Fluids & Electrolyte Case study

A.   Define homeostasis

B.  List five factors that affect homeostasis

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.

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+

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

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

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

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

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

     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.

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