8. Osmolality of all three compartments
8
Osmolality of all three compartments is the
same, because water is able to move freely
among all three compartments
9. OBJECTIVES
9
Body water compartments
Electrolytes & Non-Electrolytes distribution
IV fluids forms
Dextrose
Saline
Lactated Ringer’s
Plasma expanders
IV fluids – Clinical Correlation
11. Applied physiology of IV fluid
11
Answer this points in every IV fluid type:
1- Content?
2- Tonicity?
3- Distribution, water where are u? Use in volume replacement?
12. Tonicity
12
Isotonic Solution
Cells normal shape, no loss or
gain of water.
Hypertonic
Solution
Cells lose water and shrink.
Hypotonic
Solution
Cells swell rapidly as
water rushes into them.
13. Osmolality
is the number of particles (mmol) contained in
one liter of water, so measured in mmol/L.
i.e. it is the concentration by number
14. OBJECTIVES
14
Body water compartments
Electrolytes & Non-Electrolytes distribution
IV fluids forms
Dextrose
Saline
Lactated Ringer’s
Plasma expanders
IV fluids – Clinical Correlation
18. Dextrose solutions:
Deliver energy & water to the body.
18
Since 1 gram of dextrose (glucose) has 3.5 Cal, one liter of D5W
(50 gm glucose) has 175 Cal
D5W is used instead of pure water because D5W is isotonic to
plasma. (If pure water were given, the water would be osmotically
drawn into red blood cells, causing them to burst).
19. OBJECTIVES
19
Body water compartments
Electrolytes & Non-Electrolytes distribution
IV fluids forms
Dextrose
Saline
Lactated Ringer’s
Plasma expanders
IV fluids – Clinical Correlation
21. Saline solutions:
Distribution: Isotonic Saline 0.9%
21
Used for treatment of dehydration & hypovolemia
22. Saline solutions:
Distribution: Hypotonic Saline 0.45%
22
0.45% NaCl is commonly combined with D5W and used as a maintenance IV.
A maintenance IV is meant to replace water and solute losses and provide
some calories to patients who are not eating.
23. Saline solutions:
Distribution: Hypertonic Saline 3%
23
The NaCl adds 718 milliequivalents (359 mEq of Na and 359 mEq
of Cl) to the extracellular compartment which draws in 2,500 mL of
water from the intracellular compartment.
24. OBJECTIVES
24
Body water compartments
Electrolytes & Non-Electrolytes distribution
IV fluids forms
Dextrose
Saline
Lactated Ringer’s
Plasma expanders
IV fluids – Clinical Correlation
27. Lactated Ringer’s: Caution
27
Lactated Ringer’s is contraindicated in patients
with lactic acidosis, lactate is unable to be
converted to bicarbonate in this disorder.
Lactated Ringer’s should also be avoided in
patients with metabolic alkalosis.
28. OBJECTIVES
28
Body water compartments
Electrolytes & Non-Electrolytes distribution
IV fluids forms
Dextrose
Saline
Lactated Ringer’s
Plasma expanders
IV fluids – Clinical Correlation
29. Plasma expanders
29
human blood products (e.g., plasma, packed red blood cells, albumin)
large molecules which do not pass through the capillary walls (e.g., hetastarch, polygelatins).
expensive and can cause allergic reactions
31. OBJECTIVES
31
Body water compartments
Electrolytes & Non-Electrolytes distribution
IV fluids forms
Dextrose
Saline
Lactated Ringer’s
Plasma expanders
IV fluids – Clinical Correlation
32. IV solutions: Clinical correlation:
Caloric Expenditure Method
32
Maintenance IV fluids are typically used to supplement
daily water and electrolyte losses in patients who are
unable to eat or drink. To administer the proper amount
of IVF, daily fluid loss must be determined.
Caloric Expenditure Method done on 2 steps:
1- detect calories consumed/day.
2- detect amount of water & electrolytes that be
suspect to be lost by these calories.
33. IV solutions: Clinical correlation:
Caloric Expenditure Method
33
1- detect calories consumed/day by:
a- Holiday-Segar method: (depend on weight)
b- Body surface area:
34. IV solutions: Clinical correlation:
Caloric Expenditure Method
34
2- detect amount of water & electrolytes that be
suspect to be lost by these calories.
Special situations:
35. 35
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