IV Fluids

What are crystalloids?

Fluids that contains crystal-forming elements (electrolytes) that easily pass through vascular endothelial membrane barriers

What are colloids?

Fluids that contain both large

organic marcomolecules and

electrolytes

What is the composition of blood and blood products?

RBC's are similar to colloids

because they stay in vascular

space

What are types of isotonic crystalloids?

Normal Saline (0.9% NS), Lactated Ringer's (LR), and Plasma-Lyte

only ones will be given as a bolus

What is in Lactated Ringer's solution (LR)?

Lactate, K+, Ca2+, NaCl

What is in Plasma-Lyte?

contains less chloride and provides the most physiologic solution

When are isotonic crystalloids used?

treatment of dehydration and hypovolemia often given as IV boluses

Which type of fluid is preferred for large volume resuciation

balanced crystalloids like LR or Plasma-Lyte

What is a type of hypertonic crystalloid?

3% NS

When is 3% NS used?

life-threatening hyponatremia

What are the types of Hypotonic Crystalloids?

0.5 NS, 0.25 NS, and D5W (5% dextrose in water) and D5 1/2 NS

When are 0.5 NS and 0.25 used?

Maintenance fluids that distribute throughout the total body water

When is D5W used?

hypoglycemia, starvation ketosis, hypernatremia (free water deficit), caution with diabetes

What are the types of colloids?

5% or 25% albumin

When are colloids used?

Liver disease, peritonitis, burns, malnourishment, surgical patients experiencing "third spacing"

What is the infusion amount for a bolus?

250-1L at a time

What are the general recommendations for maintenance fluids?

75ml/hr → low need/high risk

100ml/hr → standard

125ml/hr → high need/low risk

When might potassium be added to maintenance IVF?

reat hypokalemia or for maintenance fluids if the patient is NPO; caution with LR/Plasma-Lyte or kidney disease

What is the normal urine output for post-op patients?

0.5 ml/kg/hr

What is the Parkland formula for burn patients?

- (Percentage of 2nd & 3rd degree burns) x (body weight in kg) x 4 mL in the first 24hrs

- 1/2 in 1st 8 hours

- 1/4 in 2nd 8 hours

- 1/4 during 3rd 8 hours