Fluids Flashcards
1
Q
Which type of fluid is given with blood
A
normal saline (9%)
2
Q
hyper/iso/hypo tonic: d5 in water
A
iso -> hypo tonic
3
Q
hyper/iso/hypotonic: d5 1/2 normal saline
A
hypertonic
4
Q
hyper/iso/hypotonic: normal saline
A
isotonic
5
Q
hyper/iso/hypotonic: d5 in normal saline
A
hypertonic
6
Q
hyper/iso/hypotonic: lactated ringer’s
A
isotonic
7
Q
Use for Packed Red Blood Cells
A
blood loss
8
Q
Use for fresh frozen plasma
A
trauma, burns, shock, bleeding/clotting disorders
9
Q
Use for platelets
A
thrombocytopenia
10
Q
Use for cryoprecipitate
A
used for clients with hereditary disorders that lead to inadequate clotting
11
Q
What is cryoprecipitate derived from?
A
plasma
12
Q
type and crossmatch
A
determining blood type and Rh factor
13
Q
universal donor blood type
A
o neg
14
Q
universal recipient blood type
A
AB positive
15
Q
t/f: a consent must be obtained before administration of any blood type
A
true
16
Q
Signs of a transfusion reaction
A
fever/chills, altered BP, dyspnea, allergic reaction
17
Q
loss of body water but electrolytes remain consistent
A
dehydration
18
Q
loss of both fluid and electrolytes
A
fluid volume deficit
19
Q
meds that decrease thirst sensation
A
benzos and SSRIs
20
Q
fluid volume deficit s/s
A
- hypotension
- tachy
- orthostatic hypotension
- decreased urine output
- flat neck veins
- weak pulse
21
Q
dehydration lab tests
A
↑ serum osmolarity ↑ creatinine ↑ BUN ↑ urine specific gravity ↑ electrolytes (because more concentration)
22
Q
What causes a reduced colloid oncotic pressure
A
Reduced levels of albumin
23
Q
What does protein do for fluid balance
A
Keeps fluid in the intravascular space
24
Q
What happens to the fluid when there is a reduced colloid oncotic space?
A
Third spacing (edema)
25
Causes of increased hydrostatic pressure
elevated BP, fluid overload, decreased cardiac output
26
causes of decreased colloid oncotic pressure
malnutrition, liver failure, nephrosis
27
causes of blockage or removal of lymph nodes
mastectomy, lymphoma
28
causes of increased capillary permeability
allergies, septic shock [endotoxin], pulmonary edema
29
How can someone have a fluid volume deficit if they have too much fluid somewhere?
fluid compartments need a certain amount of fluid to operate smoothly
30
s/s of fluid volume excess
(can be caused by hypertonic solutions)
| weight gain of more than 0.5 kg/day, hypertension, bounding pulse, jugular vein distention, dyspnea, crackles, orthopnea
31
Fluid volume excess treatment - medication class
furosemide, spironolactone, bumetanide, hydrochlorothiazide
32
functions of electrolytes ********
- maintaining balance of water in the body
- balancing blood pH
- moving nutrients into the cells
- moving wastes out of the cells
- maintaining proper function of the body's muscles, heart, brain
33
Potassium normal range
3.5-5 mEq/L
34
sodium normal range
135-145 mEq/Le
35
calcium normal range
Serum: 8.9-10.5 mg/dL
Ionized: 4.5-5.6 mg/dL
36
magnesium normal range
1. 8-2.3 mg/dL
| 1. 3-2.1 mEq/L
37
hypokalemia s/s
cardiac arrhythmias, constipation, fatigue
| respiratory paralysis, paralytic ileus, tetany, hypotension, rhabdo, life threatening arrhythmias
38
diuretics, metabolic alkalosis, chronic kidney disease, folic acid deficiency, gastrointestinal losses
can all cause...
hypokalemia
39
How should you give potassium
ONLY given IV through a slowwwww infusion (burning feeling in vein)
40
hypokalemia on diuretics: what change to make
switch to spironolactone
41
acute renal failure, dehydration, diabetes, burns, acidosis, blood transfusion
are all causes of...
hyperkalemia
42
s/s of hyperkalemia
- nausea, vomiting, muscle aches, weakness, dysrhythmias,
| - paralysis, heart failure, death
43
Severe vomiting/diarrhea, drinking excess water, excess alcohol intake, thiazide diuretics, liver/heart disease
are all causes of...
hyponatremia
44
when are hypertonic IV fluids used for hyponatremia
cerebral edema
45
t/f: it's important to improve sodium levels rapidly to avoid permanent damage
false: shift slowly to avoid rapid changes in neurological cells
46
dehydration (incl from mild/moderate vomiting) and consumption of high sodium items can cause
hypernatremia
47
What can cause cerebral edema with treatment of hypernatremia
if sodium is lowered too quickly
48
inadequate vitamin D, decreased estrogen production, hypoparathyroidism, renal disease, low albumin levels, stimulant laxatives, chronic steroid use, proton pump inhibitors
can all cause...
hypocalcemia
49
Positive Chvostek and Trousseau signs indicate
hypocalcemia
50
s/s of hypocalcemia
chest pain, dysrhythmias, renal calculi, numbness and tingling, muscle cramping, confusion, osteopenia, dental problems
51
is ionized or serum calcium more accurate
ionized (but serum is faster)
52
cancer, hyperarathyroidism, vitamin D toxicity, TUMS can all cause...
hypercalcemia
53
s/s of hypercalcemia
- constipation, abd pain, nausea, vomiting
- confusion, coma, death
- renal failure, arrhythmias
54
Crohn's or celiac, diarrhea, pancreatitis, t2dm, hypokalemia/hypocalcemia, decreased intake, increased renal excretion can all cause...
hypomagnesemia
55
hypomagnesemia s/s
- Decreased appetite, fatigue, nausea, weakness
| - Muscle cramps, numbness and tingling, seizures, tetany, and ***personality changes***
56
treatment for hypomagnesemia
- oral or IV magnesium
- treat hypokalemia and hypocalcemia first
- educate clients on foods high in magnesium
57
kidney disease, acidosis, hypothyroidism, trauma, medications that increase dwell time of food in the intestines, laxatives or antacids that contain magnesium all cause...
hypermagnesemia
58
s/s of hypermagnesemia
- dizziness, nausea, weakness, confusion
- blurred vision, headache, bladder paralysis, bradycardia, reduced respiratory rate, loss of deep tendon reflexes, death
59
hypermagnesemia treatment
- calcium to help with heart problems
- intravenous saline with diuretics
- dialysis in severe cases
60
sources of potassium
fruits, vegetables, orange juice, tomato juice
61
sources of calcium
dairy, dark green vegetables, sardines, salmon, oysters, tofu
62
sources of magnesium
nuts, egg yolk, milk, whole grain cereals, bananas, citrus fruit, dark green vegetables, legumes, seafood, chocolate
63
sources of phosphorus
dairy products, meats, fish, bran and wheat cereals, nuts
64
The nurse is caring for a client that has a Potassium level of 3.0 mEq/L. Which medication would the nurse expect to administer?
Potassium chloride (normal range: 3.5-5 mEq/L)
65
The nurse is caring for a client with edema. Which lab value would the nurse prioritize on the lab results in relation to edema?
albumin
66
The nurse is preparing to administer 0.45% sodium chloride to a client. Which description best matches what will happen to fluid with administration of 0.45% sodium chloride?
fluid will move from the intravascular space to the interstitial space
