IV Fluids

Question 1

Total body water is what percent of total body weight?

Answer 1

60%

Question 2

In normal state, how much fluid is in intracellular fluid compartment?

Answer 2

2/3 of body water

Question 3

In normal state, how much fluid is in extracellular fluid compartment?

Answer 3

1/3

Question 4

TIE, 60, 40, 20

Answer 4

Total body fluid = 60% of body weight
Intracellular = 40% of body weight
Extracellular = 20% of body weight

Question 5

What are the 2 major extracellular ions

Answer 5

Na+

Cl-

Question 6

What are the 2 major intracellular ions

Answer 6

K+

PO4

Question 7

What are the 3 Water inputs

Answer 7

Fluids
H2O in food
Metabolically produced H2O

Question 8

Water Outputs (4)

Answer 8

Insensible loss (through lungs)
Sweat
Feces
Urine

Question 9

Crystalloids: definition

Answer 9

fluids that contain crystal-forming elements (electrolytes) which easily pass through vascular endothelial membrane barriers followed by water, leadin to thei rquilibrating betweeing the intravascular and extracellular space (ex. NS)

Question 10

Colloids definition

Answer 10

Fluids that contain large organic macromolecules and electrolytes. Stay in vascular space, higher oncotic pressure (ex. Albumin)

Question 11

Name the 3 types of replacement IVF

Answer 11

1. Crystalloids
2. Colloids
3. Blood products

Question 12

What are 3 examples of isotonic crystalloids?

Answer 12

1. Normal saline (0.9% NaCl)
2. Lactated Ringer’s solution
3. Plasma-Lyte

Question 13

What is in lactated Ringer’s solution

Answer 13

Lactate
K+
Ca++
Na+

Question 14

If a patient is dehydrated or hypovolemic what is the best IVF to give?

Answer 14

isotonic crystalloids

Question 15

What is the main concern with correcting sodium too quickly?

Answer 15

Osmotic demylination: central pontine myelinolysis (CPM) –>irreversible brain damage

Question 16

When is Hypertonic NS (3%) indicated?

Answer 16

• life threatening hyponatremia

- neurosurgical patients to decrease cerebral edema

Question 17

Are hypotonic crystalloids used for dehydration/hypovolemia?

Answer 17

No

Question 18

In a burn patient, liver disease, or a patient with peritonitis where there is considerable protein loss from the vascular space “third spacing”-what is the preferred IVF?

Answer 18

Colloids

Question 19

What are the distinct uses of albumin 5% and albumin 25%?

Answer 19

5% - volume replacement

25% - diuresis (infrequently used)

Question 20

What is the indication for packed red blood cells

Answer 20

Blood transfusions

Question 21

1 unit of PRBCs should increase Hgb by ~___

Answer 21

1g

Question 22

At what Hgb level do you give a blood transfusion?

Answer 22

<7g

Question 23

What is the indication for Fresh Frozen Plasma (FFP)

Answer 23

to correct major bleeding complications on warfarin or with a vitamin K deficiency

Question 24

When is cryoprecipitate indicated?

Answer 24

indicated for patients with low fibrinogen

ex.

1. Massive hemorrhage
2. Consumptive coagulopathy

Question 25

What is in cryoprecipitate?

Answer 25

Factor VIII & fibrinogen

Question 26

Which IVF can be given as a bolus?

Answer 26

1. Normal saline
2. Lactated Ringers
3. Plasma-Lyte

Question 27

What are the 3 most common rates for maintenacne fluids in adults?

Answer 27

a. 75ml/hr
b. 100ml/hr
c. 125ml/hr

Question 28

Parkland formula is useful for replacement in what type of patient?

Answer 28

burn patients

Question 29

What type of fluid should be given to a burn patient?

Answer 29

Lactated Ringers Solution