ISOTONIC SOLUTION What is the purpose of isotonic solution / what does it do? When should isotonic solution be administered? Examples of isotonic solution KNOW THIS (Per Hayley)!!!

↑ Fluid Volume Administer to patients with: hypovolemia or dehydration Examples: Lactated Ringers 0.9% Normal Saline

HYPOTONIC SOLUTION What does it do? When should it be administered? When should it be avoided? Examples of Hypotonic solution KNOW THIS (Per Hayley)!!!

Causes fluid to go from extracellular space (edema, ascites, etc.) to intracellular space (veins / circulation) used for increasing low BP & hyperosmolar conditions like the treatment of DKA AVOID with BRAIN INJURIES (it can cause cellular swelling) Examples 0.45% Normal Saline

Exam 1 and Exam 2 Information Flashcards by Ellery Isenstein

Isotonic Solutions

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INCREASES fluid volume

used in the treatment of dehydration & hypovolemia

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When should Isotonic solutions be administered?

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To treat dehydration & hypovolemia

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Examples of Isotonic Solutions

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Lactated Ringers
0.9% Normal Saline

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ISOTONIC SOLUTION

What is the purpose of isotonic solution / what does it do?
When should isotonic solution be administered?
Examples of isotonic solution

KNOW THIS (Per Hayley)!!!

↑ Fluid Volume

Administer to patients with: hypovolemia or dehydration

Examples:
* Lactated Ringers
* 0.9% Normal Saline

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What does Hypotonic Solution do?

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Causes fluid to go from extracellular space (edema, ascites, etc.) into INTRACELLULAR space (veins / circulation)

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When should Hypotonic solution be given & when should it be avoided?

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GIVE: increase fluid in the veins / circulation such as, to try & increase BP or to treat DKA

AVOID with BRAIN INJURIES

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Examples of Hypotonic Solution

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0.45% Normal Saline

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HYPOTONIC SOLUTION

What does it do?
When should it be administered?
When should it be avoided?
Examples of Hypotonic solution

KNOW THIS (Per Hayley)!!!

Causes fluid to go from extracellular space (edema, ascites, etc.) to intracellular space (veins / circulation)

used for increasing low BP & hyperosmolar conditions like the treatment of DKA
AVOID with BRAIN INJURIES (it can cause cellular swelling)

Examples
* 0.45% Normal Saline

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What does Hypertonic Solution do?

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Intracellular fluid goes to extracellular space –> CELLULAR SHRINKAGE

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When should Hypertonic Solution be used?

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Brain injuries (removes fluid from the brain)

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Examples of Hypertonic Solution

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Anything with D5W
3% Normal Saline

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ISOTONIC SOLUTION

1.) Indications / use

Examples
Cautions

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1.) VOLUME EXPANSION in fluid volume deficit

Examples: 0.9% NS & Lactated Ringers

CAUTIONS:
* Pulmonary edema
* CHF
* Sodium retention
* Renal failure

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HYPOTONIC SOLUTIONS

1.) Indications / Use

Examples
Cautions

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1.) Cell Fluid REPLACEMENT / Cell SWELLS (fluid goes INTO the cells)

Examples: 0.45% NS

CAUTIONS
* Cellular swelling
* Brain Injury
* ↓ BP

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HYPERTONIC SOLUTION

1.) Indications / Use

Examples
Cautions

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1.) fluid moves OUT of the cell / cell SHRINKS (↓ size of cell)

Examples: 3% NS, anything with D5

CAUTIONS:
* may cause dehydration
* may cause circulatory overload
* may cause ECF volume overload

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When should D5W be avoided?

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In patients with brain injuries
Avoid during fluid resuscitation

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Normal range of blood sugar

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70 - 100 mg/dL

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Normal INR range for patients on warfarin (Coumadin)

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2.0 - 3.0

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Normal aPTT for patients on Heparin

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1.5 - 2.5 times the normal range

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What is the goal Hemoglobin A1C for patients with diabetes?

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< 7%

What is the blood sugar range in patients with Diabetic Ketoacidosis (DKA)?

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300 - 800 mg/dL

What is blood sugar in patients with Hyperglycemic Hyperosmolar Syndrome (HHS)?

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> 600 mg/dL

blood sugar is 600 or higher

What is infiltration What are the signs & symptoms?
What is the treatment?

Non-vessicant leaks into tissue

S/S: edema, cool, leakage out of the tissue, discomfort

Tx:
* stop the IV and start a new line
* warm compresses

What is extravasation?
What are the signs & symptoms?
**What is the treatment?

Vessicant leaks into surrounding tissues

S/S: blistering, inflammation, necrosis, pain, burning, erythema

Tx:
* leave the IV in and ask Dr. if there is an antedote
* Start a new IV in a different extremity

What is phlebitis?
What are the signs & symptoms?
What is the treatment?

Inflammation of the vein

S/S: red streak / snake or spider vein, erythema, edema, tenderness, painful

Tx:
* Discontinue the IV
* Start a new IV

**What is thrombophlebitis?** **What are the signs & symptoms?** **What is the treatment?**

**Clot + Inflammation** **S/S:** edema, **erythema, pain, malaise, leukocytosis,** fever **Tx:** * Cool compress * Elevation * Discontinue the IV & start a new one

**What is a hematoma?** **What are the signs & symptoms?** **What is the treatment?**

**Blood leakage into the tissue** (vein wall perforated) **S/S:** Swelling, leakage of blood, ecchymosis, **red/purple bloody area / bruise** **Tx:** * Discontinue IV * Apply pressure * Ice for 24 hours

**Normal range of Sodium (Na+)** | **KNOW THIS (Per Hayley)!!!**

**135 - 145**

**Normal range of Potassium (K+)** | **KNOW THIS (Per Hayley)!!!**

**3.5 - 5.0**

**Normal rang eof Calcium (Ca+)** | **KNOW THIS (Per Hayley)!!!**

**8.8 - 10.4**

**Normal range of Magnesium** | **KNOW THIS (Per Hayley)!!!**

**1.3 - 2.3**

**Normal range of White Blood Cells (WBCs)** | **KNOW THIS (Per Hayley)!!!**

**5,000 - 10,000 mm^3**

**Normal range of Red Blood Cells (RBCs)** | **KNOW THIS (Per Hayley)!!!**

**4.5 - 5.5** ## Footnote "**4.5 - 5.5**, the tissues are **alive**"

**Which metabolic disturbances do the following issues causes?** * Hyperventilation * Hypoventilation | **KNOW THIS (Per Hayley)!!!**

**Hyper**ventilation **=** respiratory **alkalosis** *Hypo*ventilation **=** respiratory *acidosis*

**Describe metabolic acidosis and metabolic alkalosis in terms of gaining or loosing bases and acids.** | **KNOW THIS (Per Hayley)!!!**

Metabolic **Acidosis = gain base or lose acid** Metabolic *Alkalosis* **=** *gain acid or lose base*

**How can you tell if an ABG is compensated?** | **KNOW THIS (Per Hayley)!!!**

pCO2 & HCO3 are both moving the **same direction** * both up * both down

**How can you tell if an ABG is mixed?** | **KNOW THIS (Per Hayley)!!!**

**CO2 & HCO3 are both out of range** * **move in opposite directions** (one goes ↑ & the other goes ↓)

**What are the 5 most common complications of diabetes?** | **KNOW THIS (Per Hayley)!!!**

* **Stroke** * **Blindness** * **Heart disease** * **Kidney failure** * **Loss of limbs**

**What is atelectasis?** | **KNOW THIS (Per Hayley)!!!**

Partial or full collapse of alveoli

**What is wasting syndrome?** | **KNOW THIS (Per Hayley)!!!**

**lose 10% of their body weight** * Chronic diarrhea, weakness, & fever without cause

**What is pneumonia?** * **What should the nurse check for?** * **Who is most at risk?** * **What is the treatment?** | **KNOW THIS (Per Hayley)!!!**

**Pneumonia = inflammation of the lungs** (usually due to fluid in the lungs) * **Check for SOB, crackles, rhonchi, & secretions** * Common in long-term care facilities & long-term smokers * **Tx:** fluids, antipyretics, decongestants, anti-convulsants

**Most Notable Sign / Symptom of Tuberculosis (TB)** | **KNOW THIS (Per Hayley)!!!**

Red-tinged sputum

**What is Virchow's Triad?** * **What does Virchow's Triad indicate / mean?** | **KNOW THIS (Per Hayley)!!!**

**1.)** **Venous Stasis** **2.)** **Vessel Trauma** **3.)** **Hypercoaguablity** * Virchow's Triad = individual is at **increased risk of clot formation** (pulmonary embolism)

**What are the 3 characteristics / signs that make up Virchow's Triad?** | **KNOW THIS (Per Hayley)!!!**

**1.) Venous Stasis** **2.) Vessel Trauma** **3.) Hypercoaguability**

**What does it mean when someone has Virchow's Triad?** | **KNOW THIS (Per Hayley)!!!**

The individual has an **increased risk of clot formation** (Pulmonary embolism)

**What are the two classifications of COPD?** | **KNOW THIS (Per Hayley)!!!**

* **Chronic Bronchitis (Blue Bloaters)** * **Emphysema (Pink Puffers)**

**What are the signs & symptoms of chronic bronchitis?** | **KNOW THIS (Per Hayley)!!!**

* **Cyanosis** * **Bloated** * **Mucous** * **Coughing up sputum** * Edema * *Respiratory acidosis* * Hypercapnia * ↑ RR * ↑ SOB

**What are the signs & symptoms of emphysema?** | **KNOW THIS (Per Hayley)!!!**

* **Pursed lip breathing** * **Barrel chest** * Wheezing * Thin appearance * Increased mucous * Talking in short sentences (due to SOB)