IV fluids

Question 1

DISCUSS COLLOIDS CLINICAL PHARM

Answer 1

Drug names: gelatins, albumin

Indications:

• expand circulating volume in states of impaired tissue perfusion (including shock)
• In cirrhotic liver disease, albumin is used to prevent effective hypovolaemia in large-volume paracentesis (ascitic fluid drainage).

Adverse effects:

• oedema
• pulmonary oedema
• hypersensitivity reactions, including anaphylaxis

Warnings/cautions:

• Patients with heart failure
• renal impairment, it is vital to monitor fluid balance

Monitoring:
- It is vital to assess haemodynamic status (e.g. pulse, blood pressure, jugular venous pressure, capillary refill time, urine output) before and after infusion as a guide to further therapy

Question 2

DISCUSS CRYSTALLOIDS CLINICAL PHARM

Answer 2

Indications: To help maintainance of fluids (dehydration cases), helps with blood loss from surgery and helps with urinary flow.
- To expand circulating volume in states of impaired tissue perfusion (including shock

Adverse effects:

• interstitium promotes oedema
• pulmonary oedema

Warnings/cautions:

• heart failure
• severe liver disease
• renal impairment, it is vital to monitor fluid balance closely

Contraindications and interactions: none

Monitoring:
- In any patient receiving fluid infusions, fluid balance should be monitored and recorded (see Glucose)
Types of crystalloids:

• helps with dehydration, surgery and blood loss
• Hypovolemia, haemorrhage

Hypotonic
- Swells- pulls water into the space
Give: to dehydrated cells
Pt’s who have no fluid in the blood stream. Cell lysis could occur
O.45% NS & 0.33% NS
DO NOT GIVE: to ICP or burn victims, diabetic pts

Hypertonic:

• Shrink: cell is swollen & needs to be hypertonic= pulls fluid out & dehydrates the area
• Treats: hyponatremia & cerebral edema
• 3% NS, 5% NS, 10%NS, & 5% dextrose in NS