Prescribing IV fluids and blood products Lecture slides (2)

Question 1

When we talk about maintenance fluids, how much fluid should the average individual receive?

1 - 5–10 ml/kg/day of water
2 - 15–20 ml/kg/day of water
3 - 15–30 ml/kg/day of water
4 - 25–30 ml/kg/day of water

Answer 1

4 - 25–30 ml/kg/day of water
- typically no more than 3L a day, unless in specific circumstances

• 20–25 ml/kg/day fluid if the patient is old/frail or if patient is at risk of re-feeding syndrome

Question 2

When we talk about maintenance fluids, how much K+, Na+ and Cl- should we receive?

1 - 1 mmol/kg/day
2 - 4 mmol/kg/day
3 - 6 mmol/kg/day
4 - 8 mmol/kg/day

Answer 2

1 - 1 mmol/kg/day

Question 3

When we talk about maintenance fluids, how much glucose should we receive?

1 - 10-30g/day
2 - 20–50 g/day
3 - 50–100 g/day
4 - 100–200 g/day

Answer 3

3 - 50–100 g/day
- important to avoid ketosis

Question 4

If a patient requires resuscitation fluids, how much and how quickly should it be given typically?

1 - crystalloid bolus of 500ml with Na+ (130-154mmol) over 15 mins
2 - crystalloid bolus of 250ml with Na+ (135-155mmol) over 15 mins
3 - crystalloid bolus of 500ml with Na+ (135-155mmol) over 30 mins
4 - crystalloid bolus of 150ml with Na+ (150-160mmol) over 15 mins1 - crystalloid bolus of 500ml with Na+ (135-155mmol) over 15 mins

Answer 4

1 - crystalloid bolus of 500ml with Na+ (130-154mmol) over 15 mins

• this should be reduced to 250ml if the patient is old and frail

Question 5

If a patient requires resuscitation fluids they will be given crystalloid bolus of 500ml with Na+ (130-154mmol) over 15 mins, reduced to 250ml in frail patients. This can be repeated as required, but what fluid level should you stop and see senior advice if the patient still isn’t responding?

1 - 1L
2 - 2L
3 - 3L
4 - 4L

Answer 5

2 - 2L
- this is 1L in old and frail patients

Question 6

Red cells can be given to patients who have lost significant blood. Typically how long are the red cells delivered over?

1 - <60 mins
2 - 60-120 mins
3 - 120-240mins
4 - >6 hours

Answer 6

2 - 60-120 mins
- no longer than 4 hours

Question 7

Platelets can be given to patients who may be at risk of bleeding. Typically how long are the red cells delivered over?

1 - 15-30 minutes
2 - 30-60 minutes
3 - <60 minutes
4 - <2 hours

Answer 7

2 - 30-60 minutes

Question 8

Fresh frozen plasma can be given to patients who need it. Typically how long are the red cells delivered over?

1 - 1-2 mL/kg/h
2 - 5-10 mL/kg/h
3 - 10–20 mL/kg/h
5 - 20-40 mL/kg/h

Answer 8

3 - 10–20 mL/kg/h