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IV fluids Pharm
IV Fluids Pharm
| Question | Answer |
|---|---|
| Based on a solution of sterile water w/ added electrolytes to approximate the mineral content of hman plasma | Crystalloids |
| Based on crystalloids, plus an added substance such as albumin, hetastarch, dextran | Colloids |
| Substantially more expensive, lack of data showing superiority, and use may be restricted | Colloids |
| Most closely mimics the electryolyte concentration of human plasma | Lactated Ringers (Crystalloids plus lactate) |
| Added to crystalloids to make a colloid solutions | Albumin, Hetastarch, Pentastarch, Dextran |
| % of water weight on M/F | M: 60% F: 50% |
| % Intracellular fluid, extracellular, intravascular vs intersticial | Intra C: 2/3 Extra C: 1/3-IV vs. IS 1:4 |
| Nl water intake/day | ~2600ml, Ingested: 1400, Food:850, Oxidation: 350 |
| Ways water is extreated from the body | Urine: 1500, Skin:500, Respiratiory: 400, Stool:200 |
| Ways volume can be depleated | GI, Renal, Skin, 3rd space sequestration |
| Vol. depletion d/t intestinal obstruction, crush injury, fracture, acute pancreatitis | Third-space sequestration |
| Rean ways of vol depleation | Diuretics, osmotic diuresis, salt wasting nephropathies, hypoaldosteronism |
| Dehydration Tx Goals | Identify and correct underlying cause, Restore normovolemia, replace ongoing losses |
| Types of fluid therapy | Replacement and Maintenance: ongoing losses of water and electrolytes under nl physiologic conditions |
| Replacement therapy rate for mild, moderate, and severe dehydration | Mild-mod: rate is arbitrary, but must add 50-100ml in excess to losses, Severe: 1-2L as fast as possible |
| Components to consider in Maintenance therapy | H20, Na+, K+, CHO; minimize protein catabolism |
| Water requirement therapy for maintenance therapy | 60mL/h + 1 mL/kg/hr over 20kg, to a max of 120 mL/h (total |
| Na+ requirement for maintenance therapy | 1-2 mEq/kg/day |
| K+ requirements for maintenance therapy | 0.5-1mEq/kg/day |
| CHO requirements for maintenance therpy | 100-150 gm/day |
| What increase in replacement for each degree above 37C | 100-150ml/day |
| Replacement of insensible losses should be with | 5% dextrose or hypotonic saline |
| Common problems with IV fluids | Underhydration Overhydration, too much Na+ or K+, too less Na+, or K+ |
| Monitoring perameters for rehydration | vitals, clinical appearance, daily wt, urine output and specific gravity, serum electrolytes |
Created by:
becker15
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