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11 Cards in this Set

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  • Back
When is fluid therapy needed?
It is needed to correct dehydration, and to maintain hydration, fluid lines and renal function
What are the signs of intracellular dehydration?
Decreased skin turgor
Dry mucous membranes
Sunken eyes
What are the signs of hypovolemia?
Tachycardia, weak pulse, increased CRT, hypothermia, cool extremities, altered mentation and decreased urine production
What are the 5 levels of clinical evaluation of dehydration?
Non apparent dehydration - loss of less than 5% body weight
Mild dehydration - decreased skin elasticity, dry mucous membranes
Moderate dehydration - small increse in CRT, further decrease in skin elasticity
Severe dehydration - skin does not return, increase in CRT
What are the different types of fluids?
Crystalloids (lactated ringers, 0.9% NaCl)
Colloids (Dextran, hetastarch)
Blood products (FFP, PRBC, FWB)
When should you use crystalloids versus colloids?
Crytalloids are less expensive and the 1st choice in most patients
Colloids are used in emergencies or with hypoproteinemia
When should you use lactated ringers?
always, except for:
Potatssium issues - shock, hypoadrenocorticism, urethral obstruction
Lactate issues - lymphoma, liver disease
pH issues - vomiting
When should you use NaCl 0.9%?
Whenever LRS is not the first choice
When should you use hypotonic fluids?
in patients with sodium issues - hypernatremia, sodium retention
Why should you never bolus hypotonic fluids or 5% dextrose?
They can cause hemolysis
When should you use 5% dextrose?
Use in patients that have hypernatremia, glucose issues (diabetic ketoacidosis), when there is risk of hypoglycemia (endotoxemia, insulinoma) and liver disease
use it as a source of free water (not a good caloric source)
You can add electrolytes to it for patients that dont have hypernatremia?