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NRSG 102: Med Surg 1 > Exam 1: IV Fluids > Flashcards

Exam 1: IV Fluids Flashcards

1
Q

Electrolyte solutions classified as isotonic

A

if between 250 and 375 mEq/L

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2
Q

Electrolyte solutions classified as hypotonic if

A

total electrolyte content is less than 250 mEq/L

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3
Q

Electrolyte solutions classified as hypertonic if

A

total electrolyte content is greater than 375 mEq/L

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4
Q

Isotonic Fluid; how much needed to replace 1 L of blood loss?

A

3 L of isotonic fluid

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5
Q

pH>7,4?

A

Alkalosis

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6
Q

pH<7.4

A

Acidosis

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7
Q

pH=7.4

A

Normal

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8
Q

What is D5W used for?

A

Used mainly to supply water and to correct an increased serum osmolality

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9
Q

What percentage is normal saline solution?

A

0.9%, and contains water, salt and chloride

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10
Q

What deos Lactated Ringer solution contain?

A

Potassium and Calcium, in addition to sodium chloride

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11
Q

What is Lactated Ringer used for?

A

To correct dehydration and sodium depletion and replace GI losses.

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12
Q

What is Hypotonic Fluid used for?

A

Used to replace cellular fluid because it is hypotonic compared with plasma.

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13
Q

What saline is used in a Hypotonic Fluid?

A

0.45% Sodium Chloride solution.

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14
Q

Where must higher concentrations of Dextrose be given?

A

50% dextose in water are strongly hypertonic and must be given into centrl veins so they can be diluted by rapid blood flow

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15
Q

What does an air embolism do?

A

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.

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16
Q

What is Phlebitis?

A

An inflammation of a vein that can be categorized as chemical, mechical, or bacterial

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17
Q

Thrombophlebitis

A

Thrombophlebitis refers to the presence of a clot plus inflammation in the vein

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18
Q

Hematoma

A

Results when blood leaks into tissues surrounding the IV insertion site.

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19
Q

Isotonic: Fluids classififed as that have osmolality close to that of

A

ECF and do not cause red blood cells to srhink or swell.

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20
Q

Isotonic: 1L expands ECF by

A

1 L

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21
Q

D5W: SOlution of D5W unique in that it may be both

A

isotonic and hypotonic

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22
Q

D5W: Once given, glucose is

A

rapidly metabolized and this isotinic solution disperses as a hypotonic fluid, (1/3 ECF, 2/3 ICF)

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23
Q

D5W: During fluid resuscitation, this soltuon should not be given bc

A

hyperglycemia can result.

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24
Q

D5W: Used mainly to supply

A

water and correct and increased serum osmolality

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25
Q

Normal Saline: Because the osmolality is entirely contributed by the electorlytes,

A

solution remains within the ECF.

26
Q

Normal Saline: What is this often used for?

A

Correct an extracellular volume deficit but is not identical to ECF.

27
Q

Normal Saline: What is this used with

A

administration of blood transfusions and to replace large sodium loses, such as in burn injuries

28
Q

Normal Saline: What is not used for

A

heart failure, pulmonary edema, renal impairment or sodium retention

29
Q

Another use of Hypotonic Fluids?

A

Provide free water for excretion of body wastes

30
Q

Hypotonic: Used to treat what electrolyte imbalance

A

hypernatremia and other hyperosmolar conditions

31
Q

Hypotonic: Excessive infusions of hypotonic solutions can led to

A

intravascular fluid depletion, decrease bp, cellular edema, and cell damage

32
Q

Hypertonic: When normal saline solution or lactated ringer solution contains 5% dextrose, the total osmolality exceeds

A

that of the ECF. However dextrose is quickly metabolisc and only isotonic solution remains

33
Q

Hypertonic: What do saline solutions do?

A

If available in osmolar concentration greater than that of ECF, it will draw water from ICF to ECF and cause cells to shrink

34
Q

What happens when Saline HYpertonic solution given too quickly?

A

will cause extracellular volume excess and precipitate cirrulatory overload and dehydration

35
Q

Overloading the circulatory system with excessive IV fludis causes

A

increased blood pressure and central venous pressure

36
Q

Signs and Symptoms of FLuid Overload?

A 
Moist crackles on auscultation of the lungs
Cough
Restlessness
Distended Neck Veins
Edema
Weight Gain
Dyspnea
And Shallow Rapid Respirations
37
Q

Possible causes of fluid overload include

A

rapid infusion of iv solution or hepatic, cardiac, or renal disease

38
Q

Manifestations of air embolism include

A

palpitations, dyspnea, continued coughing, jugular venous distenion, wheezing and cyanosis hypotension, weak/rapid pulse , AMS, and chest, lower, and back pain

39
Q

Treatmet for air embolism includes

A

clamping the canula and replace a leaking or open infusion system , place patient on left side , assess VS and breath sounds

40
Q

Complications of air emolism include

A

shock and death

41
Q

S&S of blood stream infections include

A 
abrupt temperture elevation
backache
headache
increase pulse and rate
nausea/v
diarrhea
chills
shaking
42
Q

What is Infiltration?

A

The unintentional administration of nonvesicant solution or medication into surrounding tissue . Can occur when IV cannula dislodges and perforates wall of vein

43
Q

Infiltration characterized by

A

edema around insertion site, leaking of IV fluid, discomfort, coolness and significant decrease in the flow rate

44
Q

What should be done as soon as infilitration detected?

A

Infusion should be stopped and sterile dressing applies to site

45
Q

What is Extravasation?

A

Inadvertent administration of vesicant or irritant solution or medication into the surrounding tissue.

46
Q

What can occur in Extravasation?

A

Blistering Inflammation, and Necrosis

47
Q

What should be done when Extravasation occurs?

A

Infusion stopped. May require antidotes specific to medication that extravasated.

48
Q

Normal definition of Hypotonic Solution

A

Fluid shifts from hypotonic solution inmore more concentrated solution to create balance (cells swell)

49
Q

Normal definition of Hypertonic?

A

Fluids is drawn into the hypertonic soution to create a balance (cells shrink)

50
Q

Phlebitis: Chemical phlebitis caused by

A

irritating medication or solution, rapid infusion rates, and mediction incompatibilities

51
Q

Phlebitis: Mechanical phlebitis results from

A

long periods of cannulation catheters in flexed areas, catheter gauges larger than vein and poorly secrured catheters

52
Q

Phlebitis: Bacterial phlebitis can develop from poor

A

hand hygiene, lack of aseptic technique, failure to check all equipment before use

53
Q

Phlebitis: Characterized by

A

reddened, warm area around insertion site or along path of vein, pain or tenderness at site, along with swelling

54
Q

Phlebitis: Treamtent consists of

A

Stopping IV and apply warm, moist coompress to site

55
Q

Thrombophlebitis; Evidenced by

A

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

56
Q

Thrombophlebitis; Treatment

A

discontinuing the IV infusion, applying cold compress to dress flow of blood , folowed by wamr compress ; elevating extremity.

57
Q

Hematoma: Leakage can result if

A

the opposite vein wall if perforated during venipuncture, the needle slips out of the vein, cannula too large, or insufficient pressure ina pplied

58
Q

Hematoma: Signs include

A

ecchymosis, immediate swelling at site, or leakage of blood at the inserting site

59
Q

Hematoma: Treatment

A

removing need, applying light pressure. Apply ice for 24 hours and elevate the extremity.

60
Q

Clotting and Obstruction: Blood clots may form in the IV line as result of

A

kinked IV tubing, very slow infusion rate, empty IV bag, or failure to flush the IV line after intermittent medication

61
Q

Signs of Clots?

A

Decreased flow rate and blood backflow

NRSG 102: Med Surg 1 (52 decks)

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