Exam 1: IV Fluids Flashcards
Electrolyte solutions classified as isotonic
if between 250 and 375 mEq/L
Electrolyte solutions classified as hypotonic if
total electrolyte content is less than 250 mEq/L
Electrolyte solutions classified as hypertonic if
total electrolyte content is greater than 375 mEq/L
Isotonic Fluid; how much needed to replace 1 L of blood loss?
3 L of isotonic fluid
pH>7,4?
Alkalosis
pH<7.4
Acidosis
pH=7.4
Normal
What is D5W used for?
Used mainly to supply water and to correct an increased serum osmolality
What percentage is normal saline solution?
0.9%, and contains water, salt and chloride
What deos Lactated Ringer solution contain?
Potassium and Calcium, in addition to sodium chloride
What is Lactated Ringer used for?
To correct dehydration and sodium depletion and replace GI losses.
What is Hypotonic Fluid used for?
Used to replace cellular fluid because it is hypotonic compared with plasma.
What saline is used in a Hypotonic Fluid?
0.45% Sodium Chloride solution.
Where must higher concentrations of Dextrose be given?
50% dextose in water are strongly hypertonic and must be given into centrl veins so they can be diluted by rapid blood flow
What does an air embolism do?
Its when air enters the central vein and gets into the right ventricle, where it lodges against the pulmonary valve and blocks the flow of blood.
What is Phlebitis?
An inflammation of a vein that can be categorized as chemical, mechical, or bacterial
Thrombophlebitis
Thrombophlebitis refers to the presence of a clot plus inflammation in the vein
Hematoma
Results when blood leaks into tissues surrounding the IV insertion site.
Isotonic: Fluids classififed as that have osmolality close to that of
ECF and do not cause red blood cells to srhink or swell.
Isotonic: 1L expands ECF by
1 L
D5W: SOlution of D5W unique in that it may be both
isotonic and hypotonic
D5W: Once given, glucose is
rapidly metabolized and this isotinic solution disperses as a hypotonic fluid, (1/3 ECF, 2/3 ICF)
D5W: During fluid resuscitation, this soltuon should not be given bc
hyperglycemia can result.
D5W: Used mainly to supply
water and correct and increased serum osmolality
Normal Saline: Because the osmolality is entirely contributed by the electorlytes,
solution remains within the ECF.
Normal Saline: What is this often used for?
Correct an extracellular volume deficit but is not identical to ECF.
Normal Saline: What is this used with
administration of blood transfusions and to replace large sodium loses, such as in burn injuries
Normal Saline: What is not used for
heart failure, pulmonary edema, renal impairment or sodium retention
Another use of Hypotonic Fluids?
Provide free water for excretion of body wastes
Hypotonic: Used to treat what electrolyte imbalance
hypernatremia and other hyperosmolar conditions
Hypotonic: Excessive infusions of hypotonic solutions can led to
intravascular fluid depletion, decrease bp, cellular edema, and cell damage
Hypertonic: When normal saline solution or lactated ringer solution contains 5% dextrose, the total osmolality exceeds
that of the ECF. However dextrose is quickly metabolisc and only isotonic solution remains
Hypertonic: What do saline solutions do?
If available in osmolar concentration greater than that of ECF, it will draw water from ICF to ECF and cause cells to shrink
What happens when Saline HYpertonic solution given too quickly?
will cause extracellular volume excess and precipitate cirrulatory overload and dehydration
Overloading the circulatory system with excessive IV fludis causes
increased blood pressure and central venous pressure
Signs and Symptoms of FLuid Overload?
Moist crackles on auscultation of the lungs Cough Restlessness Distended Neck Veins Edema Weight Gain Dyspnea And Shallow Rapid Respirations
Possible causes of fluid overload include
rapid infusion of iv solution or hepatic, cardiac, or renal disease
Manifestations of air embolism include
palpitations, dyspnea, continued coughing, jugular venous distenion, wheezing and cyanosis hypotension, weak/rapid pulse , AMS, and chest, lower, and back pain
Treatmet for air embolism includes
clamping the canula and replace a leaking or open infusion system , place patient on left side , assess VS and breath sounds
Complications of air emolism include
shock and death
S&S of blood stream infections include
abrupt temperture elevation backache headache increase pulse and rate nausea/v diarrhea chills shaking
What is Infiltration?
The unintentional administration of nonvesicant solution or medication into surrounding tissue . Can occur when IV cannula dislodges and perforates wall of vein
Infiltration characterized by
edema around insertion site, leaking of IV fluid, discomfort, coolness and significant decrease in the flow rate
What should be done as soon as infilitration detected?
Infusion should be stopped and sterile dressing applies to site
What is Extravasation?
Inadvertent administration of vesicant or irritant solution or medication into the surrounding tissue.
What can occur in Extravasation?
Blistering Inflammation, and Necrosis
What should be done when Extravasation occurs?
Infusion stopped. May require antidotes specific to medication that extravasated.
Normal definition of Hypotonic Solution
Fluid shifts from hypotonic solution inmore more concentrated solution to create balance (cells swell)
Normal definition of Hypertonic?
Fluids is drawn into the hypertonic soution to create a balance (cells shrink)
Phlebitis: Chemical phlebitis caused by
irritating medication or solution, rapid infusion rates, and mediction incompatibilities
Phlebitis: Mechanical phlebitis results from
long periods of cannulation catheters in flexed areas, catheter gauges larger than vein and poorly secrured catheters
Phlebitis: Bacterial phlebitis can develop from poor
hand hygiene, lack of aseptic technique, failure to check all equipment before use
Phlebitis: Characterized by
reddened, warm area around insertion site or along path of vein, pain or tenderness at site, along with swelling
Phlebitis: Treamtent consists of
Stopping IV and apply warm, moist coompress to site
Thrombophlebitis; Evidenced by
localized pain, redness, warmth, and swelling around the insertion site or along the path of the vein , immobility of extremity and swelling, sluggish fow rate, fever
Thrombophlebitis; Treatment
discontinuing the IV infusion, applying cold compress to dress flow of blood , folowed by wamr compress ; elevating extremity.
Hematoma: Leakage can result if
the opposite vein wall if perforated during venipuncture, the needle slips out of the vein, cannula too large, or insufficient pressure ina pplied
Hematoma: Signs include
ecchymosis, immediate swelling at site, or leakage of blood at the inserting site
Hematoma: Treatment
removing need, applying light pressure. Apply ice for 24 hours and elevate the extremity.
Clotting and Obstruction: Blood clots may form in the IV line as result of
kinked IV tubing, very slow infusion rate, empty IV bag, or failure to flush the IV line after intermittent medication
Signs of Clots?
Decreased flow rate and blood backflow
