of glucose 5%, 500mL sodium chloride 0.9%

Question 9

Hypertonic Glucose

Answer 9

Glucose 10%, 20%, and 50% can lead to irritant pain, phlebitis , thrombosis

Question 10

Do not give insulin and Glucose at the same time!

Question 11

Don’t be afraid to use glucose 5% in people with diabetes

Answer 11

Yes

Question 12

Two uses

Question 13

Sodium chloride 0.9%

Answer 13

0.9% with isotonic plasma

Can be given for HF patients with oedema

Question 14

Hartmann’s Solution

Answer 14

Compound Sodium Lactate - balanced salt sol

It is used to treat Hypovolaemia
(the vol of blood level is too low)

Lactate - pyruvate -glucose - CO2 - bicarbonate

Question 15

Potassium Chloride Concentration

Answer 15

KCL concentrate (10mL ampoules 15% kCL

Question 16

Average daily adult intake of water?

Answer 16

2.5 L

Question 17

What % of the daily intake of sodium is excreted in the urine?

Answer 17

95%

Question 18

What concentration of glucose is iso-osmotic with 0?9% saline

Answer 18

5%

Question 19

10% OF Glucose

Answer 19

Hypertonic

Question 20

Which is the major cation in the extracellular space ?

Answer 20

Na

Question 21

What is the normal range of concentration of chloride in plasma( units in mmoL)

Answer 21

95 to 105

Question 22

What percentage of an administered volume of NaCl 0.9% is retained within the vascular space?

Answer 22

20%

Question 23

What is the major use of IV glucose 5% ?

Answer 23

to deliver water through IV

Question 24

What is the concentration of potassium in a 250 mL bag of 0.9 saline containing 20 mmol of potassium chloride?

Answer 24

80mmoL

Question 25

The intravenous infusion rate of potassium delivered by a peripheral line should not normally exceed?

Answer 25

10mmol/h

Question 26

Which of the following is not a symptom to used to detect Hypovaelemia

Answer 26

Systolic BP greater than 140mmHg

Question 27

what percentage of an administered volume of colloid remains in the vascular space?

Answer 27

80%

Question 28

What fluid would you prescribe to an obese patient 43 years old who is admitted for elective cholecystectomy following a previous episode of cholecystitis

Answer 28

Sodium chloride 0.9% 1L with 20mmol KCL over 8h

Question 29

The most appropriate first bag of maintenance fluid to be given from midnight?

Na, K,

Answer 29

Glucose 5% of 1L with 20mmol

Question 30

What fluid regimen would you prescribe in the meantime?

Low level of potassium
Urea is low
Cr

Question 31

What fluid regimen would you prescribe?

52-year-old obese female is admitted with severe epigastric tenderness with a history of gall stones. On examination abdo felt s

Answer 31

Saline 0.9% of 500mL over 15 mints

Question 32

Which solution is used to prevent hypoglycemia when insulin is used to treat hyperkalemia ?

Answer 32

hypertonic glucose