IV Fluids Flashcards
Why is Glucose 5% and sodium chloride 0.9% both iso-osmotic with plasma?
Whole body fluid balance ?
-Sodium is the major cation in the extracellular space
Extracellular (140mM), Intracellular (5mM)
- The body can be considered to contain 3 compartments plasma, extracellular and intracellular. The plasma compartment contains a semipermeable membrane for albumin and the cell membrane a semipermeable membrane for sodium. Potassium has a high concentration in the intracellular fluid. Water can move across either membrane by osmosis which is the movement of water not the movement of solute which would be diffusion.
Where can 0.9% sodium chloride move to ?
Where can 5% glucose be distributed to
Whole body
What is the route for patients NBL eg for surgery?
Adults
3L IV maintenance fluids per day: 8h bags (2 saline/1 dextrose)
Elderly/very underweight
2L; 12h bags
In addition to sodium and water, adults also require a daily replacement of potassium.
In regards to colloid, NACL0.9%, and glucose 5% how much does it increase the circulating volume of blood?
Why would you not use Glucose 5% to treat dehydration ?
Only increases circulating volume by 7% because it travels into the intracellular space.
Gluocse 5%
Hypertonic Glucose - Glucose 10%, 20%, 50% - can be used for what ?
Can glucose 5% be used in diabetics?
Can be used - small amount can be metabolised quickly.
This is isotonic, not hypertonic glucose.
This should not be used for treatment of hypoglycemia for this reason.
Sodium Chloride 0.9%
- Can be used in maintenance
-Can be used for dehydration. - Be careful of hyperchloremia
Where can colloids move to ?
Which is the major cation (postive ion) i the extracellular space ?
- sodium
- potassium
-bicarbonate
-chloride
- Sodium
What is the average daily intake of water ?
2.5 L
What percentage of the daily intake of sodium is excreted in the urine?
95%
What concentration of glucose is iso-osmotic with 0.9% saline
5% glucose
What is the normal range for the concentration of chloride in plasma (units in mmol/l)
95-105
What percentage of NaCL 0.9% is retained within the vascular space ?
20%
What is the major use of intravenous glucose 5%?
To deliver water intravenously
What is the concentration of potassium in a 250ml bag of 0.9% saline containing 20mmol of potassium chloride?
80mmol/L
The intravenous infusion rate of potassium delivered by a peripheral line should not normally exceed what ?
10mmol/h
Which of the following is NOT a symptom used to detect hypovalemia?
- systolic BP greater than 140
- elevated plasma urea above the normal range
- Heart rate greater than 90bpm
- Respiratory rate greater than 20 breaths per min
- Systolic BP greater than 140
What percentage of an administered volume of colloid remains in the vascular space ?
80%
