IV Fluids & Elecrolytes

Question 1

Crystalloid Fluids

Answer 1

Contains water, electrolytes (K, Na, Cl), and small molecules (glucose, lactate)

Does not contain proteins/large molecules

Used to treat dehydration, used as replacement fluid.

Indications: acute liver failure, acute nephrosis, burns, hypovolemic shock, renal dialysis, etc

Adverse: May dilute plasma proteins, edema,

Examples: Normal saline, half normal saline, hypertonic saline, lactated ringers, D5W, Plasmalyte

Question 2

Only fluid used in conjunction with blood cell products

Answer 2

Normal Saline 0.9%

Question 3

Colloid fluids

Answer 3

Increase colloid osmotic pressure

Moves fluid from interstitial compartment to plasma compartment

”plasma volume expanders
Restores BP

Examples: Dextran (BIG glucose), hetastarch, modified gelatin, albumin

Superior to crystalloids in plasma volume expansion

Expensive

Disadvantages: Altered coagulation, no O2 carrying capacity

Indications: burns, trauma, sepsis, hypovolemic shock

Question 4

Blood/blood products

Answer 4

Expensive

Includes: Packed RBCs, whole blood, fresh frozen plasma, plasma protein factors,

Question 5

Packed RBCs and Whole Blood

Answer 5

To increase oxygen-carrying capacity
-Anemia
-Hemoglobin defects
-Blood loss >25%

Question 6

Fresh Frozen Plasma (FFP)

Answer 6

Increases clotting factor in patients with demonstrated deficiency = coagulation disorder

Question 7

Adverse Effects of Blood Product

Answer 7

Transfusion reaction

Transmission of pathogens

Question 8

Crystalloids advantages and disadvantages

Answer 8

Advantages
Few side effects
Low cost
Wide availability

Disadvantages
Short duration of action
May cause edema

Question 9

Colloids Advantages and Disadvantages

Answer 9

Advantages
Longer duration of action
Less fluid required for hypovolemia

Disadvantages
Higher cost
may cause volume overload
May interfere with clotting
Anaphylaxis risk

Question 10

Considerations when administering crystalloids and colloids?

Answer 10

Administer colloids slowly

Monitor for fluid overload and possible heart failure

Monitor for signs of Transfusion reactions

Question 11

Normal ECF Potassium

Answer 11

3.5 - 5 mmol/L

Question 12

Causes of hypokalemia

Answer 12

Loop and thiazide diuretics

Vomiting

Diarrhea

Question 13

Oral K associated with..

Answer 13

Diarrhea, nausea, vomiting, GI bleeding, ulcers

Question 14

Potassium infusion considerations

Answer 14

Must be closely monitored
rate should not exceed 10 mmol/hr
NEVER give as IV bolus or undiluted

Question 15

Oral potassium considerations

Answer 15

Oral K must be diluted in water or fruit juice to minimize GI issues

Monitor for nausea, vomiting, diarrhea, GI pain, GI bleed

Question 16

Normal sodium level

Answer 16

135-145 mmol/L

Question 17

Which fluids are used for hyponatremia

Answer 17

IV normal saline or lactated ringers
(for severe cases, oral sodium/fluid restriction for mild)