IV Fluids

Question 1

Define colloids

Answer 1

fluids containing larger MW particles with plasma oncotic pressure similar to plasma proteins

Question 2

Examples of colloids

Answer 2

albumin, FFP, hetastarch, dextran

Question 3

Define hypotonic crystalloid

Answer 3

a solution of lower osmotic pressure than blood. goes out the vein into the tissue, then the cell

Question 4

Define isotonic crystalloid

Answer 4

noting or pertaining to a solution containing the same salt concentration as blood. fluid stays in the vein

Question 5

Define hypertonic crystalloid

Answer 5

a solution of higher osmotic pressure than blood

Question 6

Example of hyotonic fluid

Answer 6

0.45% NaCl

Question 7

Examples of isotonic fluids

Answer 7

0.9% NaCl, Lactated Ringer’s, D5W

Question 8

Examples of hypertonic fluids

Answer 8

7-7.5% NaCl, D5 in ½ NS, Dextrose 5% in NS, Dextrose 10%, D50

Question 9

What does the serum sodium tell you?

Answer 9

the patient’s water balance but not volume balance

Question 10

What is the ideal fluid for maintenance therapy?

Answer 10

0.45% NaCl + 20 mEq KCl

Question 11

How much does the water requirement increase for each degree fever > 37C?

Answer 11

100-150ml/day

Question 12

What happens to the BUN/Cr with hypovolemia?

Answer 12

will increase to > 20:1

Question 13

What causes hypotension associated with general anesthesia?

Answer 13

it is due to loss of vascular tone which “enlarges the tank.” Not loss of volume

Question 14

If serum Na > 145 from hypovolemia due to sweating/hangover, what IV fluid should be used?

Answer 14

0.25% NaCl

Question 15

If serum Na < 138 from hypovolemia due to sweating/hangover, what IV fluid should be used?

Answer 15

0.9% NaCl

Question 16

If serum Na > 145 from hypovolemia due to vomiting or diarrhea, what IV fluid should be used?

Answer 16

0.45% NaCl

Question 17

What replacement therapy should be used first if a patient is hypovolemic due to hemorrhage or burns?

Answer 17

Bolus 1-2 LITERS 0.9% NaCl (NS) or LR through large bore IVs until labs are back

Question 18

When is a patient considered to be “tilt positive?”

Answer 18

has a change of 15 bpm with pulse AND decrease of 10 in the systolic BP.

Question 19

What else should be considered for administration with burn patients to maintain pressure and prevent edema?

Answer 19

albumin

Question 20

What is the IV fluid of choice?

Answer 20

normal saline (0.9% NaCl)

Question 21

What is the only use for D5W as a stand-alone fluid?

Answer 21

when serum Na is >145 and patient is symptomatic with hypernatremia

Question 22

Electrolyte imbalance that may occur with IV fluids

Answer 22

Dilutional hypokalemia