Exam #2: Parenteral Fluid Therapy Flashcards by Kyle Campbell

What are the three TYPES of IVF?

Crystalloids
Colloids
Blood/Blood Products

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What is the most commonly used type of IVF?

Crystalloids

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What are the four types of Crystalloid IVFs we discussed?

Isotonic
Hypertonic
Hypotonic
D5W

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What is the main osmotically active particle in Crystalloids?

SODIUM

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

Dehydration, Hypovolemia

0.9% NS
LR
Plasma-Lyte

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What are the four components of LR?

Na+
Cl-
K+
Ca2+

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

Plasma-Lyte

- Type of Crystalloid

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

Hypertonic: MORE Na+ than body is used to

- Hypotonic: LESS Na+ than body is used to

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

Life-threatening hyponatremia with water retention

- 3% NS

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

Hypertonic Crystalloid

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

Central pontin myelinolysis (CPM)

- Osmotic demyelination

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

Replacement

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

Central pontin myelinolysis (CPM)

- Osmotic demyelination

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

Maintenance Fluids (long- term NPO)

0.5 NS
0.25 NS

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

NOT dehydration/hypovolemia

- Can’t replace volume deficit

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

Hyperglycemia

- 5% dextrose in water

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What substances do Colloids contain?

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

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

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

Burn patients
Peritonitis

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

Albumin Preparations = MOST common
Dextran
Hetastarch (Hydroxyethyl Starch)

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

Edematous patients to move fluid into vascular space/blood

5% Albumin
25% Albumin

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

Useful if Albumin is <2.5 mg/dL

Liver disease
Peritonitis
Burns
Surgical patients

What are the three types of Blood/Blood Products?

PRBCs (Packed Red Blood Cells)
Platelets
FFPs (Fresh Frozen Plasma)

What are PRBCs always combined with, and why?

Combination with Crystalloids

- Expand intravascular volume

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

Blood transfusions

- Due to GI bleed or severe anemia

What are the two uses of Platelets?

- Thrombocytopenia | - Impaired platelet function

What are the two uses of FFPs?

- Major bleeding complications from Warfarin | - Vitamin K Deficiency

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

- Bolus - Maintenance - Replacement

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

- NS - LR - Plasma-Lyte - PRBCs

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

Hypovolemia - Dehydration - Acute blood loss

In what two patient types should Bolus use be cautioned?

- HF | - Renal disease

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

To maintain ongoing loss of water/electrolytes | - Patients are not eating or drinking normally (ex. NPO for surgery)

What is the primary form of Maintenance given to patients?

D5/0.5 NS with 20 meq KCl

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

“kg Method” | - Uses body weight to determine water needs

WHY is the "kg Method" adjusted for children?

Children require LESS Na+ than adults

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

Give K+ ONLY as Maintenance | - Do NOT give as Bolus

Under what condition would Replacement be used?

Correct existing water/electrolyte deficits

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

- Vital signs - UO - Symptoms/clinical presentation

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

“Parkland Formula”

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

- “Parkland Formula” | - "Rule of Nines"

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

Total Parenteral Nutrition (TPN) | - Peripheral Parenteral Nutrition (PPN) rarely used

What are the five indications for use of TPN?

- Need for bowel rest - Small bowel obstruction - Complete bowel obstruction - Inflammatory bowel disease - Pre-existing nutritional deprivation

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

SVC (central) Avoids peripheral... - Thrombophlebitis - Vein intimal damage

What are the two general complications associated with TPN?

- Metabolic/electrolyte abnormalities | - Catheter-related complications

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

- Air embolism - PTX - DVT (due to catheter) - Infection