Fluids & Electrolyte Case study

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Fluid and electrolyte case study

John Smith is a 60-year-old farmer. He spends a lot of time outside. He was admitted with heat exhaustion (dry mucous membranes, urine output @ 10ml/hr, urinalysis pH 7.35, SG 1.035, BP 90/45, HR 110bpm), after a long harvest of maize in extreme heat. The doctor orders IV therapy to commence, U&E’s, and rest, as he believes he is dehydrated at the intracellular level.

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Open Ended

A.   Define homeostasis

 

Open Ended

B.  List five factors that affect homeostasis

Open Ended

John Smith is a 60 year old farmer. He spends a lot of time outside. He was admitted with heat exhaustion (dry mucous membranes, urine output @ 10ml/hr, urinalysis pH 7.35, SG 1.035, BP 90/45, HR 110bpm), after a long harvest of maize in extreme heat. The doctor orders IV therapy to commence, U&E’s, and rest, as he believes he is dehydrated at the intracellular level.

C. Explain the difference between intracellular and extracellular compartments.

Open Ended

John is showing signs of confusion and the doctor believes he has hypokalaemia and hyponatraemia.

     D. State the functions of the following electrolytes and whether they are intracellular or extracellular ions:

K+

Na2+

Open Ended

 E.   Explain how IV fluid will move to rehydrate the intracellular space

Open Ended

John develops peripheral oedema following infusion of 2L of IV fluid over 8/24.

    F.  Explain in which compartment the infused fluid is sitting.

Open Ended

      G. State whether the fluid John is receiving is maintenance or replacement therapy.

Open Ended

  H.  The doctor now prescribes a crystalloid solution to be infused. Outline the difference between a crystalloid and colloid solution.

Open Ended

     I. The IV fluid selected is 0.33% NaCl (Sodium Chloride). It is a hypotonic, crystalloid solution. Explain why this specific solution was chosen for John.

Open Ended

    J.  If John becomes hypotensive due to hypovolaemia, what type of fluid would then be appropriate? Give two examples of this type of fluid.

Dropdown

K. Choose the correct type of fluid for each problem:





Patient bleeding post-surgery with a Hb of 7.0

 

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L. Choose the correct type of fluid for each problem:



Dehydrated man post a marathon







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Isotonic-0.9%NaCL

Hypotonic-0.45%NaCL

Hypertonic-3%NaCL

Distilled water

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M. Choose the correct type of fluid for each problem:

Vomiting Child​

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hypertonic-3%NaCl

hypotonic-0.45%NaCl

isotonic-0.9%NaCl

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N. Choose the correct type of fluid

Severely dehydrated 90-year-old man



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Hypotonic-0.45NaCl

Isotonic-0.9NaCl

Hypertonic-3%NaCl

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​O. Choose the correct type of fluid

Hypotensive patient with a low serum albumin​

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hypotonic +albumin

isotonic -albumin

hypertonic -albumin