Intravenous Fluids

Question 1

What is diffusion?

Answer 1

Movement of solute from high conc to low through semi-permeable membrane

Question 2

What is osmosis?

Answer 2

Movement of water from high to low conc through a solute-impermeable membrane

Question 3

What is osmolarity?

Answer 3

Solute conc per unit volume of solvent

Question 4

What is osmolality?

Answer 4

Measure of solute conc per unit mass of solvent

Question 5

What is Tonicity?

Answer 5

Measure of the osmotic pressure gdt between two solutions

Question 6

In what proportions is water stored in the body?

Answer 6

2/3 intracellular

1/3 extracellular (20% intravascular)

Question 7

How is fluid balanced assessed?

Answer 7

ABCDE
Capillary refill
ECG 
Skin turgor
Patient weight 
Pulse contraanalysis
Input/output

Question 8

What are the 4 uses of fluids?

Answer 8

Resuscitation
Routine maintenance 
Replacement 
Redistribution
(reassessment)

Question 9

What is the limit for maintenance fluids?

Answer 9

MAX 100mls/hr

Question 10

What are the types of fluid?

Answer 10

Crystalloid

Colloid

Question 11

What are some crystalloid fluids?

Answer 11

Salines

Dextrose

Question 12

What are some Colloid fluids?

Answer 12

Blood
Albumin
Starch

Question 13

How does hypovolaemia present?

Answer 13

Nauseous
Thirsty
Flat veins
Cool peripheries
No sweat
Low/postural BP
High heart rate
Concentrated oliguria

Question 14

How is a hypovolaemic patient managed?

Answer 14

Resuscitation fluids if low BP
Rehydration fluids
Find the cause

Question 15

How does hypervolaemia present?

Answer 15

Breathless, not thristy
Distended veins
Warm, oedematous extremities
Sweaty
High BP/HR
Dilute urine

Question 16

How is a hypervolaemic patient managed?

Answer 16

Diuretics

Haemofiltration (if anuric)

Question 17

What can cause difficulty in treating patients with fluid imbalance?

Answer 17

Low oncotic pressure

Heart failure

Question 18

Low protein can cause oedema in dehydrated patients how?

Answer 18

Loss of intracapillary fluid whilst behaving hypovolemic

Question 19

What are the questions to be asked in prescribing fluids?

Answer 19

What is the patient’s volume status?
Does the patient NEED IV fluids?
How much fluid is needed?
What types of fluid do they need?

Question 20

What must be taken into consideration when working out how much fluid a patient needs?

Answer 20

Work out water deficit
Catheters/drains
Input charts
Vomit bowls/sputum pots
Stool charts

Question 21

What is the normal daily loss of water in adults?

Answer 21

400-800mls

Question 22

What conditions can affect how much fluid a patient needs?

Answer 22

Sepsis
Ventilation
Open wounds
Burns
Bleeding

Question 23

What are the benefits of Dextrose fluids?

Answer 23

Moves through all compartments
Chronic dehydration
Hypernatremia

Question 24

What are the risks of dextrose fluids?

Answer 24

Not useful for blood volume expansion
Isotonic
Not useful in resus, low albumin

Question 25

When are crystalloids used?

Answer 25

Acute dehydration
AKI
Resuscitation

Question 26

When are crystalloids not used?

Answer 26

Long term maintenance
Hypernatremic patient (High sodium load)

Question 27

Dextrose fluids enter what fluid compartment?

Answer 27

Total body water

Question 28

Crystalloid fluids enter what fluid compartment?

Answer 28

Remain in ECF

Question 29

Plasma expander fluids enter what fluid compartment?

Answer 29

IVS (as colloid)

Question 30

When are plasma expanders used?

Answer 30

Liver patients

Inter-operative