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Adults 1 > Fluid Therapy > Flashcards

Fluid Therapy Flashcards

1
Q

What are some causes of Fluid Volume Deficit?

A

Abnormal loss of body fluids (diarrhea, fistula drainage, hemorrhage, polyuria), inadequate intake, or fluid shift from plasma to interstitial fluid.

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2
Q

What would you do from a nurse’s perspective for Fluid Volume Deficit?

A

Correct underlying cause and replace water and any needed electrolytes.

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3
Q

What are common fluids administered for Fluid Volume Deficit?

A
  • Lactated Ringers
  • 0.9 Sodium Chloride
  • Packed Red Blood Cells when due to blood loss
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4
Q

What is something to be be worried about when administering fluid for someone with Fluid Volume Deficit?

A

Monitor for signs of fluid volume excess during volume repletion.

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5
Q

What are causes of Fluid Volume Excess?

A

Excessive fluid intake, abnormal retention of fluids (heart/renal failure), or shift form interstitial space into plasma fluid.

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6
Q

What are some nursing considerations when it comes to Fluid Volume Excess?

A

Correct underlying cause, diuretics, fluid restriction, and sodium restriction

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7
Q

What are some things that nurses should assess for dealing with Fluid Balance?

A
  • Jugular Vein Distention
  • Dyspnea, cough, moist crackles
  • Increased RR
  • Neuro Changes
  • Skin turgor
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8
Q

What are some nursing interventions for Fluid Balance?

A
  • Strict I/O
  • Daily weight
  • Vital signs
  • Skin care
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9
Q

Which is more important, strict I/O, or daily weights?

A

Daily weights are going to be most important, because they can account for insensible loss.

*It is important to get a weight that is important. When taking weights, compare to day before.

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10
Q

White Blood Cells (WBC)

A

4,000- 11,000 uL

-Total number of leukocytes

Elevated:
-associated with infection, inflammation, tissue injury/death, malignancies (leukemia and lymphoma)

Decreased:
-Associate with bone marrow depression, severe/chronic illness, some types of leukemia

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11
Q

Hemoglobin (Hgb)

A

(female) 11.7- 16 g/dL
(male) 13.2- 17.3 g/dL
GENERAL: 12-17 g/dL

-measurement of gas carrying capacity of red blood cells

Elevated:
-Associated with polycythemia, hemoconcentrated states (dehydration)

Decreased: associated with anemia, hemorrhage, demodilution states (fluid volume excess)

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12
Q

Hematocrit (Hct)

A

(female) 35-47%
(male) 39-50%

  • measurement of packed cell volume of RBCs expressed as a percentage of the total volume
  • generally 3x hemoglobin
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13
Q

Platelet

A

150,000- 400,000 uL

  • Number of platelets available to maintain platelet clotting functions
  • Does not measure quality of platelet FUNCTION
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14
Q

Where are blood group antigens found?

A

They are found only on RBC membranes

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15
Q

(True/False) Presence of absence of blood group antigens (AB) is the basis for the four blood types.

A

True

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16
Q

Rh is based on what antigen?

A

The D antigen

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17
Q

Rh negative people (have/don’t have) the D antigen

A

Do NOT have

18
Q

Each person has _____ in the serum, that interact with A or B antigens.

A

Antibodies

19
Q

What blood types is considered the universal donor?

A

O negative

20
Q

What blood type is considered the universal recipient?

A

AB+

21
Q

Why would you use plasma, as opposed to WBC?

A

For clotting factors

22
Q

Packed Red Blood Cells

A

Volume: 250-310 ml
Description: Prepared from whole blood with 85-90% of the plasma removed
Expected Response: One unit of packed red blood cells should increase a 70kg recipient’s Hgb by one g/dL, Htc by 3 g/dL

Complications: Infectious diseases, alloimmunizations, and transfusion reactions. Massive transfusions may precipitate hypothermia, coagulation disorders, citrate, and/or ammonia intoxication.

23
Q

Fresh Frozen Plasma

A

Volume: 225-250
Description: Several different ways to manufacture. Contains all coagulation proteins.

Indications: Deficit of multiple plasma coagulation factors. liver disease associated with hemostatic deficit, DIC, thrombotic thrombocytopenia, purpora

Expected Response: Hemostatis and/or improvement in coagulation parameters

Complications: Infectious disease, volume overload, allergic and febrile transfusion reactions

24
Q

Platelets (Pooled and Pheresis)

A

Volume: Variable; 30-60 mL/unit. At VCUHS, adult standard dose is 4 units
Description:
-pooled: prepared form fresh, whole blood (multiple donors)
-pheresis: single-donor obtained from plateletpheresis

Indications: Thrombocytopenia (low platelet count) with bleeding; platelet dysfunction

Expected Response: Increase platelet count 30,000-50,000/ mm3 in average 30kg adult

Complications: Frequent platelet transfusions may compromise future ability to control bleeding (via alloimmunization), infectious diseases, transfusion reactions (allergic and febrile)

25
Q

Cryoprecipitate

A

Volume: 10-20 ml
Description: Concentrated factor VIII fibrinogen, factor XIII and Von Willebrand factor prepared from one unit of Fresh Frozen Plasma

Indications: Factor deficiencies, uremic platelet dysfunction

Expected Response: Hemostasis and/or improvement in coagulation parameters

Complications: Infectious diseases, transfusion reaction (febrile/allergic)

26
Q

What kinds of patient teaching do you give someone who is receiving a blood product?

A
  • Purpose

- Sign/Symptom of a Reaction

27
Q

What is important to take before administering blood products?

A

Baseline VS

28
Q

It is important to start blood transfusion within _____ of blood arriving on unit

A

30 minutes

29
Q

When giving blood products, remain with patient for ____ after administering blood products, then ____.

A

Remain with them for at least 15 minutes, then recheck VS

30
Q

When administering blood products to adults, it is important to use a ____ gauge or larger.

A

20 gauge

31
Q

What is the adult dose for packed red blood cells

A

1 unit

Response:
Hemoglobin- 1 g/dL
Hematocrit- 3 g/dL

  • When blood loss is greater than 30%
  • Need to increase O2 carrying capacity
  • Hb is less than 8 g/dL
32
Q

When do you give platelets?

A
  • Plt is less than 10-20,000 uL
  • Plt is less than 50,000 with bleeding or invasive procedure
  • Plt is less than 100,000 with invasive procedure
  • Plt dysfunction with bleeding
33
Q

What is the adult dose for plasma?

A

2-4 units

34
Q

What is the response of plasma?

A
  • Decrease in PT/INR

- Replace coagulation factor

35
Q
  • Due to ABO incompatibility

- Antibodies in recipient’s plasma attach to antigens on transfused RBCs, causing hemolysis

A

Acute Hemolytic

36
Q

Reaction between transfused antileukocyte antibodies and recipients leukocytes, causing pulmonary inflammation and capillary leak

A

Transfusion-Related Acute Lung Injury (TRALI)

37
Q

What should a nurse to for a mild allergic reaction to a blood product?

A

Administer antihistamines, resume transfusion if improved within 30 minutes

38
Q

How would you react to a mild/severe allergic reaction to a blood product?

A

Administer antihistamines, epinephrine, vasopressors, and corticosteroids as needed.

39
Q

How to react to acute hemolytic transfusion

A

Treat shock with vasopressors; maintain airway; administer fluids and diuretics; monitor for acute renal failure

40
Q

How to react to TRALI

A

Respiratory support! Most will be resolved within 24-96 hours.

41
Q

What is the first step when you notice a transfusion reaction taking place?

A

STOP TRANSFUSION!

42
Q

After you stop transfusion, what is the next step when you notice a transfusion reaction?

A

Maintain 0.9 Sodium Chloride

Adults 1 (5 decks)

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