IV Fluids Flashcards
Total body water is what percent of total body weight?
60%
In normal state, how much fluid is in intracellular fluid compartment?
2/3 of body water
In normal state, how much fluid is in extracellular fluid compartment?
1/3
TIE, 60, 40, 20
Total body fluid = 60% of body weight
Intracellular = 40% of body weight
Extracellular = 20% of body weight
What are the 2 major extracellular ions
Na+
Cl-
What are the 2 major intracellular ions
K+
PO4
What are the 3 Water inputs
Fluids
H2O in food
Metabolically produced H2O
Water Outputs (4)
Insensible loss (through lungs)
Sweat
Feces
Urine
Crystalloids: definition
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)
Colloids definition
Fluids that contain large organic macromolecules and electrolytes. Stay in vascular space, higher oncotic pressure (ex. Albumin)
Name the 3 types of replacement IVF
- Crystalloids
- Colloids
- Blood products
What are 3 examples of isotonic crystalloids?
- Normal saline (0.9% NaCl)
- Lactated Ringer’s solution
- Plasma-Lyte
What is in lactated Ringer’s solution
Lactate
K+
Ca++
Na+
If a patient is dehydrated or hypovolemic what is the best IVF to give?
isotonic crystalloids
What is the main concern with correcting sodium too quickly?
Osmotic demylination: central pontine myelinolysis (CPM) –>irreversible brain damage
When is Hypertonic NS (3%) indicated?
- life threatening hyponatremia
- neurosurgical patients to decrease cerebral edema
Are hypotonic crystalloids used for dehydration/hypovolemia?
No
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?
Colloids
What are the distinct uses of albumin 5% and albumin 25%?
5% - volume replacement
25% - diuresis (infrequently used)
What is the indication for packed red blood cells
Blood transfusions
1 unit of PRBCs should increase Hgb by ~___
1g
At what Hgb level do you give a blood transfusion?
<7g
What is the indication for Fresh Frozen Plasma (FFP)
to correct major bleeding complications on warfarin or with a vitamin K deficiency
When is cryoprecipitate indicated?
indicated for patients with low fibrinogen
ex.
- Massive hemorrhage
- Consumptive coagulopathy
What is in cryoprecipitate?
Factor VIII & fibrinogen
Which IVF can be given as a bolus?
- Normal saline
- Lactated Ringers
- Plasma-Lyte
What are the 3 most common rates for maintenacne fluids in adults?
a. 75ml/hr
b. 100ml/hr
c. 125ml/hr
Parkland formula is useful for replacement in what type of patient?
burn patients
What type of fluid should be given to a burn patient?
Lactated Ringers Solution
