Week 7 - Fluids

Question 1

Normal cell osmolarity

Answer 1

275 - 295

Question 2

Hypotonic fluids (2)

Answer 2

• D5

- 0.45% Na Cl

Question 3

D5W indications (2)

Answer 3

• hypernatremia

- dehydration

Question 4

D5 consideration

Answer 4

• no electrolytes

Question 5

D5 is not for ____ patients

Answer 5

3rd spacing patients

Question 6

D5 should not be mixed with IV ____

Answer 6

IV Dilantin –> will crytallize

Question 7

0.45% Na Cl indication

Answer 7

Dehydration

Question 8

0.45% Na Cl considerations

Answer 8

• no calories

- monitor sodium

Question 9

Isotonic fluids aka

Answer 9

Crystalloids

Question 10

Isotonic fluids…

Answer 10

Stay where you put it (good for raising BP!)

Question 11

If you give isotonic fluids to vulnerable patients…

Answer 11

Check for CHF and pulmonary edema

Question 12

Isotonic fluids (3)

Answer 12

• NS
• LR
• Hestastarch (Hespan)

Question 13

NS indications

Answer 13

• hyponatremia
• shock
• hypotension
• volume expansion
• sepsis
• cardiac arrest
• hemorrhage

Question 14

NS is compatible with

Answer 14

blood products

Question 15

NS considerations (2)

Answer 15

• no calories

- monitor Na, BP, breath sounds, CHF

Question 16

NS should be used in caution in what kind of patients?

Answer 16

Renal patients

Question 17

LR has a lot of

Answer 17

electrolytes

Question 18

LR indications (4)

Answer 18

• post op
• hypotension
• volume expansion
• metabolic acidosis (lactate gets converted to bicarb by liver –> increased bicarb –> more alkaline)

Question 19

LR considerations (2)

Answer 19

• good for burn patients

- monitor K+, metabolic alkalosis

Question 20

LR should be avoided in what kind of patients?

Answer 20

Liver patients –> can’t covert lactate –> lactate acidosis

Question 21

Hespan ________ vessel ______

Answer 21

Stays in the vessel longer

Question 22

Hespan indications (2)

Answer 22

• volume expansion

- bolus for hypotension or decreased urine output

Question 23

Hespan considerations

Answer 23

• monitor BP, HF

- Inhibits factor B

Question 24

Hespan should be cautioned in what kind of patients

Answer 24

Patients with coagulopathies

Question 25

Hypertonic fluids pulls…

Answer 25

Water out of the cell

Question 26

Hypertonic fluid are not seen in what kind of patients?

Answer 26

Cardiac patients

Question 27

Hypertonic fluids (4)

Answer 27

• D10
• D5LR
• 3% NaCl
• 20% Mannitol

Question 28

D10 indications (2)

Answer 28

• Hypoglycemia

- TPN substitute

Question 29

D10 considerations

Answer 29

• monitor glucose, HF, pulmonary edema

Question 30

3% NaCl indications (2)

Answer 30

• symptomatic hyponatremia (Addison’s disease)

- Brain swelling

Question 31

3% NaCl considerations (2)

Answer 31

• monitor Na, HF, pulmonary edema

- short term infusion

Question 32

D5LR indications (3)

Answer 32

• volume expansion
• dehydration
• post op

Question 33

D5LR considerations

Answer 33

• monitor renal, BP, HF, pulmonary edema, urine output

Question 34

20% Mannitol indications (2)

Answer 34

• increased ICP

- rhabdomyalisis

Question 35

To give 20% mannitol, the patient needs…

Answer 35

Good kidneys!

- can’t diurese a patient who can’t pee

Question 36

As osmolarity of the fluid increases…

Answer 36

so does the risk of pulmonary edema and HF!