4: IV fluid prescribing Flashcards Preview

Renal Week 1 2017/18 > 4: IV fluid prescribing > Flashcards

Flashcards in 4: IV fluid prescribing Deck (29)
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1
Q

Why may patients be given fluids?

A

Resuscitation in emergencies

Replacement in deficiency (could also be an emergency)

Routine maintenance

2
Q

It is important that people being given IV fluids are ___.

A

reassessed

3
Q

passive leg raise for indication of fluid level

A
4
Q

If a patient is hypotensive, how much fluid can you give them in 500ml boluses before you should call for help?

A

2L

5
Q

If a patient is at risk of heart failure, you should give ___ml boluses of fluid.

A

250ml

6
Q

look at values for routine maintenance

A
7
Q

look at table for types of fluid therapy and what to use for each

A
8
Q

In routine maintenance, your daily fluid requirement depends on your ___.

A

weight

9
Q

All fluids apart from crystalloids (and colloids) rapidly ___ out of the vascular system.

A

redistribute

10
Q

Why isn’t 0.9% NaCl used for routine maintenance?

A

Twice the daily Na

11
Q

potassium chloride is almost a controlled drug

A
12
Q

use hartmann’s in dka (contains K) - hypokalaemia, monitor

A
13
Q

remember for routine maintenance:

need to make up to 2L

and need to be within daily requirements

you can half / double / mix things

A
14
Q

When are colloid solutions used?

A

Severe sepsis

revise that lecture

15
Q

large volume ascites paracentesis in liver failure:

evacuated space > loads of fluid drains in after paracentesis

so blood volume goes down, renals not perfused, nothing else perfused

give colloids (hyperoncotic, stays in the vascular system) to avoid this

A
16
Q

hepatorenal syndrome in liver failure:

kidneys don’t work

give colloid fluids

A
17
Q

blood products which can be given IV:

packed red cells

platelets

fresh frozen plasma (full of antibodies)

cryoprecipitate

A
18
Q

What can cause hyponatraemia?

A

Too much water (fluid overload e.g SIADH)

Too little salt

19
Q

How do you treat hyponatraemia due to

a) too much water
b) too little salt?

A

a) Fluid restrict

b) Give 0.9% NaCl

20
Q

Which endocrine disorder causes hyponatraemia in a euvolaemic patient?

A

SIADH

21
Q

What happens to plasma and urine osmolality in SIADH?

A

Plasma osmolality decreases - too much salt

Urine osmolality increases - MORE salty water excreted as RAAS turns off

22
Q

In SIADH, urine sodium levels are (high / low).

A

high

23
Q

How is SIADH treated?

A

Fluid restrict until cause (inflammation/infection/tumour) is resolved

24
Q

If sodium imbalance is corrected far too quickly, what occurs?

A

Brain damage

25
Q

Which patients are at risk of brain damage by rapid sodium correct?

A

Hyponatraemic

Malnutrition

Extremes of age

26
Q

By how much can you change a patient’s [Na] in a 24h period?

A

4-6

27
Q

Sodium excess / deficiency must be corrected very ___.

A

slowly

28
Q

In emergency correction of hyponatraemia, how much are you aiming to correct [Na] by?

A

4-6

just in less time

29
Q
A