Therapeutics - Fluids 4

  1. What is the main difference between LR and R?
    R Does not provide lactate
  2. What does Ringer’s solution contain?
    Na, Cl, Ca and K
  3. Does Ringer’s provide free water?
  4. Why does D5W not usually cause ECFV overload?
    It doesn’t contain Na
  5. What fluid might you give at a low rate (10-15 mL/hr) to keep a vein open (KVO)?
  6. What is the main use of D5W?
    Small infusions (~100mL) to dilute meds in for non-diabetic patients
  7. What fluid would you administer for severe hypernatremia?
  8. Why does the Creighton medical center usually use NS instead of D5W for piggybacks?
    To reduce risk of increased blood sugar due to many meds being administered with D5W
  9. D5W 0.9% NaCl is mainly used to treat what?
    Fluid volume deficit, hypotonic dehydration and Syndrome or inappropriate diuretic hormone secretion (SIADH), daily maintenance of body fluids and nutrition
  10. Why should you use caution when using D5W 0.9% NaCl for cardiac and renal failure patients?
    Can cause HF or pulmonary edema
  11. D51/2NS is sued for what purposes?
    For daily maintenance of body fluids when Cl and Na aer required, hypernatremia, replacement of hypotonic losses
  12. Once a patient has had all of their fluid deficits resolved, what maintenance fluid is common to put them on?
  13. What is the Na and Cl contribution in mEq/L in 3% NaCl solution?
    Na: 513 mEq/L and Cl: 513 mEq/L
  14. How many mEq’s of Na does LR have?
    130 mEq/L
  15. How many mEq’s of Cl does LR have?
    109 mEq/L
  16. What are the common colloidal solutions?
    Albumin 5% or 25%, Dextrans, Hetastarch, Fresh frozen plasma
  17. What I Albumin used for?
    Volume expansion
  18. Why are colloidal solutions more likely to cause fluid overload than crystalloids?
    They take less volume to create the same volume expanding effects
  19. What is the therapeutic advantage of colloids over crystalloids?
    None in most therapeutic situations
  20. What type of fluid movement would you expect with administration of Colloid solutions?
    Movement from ICF to ECF
  21. Which costs more crystalloid or colloids?
  22. What is the purpose of albumin in the body?
    Transports and sequesters bilirubin, transports Fatty acids, hormones and enzymes
  23. Risk of death is inversely or directly related to serum albumin in critically ill patients?
  24. Administration of 5% or 25% albumin to treat hypovolemia has what positive effects?
    Restores volume and maintains cardiac output
  25. Could you treat Hypovolemia with or without shock using Albumin solution?
  26. What outcome would you expect for a patient with a serum albumin of less than 1?
  27. What increase in plasma volume would you expect with administration of 500mL of 5% albumin?
  28. Would you use albumin in a patient with traumatic brain injury?
  29. Is there an advantage to using albumin over crystalloid solutions in general?
  30. Is albumin easy to acquire?
  31. Where is albumin acquired from?
    Fractionation of human plasma
  32. Each liter of plasma has how much IVIG and albumin in it?
    20-25 grams of albumin and 2-3 grams of IVIG
  33. What are the most appropriate indications for albumin use?
    Plasmapheresis/apheresis, large volume paracentesis, hypotensionin hemodialysis and need for aggressive dieresis in hypoalbuminemic or hypotensive patients
  34. Why is albumin used for hypotension in hemodialysis?
    Low blood pressure is the most common negative effect of hemodialysis
  35. What is plasmapheresis?
    Removal, treatment and return of blood plasma
  36. What is paracentesis?
    Removal of peritoneal fluids
  37. Albumin and furosemide have been studied and shown to have a positive effect on fluid balance and hemodynamics of what patients?
    Acute lung injury
  38. If a patient is hypoalbunemic and you would like to give albumin, should you give it IV, along with parenteral nutrition or by enteral routes?
    Enteral, never give in TPN
  39. Should you give albumin to replace serum albumin?
  40. Can you give albumin for thermal injuries?
    Yes, if you have tried other alternatives and it did not work
  41. What is hetastarch?
    Large carbohydrate molecule used for the treatment of hypovolemia after elective surgery, 6% starch and 0.9% NaCl
  42. Can hetastarch carry oxygen?
  43. What are the risks of using hetastarch?
    Hypersensitivity, bleeding, impairment of clotting mechanisms
  44. What consideration should you keep in mind when giving Hetastarch to renal dysfunction patients?
    Reduce dose
  45. Why can you impair platelet aggregation/clotting with use of Hetastarch?
    Because of dilution
  46. Is hetastarch a good maintenance fluid?
    No, not used for this purpose
Card Set
Therapeutics - Fluids 4
Therapeutics - Fluids 4