IV Fluids and Electrolytes Flashcards
normal fluid requirement
35ml/kg/day
weight in kilos + 40
Na content in NS and 1/2 saline
154
77 respectively
If you want to give fluid with potassium and chloride and Ca?
LR
avoid in hyperkalemia, hypercalcemia!
what to use in non HDS, (i.e. GI bleeding), what to use?
NS (LR also acceptable)….will put most volume into intracascular space)
hypernatremic woman on tube feeds, no signs of VOLUME depletion
she’s dehydrated
just give water via NG! to correct hypernatremia (BUT DON’T CORRECT MORE THAN 10 mEQ/day
volume depleted, hypernatremic male with dementia, what fluid?
1/2 NS
post op pain patient on narcotics, what fluid to give?
NS or LR
narcotics and post op pain cause ADH which will lead to dangerous hyponatremia so don’t give hypotonic fluids!
ESRD patient with hyperkalemia comes into ED
150 meq bicarb (3amps) in D5w
bicarb will help acidosis and drive poatssium intracellularly
dextrose will cause insulin release and will drive K into cells (d5w causes hypokalemia often)
45 yo male with AKI, bicarb low
75 meq bicarb in 1/2 NS (it’s like giving LR without the K)
non anion gap met acidosis, so giving NS alone may worsen acidosis
19 yo with DKA presents, non HDS
NS! b/c NS to address hemodynamics!
in DKA, NS usually first choice
32 yo before elective hernia repair, what to use for maintenance?
can argue for no IVF but for general maintenance
d5w + 1/2 NS
after elective hernia repair, patient is HDS
no fluids (esp if he got fluids during the procedure)
64 with female with Na 102 with seizures
3% saline (hypertonic) since it’s an emergency and she’s having seizures
ex: 50 mL bolus to stabilize and then slowly correct from there…call attending or nephrology!)
AKI, volume overloaded (ascitic), non HDS
25% albumin
major indications for albumin (hepatorenal, SBP, large volume paracentesis)
common causes hypokalemia
diuretics, diarrhea, vomiting
