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Anaesthetics and Genetics > IV Fluids > Flashcards

IV Fluids Flashcards

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1
Q

What is diffusion?

A

Movement of SOLUTE from high concentration to low concentration

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2
Q

What feature must the membrane have for diffusion?

A

Must be solute permeable

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3
Q

What is osmosis?

A

Movement of water from high concentration to low concentration

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4
Q

What feature must the membrane have for osmosis?

A

Solute impermeable

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5
Q

What is osmolarity?

A

The measure of the solute concentration per unit VOLUME of solute

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6
Q

What does osmolarity take into account?

A

ALL of the solute concentrations, not just the ones that cant cross the semipermeable membrane

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7
Q

What would be the concentrations of H20 and solute be in the hyperosmotic side?

A

Higher solute concentration

Lower free H20 concentration

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8
Q

What concentrations of H20 and solute be in the hypoosmotic side?

A

Lower solute concentration

higher free H20 concentration

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9
Q

What is osmolality?

A

Measure of solute concentration per unit MASS of solvent

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10
Q

Osmolality in the ICF and ECF

A

It is the same in the ICF and ECF

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11
Q

What is tonicity?

A

The measure of the osmotic pressure gradient between two solutions

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12
Q

What is tonicity influenced by?

A

Only influenced by solutes that cannot cross the semipermeable membrane, because these are the solutes influencing the osmotic pressure gradient

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13
Q

How much water is in the body of a average 70kg male?

A

42 litres

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14
Q

Distribution of water in the body

A 
42 L in total 
2/3 (28L) INTRACELLULAR
- 66%
1/3 (14L) EXTRACELLULAR 
- 20% plasma (3L)
- 80% interstitial
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15
Q

How much water is needed per day?

A

25 - 30 ml / kg/ day

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16
Q

How much sodium is needed per day?

A

1 mmol / kg / day

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17
Q

How much potassium is needed per day?

A

1 mmol / kg / day

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18
Q

How much glucose is needed per day?

A

50-100g / day

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19
Q

How much of fat is water?

A

10%

20
Q

How much of muscle is water?

A

75%

21
Q

How much does our water content change with age?

A

Babies = 70%
Child = 60%
Old person = 50%

22
Q

Questions to ask about fluids

A
  1. What is my patients volume status?
  2. Does my patient need IV fluids?
  3. How much fluid do they need?
  4. What types of fluid do they need?
23
Q

What is euvolaemia?

A

The right amount of fluid in the body

24
Q

Presentation of euvolaemia

A 
Feels well 
Not thirsty
Veins well filled
Warm extremities 
Mild sweat 
Normal BP and HR
Normal urine
25
Q

Needs of euvolaemia

A

No fluids (unless electrolyte deplete or low BP)

26
Q

Presentation of hypovolaemia

A 
nausea
thirsty
flat veins
cool peripheries 
no sweat 
low or postural BP and high HR
Concentrate oliguria 
Responds to SLR
27
Q

Needs of hypovolaemia

A

Resuscitation fluids (if low BP)
Rehydration fluids
“plug the leak”

28
Q

Presentation of hypervolaemia

A 
Feels breathless 
Not thirsty
Veins distended
Warm and oedematous extremities 
sweaty
high BP and high HR 
Dilute urine (could be oliguric or polyruic)
29
Q

Needs of hypervolaemia

A

No more fluids
Possibly diuretics (if resp compromise)
Hemofiltration (if anuric)

30
Q

Low oncotic pressure (low protein/albumin) can present as what?

A

Oedema in dehydrated patients due to loss of intracapillary fluid
Tends to be odematous, but behave hypovolaemic (low BP, high HR, thirsty)

31
Q

What can heart failure present as?

A

Oedema
Low BP
but still require diuresis due to high circulating volume causing increased RVP

32
Q

Things to look at to work out the water deficit

A 
Catheters
Drains
Input charts
Vomit bowels 
Sputum pots
Stool charts and stoma losses
33
Q

What are the insensibles?

A

Transepidermal diffusion
Open wounds
Burns
Bleeding

34
Q

What is Transepidermal diffusion?

A

Water that passes through the skin and is lost by evaporation AND water loss from the resp tract.
Sepsis (sweat)
ventilation

35
Q

How much loss of fluid occurs daily in adults by Transepidermal diffusion?

A

400-800mls

36
Q

The 5 Rs

A 
Resuscitation 
Routine maintenance
Replacement 
Redistribution 
Reassessment
37
Q

What are IV fluids used?

A

If cannot take orally
Urgently to restore circulation with hypovolaemia
Enterally to meet patient maintenance requirements

38
Q

If dont need IV fluids for resuscitation, when is another scenario you may need for IV fluids?

A

If need IV additional to maintenance to correct existing deficit OR
ongoing abnormal external losses e.g. diarrhoea, fever

39
Q

Where can dextrose move in the body?

A

Through all compartments

40
Q

Dextrose is useful in …..

A

Chronic dehydration

Hypernatraemia

41
Q

When is dextrose not useful?

A

Resuscitation

Low albumin

42
Q

Where do crystalloids remain?

A

In ECF

43
Q

Crystalloids are useful in …..

A

Acute dehydration
AKI
resuscitation

44
Q

When are crystalloids not useful?

A

Long term maintenance

Hypernaetraemic patient

45
Q

Plasma expanders are useful in …..

A

liver patients

select intra-operative

46
Q

What are plasma expanders not useful in?

A

much else

47
Q

What are plasma expanders and where are they found in the body?

A

Colloids

Exclusively stay in IVS

Anaesthetics and Genetics (15 decks)

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