IV fluid prescribing

Question 1

5Rs

Answer 1

Resuscitation
Replacement
Routine Maintenance

Redistribution (what happens with fluid?)
Reassessment (understanding to check fluid and electrolytes)

Question 2

IV fluid management plan should include:

Answer 2

Fluid and electrolyte prescription over next 24 hours

Assessment and monitoring plan

Question 3

NICE recommended fluid resuscitation:

Answer 3

Balanced Crystalloid (NOT colloid or crystalloid - risk of hyperchloraemic metabolic acidosis)

Question 4

Exception to NICE recommendation for fluid resuscitation

Answer 4

Rhabdomyolysis -

0.9% sodium chloride (crystalloid) because of risk of hyperkalaemia

Question 5

How much of 1 litre of saline will stay in the plasma volume

Answer 5

18% (180ml)

Question 6

volume required per kg per day

Answer 6

25-30ml/kg/day

Question 7

Consider human albumin solution 4-5% (colloid) in patients with …

Answer 7

severe sepsis

Question 8

Indication for Colloid (human albumin solution)

Answer 8

large volume paracentesis

• 100ml every 3L if normal renal function
• 100ml every 2L if renal dysfunction

HepatoRenal Syndrome

Therapeutic Plasma Exchange

Question 9

Blood products:

Answer 9

• Fresh Frozen Plasma
• Platelets
• Pack red cells
• Cryoprecipitate

Question 10

Euvolaemic in Hyponatraemia:

Answer 10

ADH retains water while RAAS acts to expel urine containing sodium.
Syndrome of Inappropriate AntiDiuretic Hormone Secretion is a cause

Question 11

Treatment of Dry hyponatraemia:

Answer 11

0.9% saline (cautious + U+Es monitoring)

Question 12

Treatment of SIADH:

Answer 12

restrict water to <1L per day and treat underlying cause

Question 13

Overloaded and hyponatraemia:

Answer 13

restrict water, consider diuretics if significant volume or symptom.

Question 14

Severe Hyponatraemia =

Answer 14

<120mmol/L

Emergency treatment = 100ml of 3% saline over 10-15 minutes