Intravenous Fluids Flashcards
Why are both iso-osmotic with plasma?
Osmolality is a binding together property that is produced by the number of particles in a solution
Glucose 5%
Molecular weight = 180
Sodium Chloride 0.9%
Molecular weight 58.5 (Na+/Cl-)
Osmolality
Intracellular -k (H2O)
Extracellular -Na(H2O)
Plasma - Na (H2O) Protein
Osmolality
Sodium Na is the major cation in the Extracellular space
Extracellular(140mM)
Intracellular (5mM)
Maintenance of IV fluids
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.
What is the percentage of volume of IV fluids remain within the vascular space?
Colloid
Sodium Chloride
Glucose
2 types of fluids
Glucose 5%
(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%
Hypertonic Glucose
Glucose 10%, 20%, and 50% can lead to irritant pain, phlebitis , thrombosis
Do not give insulin and Glucose at the same time!
Don’t be afraid to use glucose 5% in people with diabetes
Yes
Two uses
Sodium chloride 0.9%
0.9% with isotonic plasma
Can be given for HF patients with oedema
Hartmann’s Solution
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
Potassium Chloride Concentration
KCL concentrate (10mL ampoules 15% kCL
Average daily adult intake of water?
2.5 L
What % of the daily intake of sodium is excreted in the urine?
95%
What concentration of glucose is iso-osmotic with 0?9% saline
5%
10% OF Glucose
Hypertonic
Which is the major cation in the extracellular space ?
Na
What is the normal range of concentration of chloride in plasma( units in mmoL)
95 to 105
What percentage of an administered volume of NaCl 0.9% is retained within the vascular space?
20%
What is the major use of IV glucose 5% ?
to deliver water through IV
What is the concentration of potassium in a 250 mL bag of 0.9 saline containing 20 mmol of potassium chloride?
80mmoL
The intravenous infusion rate of potassium delivered by a peripheral line should not normally exceed?
10mmol/h
Which of the following is not a symptom to used to detect Hypovaelemia
Systolic BP greater than 140mmHg
what percentage of an administered volume of colloid remains in the vascular space?
80%
What fluid would you prescribe to an obese patient 43 years old who is admitted for elective cholecystectomy following a previous episode of cholecystitis
Sodium chloride 0.9% 1L with 20mmol KCL over 8h
The most appropriate first bag of maintenance fluid to be given from midnight?
Na, K,
Glucose 5% of 1L with 20mmol
What fluid regimen would you prescribe in the meantime?
Low level of potassium
Urea is low
Cr
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
Saline 0.9% of 500mL over 15 mints
Which solution is used to prevent hypoglycemia when insulin is used to treat hyperkalemia ?
hypertonic glucose
