Exam #2: Parenteral Fluid Therapy Flashcards

1
Q

What are the three TYPES of IVF?

A
  • Crystalloids
  • Colloids
  • Blood/Blood Products
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2
Q

What is the most commonly used type of IVF?

A

Crystalloids

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3
Q

What are the four types of Crystalloid IVFs we discussed?

A
  • Isotonic
  • Hypertonic
  • Hypotonic
  • D5W
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4
Q

What is the main osmotically active particle in Crystalloids?

A

SODIUM

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5
Q

What are the three types of Isotonic Crystalloids, and what are they used to treat (2)?

A

Dehydration, Hypovolemia

  • 0.9% NS
  • LR
  • Plasma-Lyte
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6
Q

What are the four components of LR?

A
  • Na+
  • Cl-
  • K+
  • Ca2+
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7
Q

Which type of IVF is most physiologic to the normal body?

A

Plasma-Lyte

- Type of Crystalloid

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8
Q

How does sodium content in Hypertonic and Hypotonic Crystalloids compare to Isotonic?

A
  • Hypertonic: MORE Na+ than body is used to

- Hypotonic: LESS Na+ than body is used to

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9
Q

What is the primary type of Hypertonic Crystalloids, and what is it used to treat?

A

Life-threatening hyponatremia with water retention

- 3% NS

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10
Q

With which TYPE of IVF should you caution rapid correction could cause central pontin myelinolysis (CPM), osmotic demyelination?

A

Hypertonic Crystalloid

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11
Q

What two complications should you be cautious of with using Hypertonic Crystalloid?

A
  • Central pontin myelinolysis (CPM)

- Osmotic demyelination

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12
Q

With which ROUTE of IVF should you caution rapid correction could cause central pontin myelinolysis (CPM), osmotic demyelination?

A

Replacement

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13
Q

What two complications should you be cautious of when administering Replacement IVF?

A
  • Central pontin myelinolysis (CPM)

- Osmotic demyelination

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14
Q

What are the two types of Hypotonic Crystalloids, and what are they used to treat?

A

Maintenance Fluids (long- term NPO)

  • 0.5 NS
  • 0.25 NS
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15
Q

What should Hypotonic Crystalloids NOT be used to treat, and why?

A

NOT dehydration/hypovolemia

- Can’t replace volume deficit

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16
Q

What is D5W, and what is it used to treat?

A

Hyperglycemia

- 5% dextrose in water

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17
Q

What substances do Colloids contain?

A

High-molecular weight substances that do NOT migrate easily across capillary walls

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18
Q

When are Colloids used, and in what two types of patients specifically?

A

When Crystalloids cannot treat low plasma volume due to low osmotic pressure

  • Burn patients
  • Peritonitis
19
Q

What are the three types of Colloids, and which is MOST commonly used?

A
  • Albumin Preparations = MOST common
  • Dextran
  • Hetastarch (Hydroxyethyl Starch)
20
Q

What are the two types of Albumin Preparations, and what are they used to treat?

A

Edematous patients to move fluid into vascular space/blood

  • 5% Albumin
  • 25% Albumin
21
Q

When are Albumin Preparations most useful, and in what four types of patients specifically?

A

Useful if Albumin is <2.5 mg/dL

  • Liver disease
  • Peritonitis
  • Burns
  • Surgical patients
22
Q

What are the three types of Blood/Blood Products?

A
  • PRBCs (Packed Red Blood Cells)
  • Platelets
  • FFPs (Fresh Frozen Plasma)
23
Q

What are PRBCs always combined with, and why?

A

Combination with Crystalloids

- Expand intravascular volume

24
Q

What is the use of PRBCs, and why would this be necessary (2)?

A

Blood transfusions

- Due to GI bleed or severe anemia

25
Q

What are the two uses of Platelets?

A
  • Thrombocytopenia

- Impaired platelet function

26
Q

What are the two uses of FFPs?

A
  • Major bleeding complications from Warfarin

- Vitamin K Deficiency

27
Q

What are the three WAYS/FORMS (i.e. forms) by which you can give IVF?

A
  • Bolus
  • Maintenance
  • Replacement
28
Q

What four types of IVF can be given in Bolus form?

A
  • NS
  • LR
  • Plasma-Lyte
  • PRBCs
29
Q

Under what condition would a Bolus be used, and what might cause this (2)?

A

Hypovolemia

  • Dehydration
  • Acute blood loss
30
Q

In what two patient types should Bolus use be cautioned?

A
  • HF

- Renal disease

31
Q

Under what condition would Maintenance be used, and what might cause this?

A

To maintain ongoing loss of water/electrolytes

- Patients are not eating or drinking normally (ex. NPO for surgery)

32
Q

What is the primary form of Maintenance given to patients?

A

D5/0.5 NS with 20 meq KCl

33
Q

What type of calculation is used to evaluate Maintenance for a normal adult patient?

A

“kg Method”

- Uses body weight to determine water needs

34
Q

WHY is the “kg Method” adjusted for children?

A

Children require LESS Na+ than adults

35
Q

How should K+ be administered (form/way)? How should it NOT be administered?

A

Give K+ ONLY as Maintenance

- Do NOT give as Bolus

36
Q

Under what condition would Replacement be used?

A

Correct existing water/electrolyte deficits

37
Q

What three things can be monitored to evaluate the effectiveness of Replacement IVT?

A
  • Vital signs
  • UO
  • Symptoms/clinical presentation
38
Q

What type of calculation is used to evaluate Replacement for a surgical patient?

A

“Parkland Formula”

39
Q

What two types of calculation are used to evaluate Replacement for a burn patient?

A
  • “Parkland Formula”

- “Rule of Nines”

40
Q

What is the most common type of Parenteral Nutrition? What is the other type (more rare)?

A

Total Parenteral Nutrition (TPN)

- Peripheral Parenteral Nutrition (PPN) rarely used

41
Q

What are the five indications for use of TPN?

A
  • Need for bowel rest
  • Small bowel obstruction
  • Complete bowel obstruction
  • Inflammatory bowel disease
  • Pre-existing nutritional deprivation
42
Q

What is the specific route of entry for TPN, and what two complications is this used to avoid (ROUTE specific)?

A

SVC (central)

Avoids peripheral…

  • Thrombophlebitis
  • Vein intimal damage
43
Q

What are the two general complications associated with TPN?

A
  • Metabolic/electrolyte abnormalities

- Catheter-related complications

44
Q

What are the four catheter-related complications associated with TPN?

A
  • Air embolism
  • PTX
  • DVT (due to catheter)
  • Infection