Fluid Resolution Flashcards
what type of fluid resolution contains water, fluid or plasma
solvent
what type of fluid resolution that contains solids such as cells, electrolytes and gasses
solute
what type of fluid resolution that has a mixture of blood (endogenous)
solution
what are the 2 exogenous solutions
- crystalloids
- colloids
smaller particles, electrolytes , glucose
(isotonic, hypotonic, hypertonic)
crystalloids
larger particles, (albumin, dextron, blood products
colloids
water moves from an area of low solute to high solute area; to Dilute the highly concentrated area
osmosis
type of solution that is equal= no movement of water, stays in the blood
isotonic, BEST FOR FLUID REPLACEMENT
for blood, shock and FVD
type of fluid that has a water + sodium chloride. ONLY COMPATIBLE SOLUTION IN BLOOD TRANSFUSION, IRRIGATION, DKA, USE FOR BODY CAVITY. USE FOR SHOCK.
PNSS (0.9% NaCl)
Do not use in instrument because can cause rust
type of fluid used in metabolic acidosis, DKA and BEST FOR BURNS
Plain LR (na, cl, k+, ca, lactate (alkaline)
it can be categorize as isotonic or hypotonic solution. given for the Hypoglycemic pt
D5water
Never give it to Hyperglycemia, Give for hyponatremia
D2.5 water and D5water for hypoglycemia
considered as a isotonic solution
plasmalyte 148 and Normosol M
type of fluid that has more water diluted and cells will swell can cause hypovolemia. This must be given to CELLULAR DEHYDRATION BUT C/I to SHOCK, FVD, CELLULAR EDEMA AND INCREASED ICP
HYPOTONIC
Ex. Hypotonic saline (<0.9%)
-0.33% NaCl will increased K+ and Ca
-0.45% Nacl
More solute, concentrated; Cell shrinking/crenation
Hypertonic solution- good for hypovolemia
C/I cellular dehydration
Such as:
SIADH, CHF, Renal Failure, Pulmonary edem
Hypertonic saline ex:
-3%nacl for cerebral edema
-5%nacl
Alternative for TPN
D10water for hypogly
Given to the hypoglycemia coma px GCS 3. Sugar <70+unconscious
D50w given via central line
What are the solutions that are good sources of glucose
-0.45% NSS with dextrose
-D5LR to decrease glycemia and k
-D5Nss
What is the best insetion of IVTT procedure
Arteriovenousarch
-dorsal of the hand basilic and becalic
Best IVTT insertion in infant
Feet and scalp vein
-Naturally splinted by bones
-avoid areas of flexion.
What are you going to avoid in IVTT procedure
the AV fistula site & Mastectomy site
what are the Gauges of Adult and Infant
Adult 22-27
infant 24-27
what compression type of used in vein distention
warm compress (moist heat)*
wrap hand 10-15 mins
sequence of IVTT procedure
- apply tourniquet with 6 inches
- dangle
- gently tap the vein
- clench fist
- stroke the vein upward (towards the heart)
- Distal vein first
BQ: IV prep
-technique is sterile
-clean glove
-change IV tubes if unsterile
air embolism postion
left lateral Trendelenburg/ Durant position
O2 therapy BVM (100%)
Pulmonary edema position
upright
Best Disinfect
Chlorhexidine
2nd option 70% alcohol
-cleanest- dirties (circular motion)
IV angle insertion
15-30 degree backflow, flush with PNSS (5ml). 2 failed attempt called another nurse.
-secure with Transparent Dressing
Dressing Q72-96
Tubing and IV bag Q24-48hrs
Leakage of solution to tissue
infiltration
-swelling, pain, COOL, PALLOR
inflammation of vein, pain, warm, Redness, (+) redstreak
Phlebitis
-causing on keeping moving, dancing, wrong gauge
inflammation of the vein (+) cord like vein, like a telephone cord
Thrombophlebitis
leakage px vesicants cause potent irritants
Extravasation
- antibiotics, kcl, chemo drugs, vasopressor, Na Hco3
- cause Blisters, ulcerations & necrosis/ eschar
- Do not remove first need to aspirate
FVO risk blood tranfusion
Mild: Increased BP= slow to KVO rate
-10ml/hr
-10-20gtts/min * upright
-2ml/min
inflammation, pain warm, redness (+) discharge , serous discharge, purulent discharge, fever increased wbc
infection/ sepsis
Stop & remove IV
mgt
1. stop
2. elevate
3. compress: warm- decreased
cool- for pain numbness of the vessels
4. cool for vesicant *- irritation of the skin except
2V VV arm=Vasopressors, Vinca alkaloids
found in RBC surface also known agglutinogen
Antigen
found in the plasma, agglutinin
antibodies
kapila na baby naay complication si mother sa rh
2nd exposure
universal donor
O-
Universal receipient
AB+
rareset “Golden blood”
RH null
- no rh antigen and autosomal recessive
how many mins should the blood need to be START to be transfused and how many hrs will be transfused?
30 mins
- 4 hrs
Stay with pt for first 15-30 mins 2ml/ml or 20ggts/min
prefusion meds
acetaminophen- paralytic drug, it is hepatotoxic, Limit 400mg/day
-Diphenhydramine- for itchiness
Hydrocortisone-for corticosteroid
baseline lung sound
crackles- fluid overload
wheezing- bronchospasm
stridor- anaphylaxis
urine with complication after transfusion
Hematuria= homolytic reaction
complications after blood transfusion
- febrile Nonhemolytic reaction= expected
- fever, chills, anxiety
- give acetaminophen
2.Hemolytic transfusion reaction
-fever, chills, chestpain, impending doom, flank pain, acute kidney infection, hematuria, hypotension, increased HR RR s/sx of hypoxia
-STOP TRANSFUSION, INCOMPATIBLE BLOOD, CHANGE TO NSS @KVO RATE
- allergic reaction- rashes, pruritus
- FVO-s/sx crackles and edema
- Communicable DSE- hepa, HIV, Malaria, dengue
- electrolyte imbalances
- Anaphylactic shock- Rushes pruritus, stridor, dob hypoxia, hypo- tachy-tachy
STOP -IM, IV, EPINEPHRINE
BQ: Px has been stab, what type of blood will you transfused
Pack RBC
type of blood product best for blood loss r/t trauma or surgery
PRBC
Hgb 1unit=1g/dl
Hct=3%
made from plasma, for thrombocytopenia, candidate for transfusion, with or without bleeding
platelet concentrate
-for dengue, hemolytic fever
contain clotting factors, #1 fibrinogen
Fresh frozen plasma
- can be transfused at DIC- disseminated intravascular coagulation- clotting and bleeding condition by chemo, amotic embolism
blood product for Hemophilia, vonwille brands dse, DIC
Cryoprecipitate
time transfusion for PRBC, platelet, fresh frozen plasma, cryoprecipitate
PRBC 2-4hrs
platelets, FFP, Cryo= within 30 mins
