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Specialities - Pharmacology > IV Fluids > Flashcards

IV Fluids Flashcards

1
Q

What is the definition of diffusion?

A

The movement of solute from high to low concentration (membrane must be permeable to solute)

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2
Q

What is the definition of osmosis?

A

The movement of water from high to low concentration (membrane has to be solute impermeable)

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3
Q

What is the definition of osmolarity?

A

The measure of solute concentration per unit volume of solvent

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4
Q

What is the definition of osmolality?

A

The measure of solute concentration per unit volume of MASS of solvent

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5
Q

Is Osmolality the same between ICF and ECF? Why?

A

Yes - because water moves freely across cell membranes

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6
Q

What is the definition of tonicity?

A

The measure of the oncotic pressure gradient between two solutions

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7
Q

Which type of solutes are taken into account in the computation of tonicity? Solutes that CAN or CANNOT cross the semipermeable membranes?

A

CANNOT

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8
Q

How much water does the average 70kg male body carry?

A

42l

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9
Q

How much of bodily fluid is ICF and how much is ECF?

A

ICF - 2/3

ECF - 1/3

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10
Q

How much of the ECF is contained within plasma?

A

20%

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11
Q

What are the components of blood?

A

Plasma + cells (white & red) + platelets (clotting)

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12
Q

What solutes are found within plasma?

A

Na

Mg

Cl

K

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13
Q

Apart from solutes (electrolytes), what else is found within plasma?

A

Urea

Protein

Bilirubin

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14
Q

Which solute has the highest concetration within ICF?

A

Potassium

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15
Q

Which solute has the highest concentration within ECF?

A

Sodium

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16
Q

What are the 2 components of fluid found with the ECF?

A

1 - Interstitial compartment

2 - Plasma compartment

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17
Q

Is osmolality the same between all fluid compartments in the body?

A

Yes

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18
Q

What are the bodies daily requirements for water, sodium, potassium and glucose?

A

Water - 25/30ml/kg/day

Sodium - 1mmol/kg/day

Potassium - 1mmol/kg/day

Glucose - 50-100g/day

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19
Q

How much of fat is composed of water?

A

10%

20
Q

How much of muscle is composed of water?

A

75%

21
Q

Does the body need less or more water as we get older?

A

Less

22
Q

What are the important questions to ask yourself when assessing a patient who may need fluids?

A

1 - What is the fluid status of my patient?

2 - Does my patient need IV fluids?

3 - How much fluid does my patient need?

4 - What type of fluid does my patient need?

23
Q

What is the first step in assessing your patients fluid status?

A

Identify the cause of the deficit/surplus:

A - Airway

B - Breathing

C - Circulation

D - Disability

E - Extremities

24
Q

What are the possible fluid status’s of patients?

A

Hypovolaemic

Euvolaemic

Hypervolaemic

25
Q

What are the features of euvolaemic patient?

A

1 - Does not feel thirsty

2 - Warm extremities

3 - Well filled veins

4 - Normal HR & BP

5 - Normal urine

6 - Mild sweat

26
Q

What are the features of a hypovolaemic patient?

A

1 - Feels nauseous & thirsty

2 - Flat veins

3 - Cool peripheries

4 - No sweat

5 - Low or postural BP and high HR

6 - Low urine output

7 - Confusion

27
Q

What does a hypovolaemic patient need?

A

1 - Resuscitation fluids (if BP low)

2 - Rehydration fluids

3 - “Plug the leak”

28
Q

What are the features of a hypervolaemic patient?

A

1 - Breathless

2 - Distended veins

3 - Warm and oedematous extremities

4 - Sweaty

5 - High BP & HR

6 - Dilute urine

29
Q

What does a hypervolaemic patient need?

A

1 - Diuretics (if respiratory system is compromised)

2 - Haemofiltration (if anuric)

30
Q

In what case can hypovolaemic patients become oedematous?

A
  • Low Albumin or Protein levels (causes low oncotic pressure and therefore loss of intracapillary pressure)
  • Patients become oedematous but have features of hypovolaemia (low BP, high HR and thirsty)
31
Q

What needs to be considered when computing how much fluid your patient needs?

A

1 - Catheters/drains

2 - Input charts

3 - Vomit bowls

4 - Sputum pots

5 - Stool charts and stoma losses

32
Q

Via which routes can patients loose ‘insensible’ water?

A

1 - Sepsis (sweat)

2 - Ventilation

3 - Open wounds

4 - Bleeding

5 - Burns

33
Q

What is the normal volume of insensible fluid losses in humans per day?

A

400-800mls

34
Q

What are the routes via which fluid can be adminstered to a patient?

A

IV

Oral

NG

35
Q

What are the different fluid types that can be adminstered to patients?

A

1 - Dextrose

2 - Crystalloids

3 - Plasma expanders

36
Q

For what reasons can patients need IV fluids?

A

Resuscitation - IV fluids urgently to restore circulation with hypovolaemia

Routine maintenance - If patient cannot take fluids orally or parenterally

Replacement - Not as urgent as IV resuscitation, but need additional fluids ontop of maintenance due to external losses e.g. diarrhoea, fever

Redistribution - For patients with abnormal fluid distribution (sepsis, cardiac, liver or renal disease)

37
Q

What are the features of dextrose?

A

1 - Moves through all compartments of the body

2 - Zero sodium load

3 - Isotonic

38
Q

When should dextrose fluid be used?

A

1 - Chronic dehydration

2 - Hypernatraemia

39
Q

When should dextrose not be used?

A

1 - Fluid resuscitation

2 - Low albumin

40
Q

What are the features of crystalloid fluids?

A

1 - Very practical

2 - Remains in ECF

3 - High Na load

41
Q

In what situations are crystalloid fluids useful?

A

1 - Acute dehydration

2 - AKI

3 - Resuscitation

42
Q

In what situations are crystalloid fluids not useful?

A

1 - Long term maintenance

2 - Hypernatraemic patient

43
Q

What are the features of plasma expanders?

A

1 - Stays in IVS

2 - Similar efficacy to crystalloids for resuscitation

3 - Sometimes used in Liver Cirrhosis

44
Q

In what situations are plasma expanders useful?

A

1 - Liver patients

45
Q

What are the 3 fluid compartments in humans?

A

1 - ICF

2 - Interstitial fluid (ECF)

3 - Plasma fluid (ECF)

Specialities - Pharmacology (4 decks)

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