IV Fluids Flashcards
Define colloids
fluids containing larger MW particles with plasma oncotic pressure similar to plasma proteins
Examples of colloids
albumin, FFP, hetastarch, dextran
Define hypotonic crystalloid
a solution of lower osmotic pressure than blood. goes out the vein into the tissue, then the cell
Define isotonic crystalloid
noting or pertaining to a solution containing the same salt concentration as blood. fluid stays in the vein
Define hypertonic crystalloid
a solution of higher osmotic pressure than blood
Example of hyotonic fluid
0.45% NaCl
Examples of isotonic fluids
0.9% NaCl, Lactated Ringer’s, D5W
Examples of hypertonic fluids
7-7.5% NaCl, D5 in ½ NS, Dextrose 5% in NS, Dextrose 10%, D50
What does the serum sodium tell you?
the patient’s water balance but not volume balance
What is the ideal fluid for maintenance therapy?
0.45% NaCl + 20 mEq KCl
How much does the water requirement increase for each degree fever > 37C?
100-150ml/day
What happens to the BUN/Cr with hypovolemia?
will increase to > 20:1
What causes hypotension associated with general anesthesia?
it is due to loss of vascular tone which “enlarges the tank.” Not loss of volume
If serum Na > 145 from hypovolemia due to sweating/hangover, what IV fluid should be used?
0.25% NaCl
If serum Na < 138 from hypovolemia due to sweating/hangover, what IV fluid should be used?
0.9% NaCl
If serum Na > 145 from hypovolemia due to vomiting or diarrhea, what IV fluid should be used?
0.45% NaCl
What replacement therapy should be used first if a patient is hypovolemic due to hemorrhage or burns?
Bolus 1-2 LITERS 0.9% NaCl (NS) or LR through large bore IVs until labs are back
When is a patient considered to be “tilt positive?”
has a change of 15 bpm with pulse AND decrease of 10 in the systolic BP.
What else should be considered for administration with burn patients to maintain pressure and prevent edema?
albumin
What is the IV fluid of choice?
normal saline (0.9% NaCl)
What is the only use for D5W as a stand-alone fluid?
when serum Na is >145 and patient is symptomatic with hypernatremia
Electrolyte imbalance that may occur with IV fluids
Dilutional hypokalemia
