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Index
»
SURGERY: FLUIDS AND ELECTROLYTES
»
Chapter 1
»
Level 1
level: Level 1
Questions and Answers List
level questions: Level 1
Question
Answer
1. NS - NaCl 0.9% - 150 Na, 150 Cl 2. HS - NaCl 0.45% - 77 Na, 77 Cl 3. D5% - Dextrose 50g/L 4. D10% - Dextrose 100g/L 5. HM - NaCl, KCl, CaCl2, Na Lactate 6. 3% Saline - Na l 30g (3%)
What is the common fluids and its contents?
Mild 5% Moderate 7.5% Severe 10%
What is percentage mild, moderate, severe dehydration?
total : Maintainance + deficit + ongoing losses Ongoing losses : RT aspiration, thkrd space loss, drainage, plasma loss
What is total fluid requirement?
maintainance: 40cc/kg/day If paeds, use Holliday Segar Formula 1st 10kg: 4cc/kg/h Next 10kg: 2cc/kg/h Subsequent kg: 1cc/kg/h Deficit: 10× %loss × weight (kg) *replace over 12 hours
What is maintainance and deficit?
1. ns 2. Hm 3. 1/2 NSD5%
in all head injury,give ______________ in burn pt, parkland correction by __________ in paeds pt, usually use ______________ What fluid?
gcs, chapped lips, sunken eye, coated tongue, skin turgor, crt, warm/cold peripheries, bp, pr, urine output
What to assess on hydration?
Total requirement : maintanance + deficit Maintainance: 2-3 mmol/kg/day Deficit: (140- x) × wt × 0.6 (constant) *to convert to g, divide 23.3
What is formula for Na req?
Formula: maintainance + deficit Maintainance: 0.5-1 mmol/kg/day Deficit: (4-x) × wt × 0.4 * to covert to g, divide with 13.3
what is formula of K req?
Rules of K correction: Rate should not > 1.5g per hour Concentration should not > 3g in 1L (1.5g in 500ml)
Rules of K correction: Rate should not > ______ per hour Concentration should not > _______ in 1L
hypoK - use mist KCl 15ml TDS severe hypoK - 1g KCl in 100cc NS over 1 hr 2g KCl in 200cc NS over 2 hr Make sure to put ECG/cardiac monitoring during loading Repeat RP post loading 2 hours ECG hypo U wave Hyper Tall tented Twave
tx for hypoK and severe hypoK
hyperK - oral Kalimate 15g TDS severe hyperK - "insulin chase" IV Ca Gluconate 10% 10cc over 2-5min then IV Dextrose 50% 50cc then IV Actrapid 10 unit
Tx for hyperK and severe hyperK